Current indications and principles for autologous haematopoietic cell transplantation
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 7
Abstract
High dose chemotherapy with autologous haematopoietic stem cell transplantation may result in clinical improvement in many patients with haematological neoplasms, solid tumours and autoimmune diseases. According to EBMT registry 18 922 autologous transplantations were performed in 2009 year in European countries. In our clinical department 103 procedures were performed in 2009. Peripheral blood haematopoietic cells obtained after mobilization using G-CSF are used in autologous transplantation. Stem cell collection is proceeded by chemotherapy. The optimal number of CD34-positive cells needed for safety transplantation is > 2.0 x 10^6/kg. Bone marrow as a source of cells for AHSCT is used only exceptionally. The first step of autologous haematopoietic stem cell transplantation is conditioning which principles are similar to that seen in allogeneic transplantation.The advantage of AHSCT is low transplant related mortality (below 5% according the EBM Registry, < 2.5% in our department), short time of hospitalization and fact that immunosuppression is not required after AHSCT. The lack of immune mediated effects is associated with high relapse rate up to 78%. The most frequent indication for AHSCT is multiple myeloma and these patients have longer progression free survival if compared to conventional chemotherapy. The similar results were demonstrated for other indications. AHSCT may precede allotransplantation and through this reduce tumor mass burden. In this paper we presented details of transplantation procedures and results of AHSCT.
Authors and Affiliations
Małgorzata Krawczyk-Kuliś, Sławomira Kyrcz-Krzemień
Keywords
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