Hematopoietic Stem Cells

Paper Summary:

This paper defines what are known as stem cells and what is involved in stem cell (SC) transplantation, and provides a list of current uses for SC transplantation. The writer explains that most common sources for such transplants are bone marrow, blood and cord blood stem cells, and describes in detail how bone marrow and cord blood stem cells are obtained and what is entailed in bone marrow transplantation (BMT). Despite considerable progress in BMT over the years, there are still major problems with graft-versus-host disease (GVHD), failure to engraft and lack of suitable donors. The writer notes that younger donors and good transplant timing lead to better transplant outcomes, and suggests that in the future, emphasis should be on better control of GVHD with novel immunosuppressive and other immunomodulatory agents. This paper contains tables.

Outline:
Introduction
Application of SCs in Transplantation
Types of Disorders Treated
Types of SC Transplants Available
Availability & Collection of Different Sources
Bone Marrow Registries
Cord Blood Banks
Donor Search
Growth Factors
Harvesting
PBSC Harvesting
Cord Blood Harvesting
Risks for Donors
Ethical Issues Regarding the Sources
Outcome of SC Transplantation
Factors Affecting the Outcome
Conditioning Regimen
Non-myeloablative Allogeneic HSCT
Time for Engraftment or Immune Reconstitution
Transplant Related Mortality
Relapse
Role of HLA Compatibility
Effect of Other Cells in the Graft in GVHD and GVL, and the Balance of GVHD and GVL
Conclusion

From the Paper:

"The sources for allogeneic stem cell transplant include: half-matched family members, unrelated adult volunteer donors, and related or unrelated umbilical cord blood units (CBU) (Burt & Brush, 1999). The ideal allogeneic bone marrow donor for a patient would be a monozygotic twin, since this transplant is not only HLA-matched but also matched for all other genetic loci. A transplant can be done if a related donor with only one HLA difference is identified, although there is a risk of GVHD. For those without siblings or other related donors, unrelated bone marrow donors would be the only option (Carella et al, 2001)."

Sample of Sources Used:

• Antin, J.H. (2001) Acute graft-versus-host disease: inflammation run amok? J Clin Invest, 107, 1497-1498.
• Appelbaum, F.R. (2003) The current status for hematopoietic cell transplantation. Annu. Rev. Med, 54, 491.
• Arai, S., Klingemann, H.G., (2003) Hematopoietic Stem Cell Transplantation: Bone Marrow vs. Mobilized Peripheral Blood. Arch Med Res, 34, 545.
• Australian Academy of Science (2001) Human stem cell research. www.science.org.au/reports/stemcell.pdf p.10.
• Austen, K.F, Rosen, F.S, Burakoff, S.J & Strom, T.B., (2001) In: Therapeutic Immunology, 2nd ed. p. 508. Blackwell Publishing.

More papers on Hematopoietic Stem Cells:

• Research Paper # 110050 : "Stem Cells"
• Term Paper # 67722 : "Stem Cell Research"
• Comparison Essay # 61920 : "Cord Blood Banking"

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