Peripheral stem cell transplantation

Hematopoietic stem cell

Peripheral stem cell transplantation (PSCT) is a medical procedure in which hematopoietic stem cells are collected from the peripheral blood of a donor or the patient themselves and then transplanted to the recipient. This procedure is commonly used to treat various types of hematologic malignancies, such as leukemia, lymphoma, and multiple myeloma, as well as some non-malignant conditions.

Procedure

The process of peripheral stem cell transplantation involves several key steps:

Mobilization

Before the stem cells can be collected, they need to be mobilized from the bone marrow into the peripheral blood. This is typically achieved using growth factors such as granulocyte colony-stimulating factor (G-CSF) or through chemotherapy.

Collection

Once the stem cells are mobilized, they are collected from the blood using a process called apheresis. During apheresis, blood is drawn from the donor or patient, passed through a machine that separates the stem cells, and then the remaining blood is returned to the donor or patient.

Conditioning

Before the transplant, the recipient undergoes a conditioning regimen, which may include high-dose chemotherapy and/or radiation therapy. This is done to destroy any remaining cancer cells and to suppress the recipient's immune system to prevent rejection of the transplanted cells.

Transplantation

The collected stem cells are then infused into the recipient's bloodstream. These cells travel to the bone marrow, where they begin to produce new blood cells, a process known as engraftment.

Types of Transplants

There are two main types of peripheral stem cell transplants:

• Autologous transplant: The patient's own stem cells are collected, stored, and then reinfused after the conditioning regimen.
• Allogeneic transplant: Stem cells are collected from a donor, who may be a sibling, parent, or an unrelated matched donor.

Complications

Peripheral stem cell transplantation can be associated with several complications, including:

• Graft-versus-host disease (GVHD) in allogeneic transplants
• Infections due to immunosuppression
• Graft failure
• Organ damage from high-dose chemotherapy or radiation

Recovery

Recovery from peripheral stem cell transplantation can be a lengthy process. Patients typically require close monitoring and supportive care, including antibiotics, antifungals, and antivirals to prevent infections, as well as blood transfusions and growth factors to support blood cell production.

See Also

• Bone marrow transplant
• Hematopoietic stem cell transplantation
• Leukemia
• Lymphoma
• Multiple myeloma