Haematopoietic stem cell
transplantation

learn more about the haematopoietic stem cell transplantation

Haematopoietic stem cells regenerate haematopoietic tissue by creating leukocytes, red blood cells and platelets.

Haematopoietic stem cell transplantation is a therapy for neoplastic diseases (malignant tumours) and bone marrow function disorders. The procedure also treats immune system diseases and a number of congenital metabolic disorders. Haematopoietic stem cells are obtained from bone marrow.

Currently, the cells are extracted from blood, the umbilical cord and placenta. These cells are located within the bone marrow.

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Haematopoietic stem cell transplantation is a therapeutic procedure employed for neoplastic diseases (malignant tumours) and diseases that disrupt the bone marrow function (the organ in charge of producing blood cells).

This therapy can also be used for the treatment of various immune system diseases, as well as a number of congenital metabolic disorders.

This procedure has traditionally been known as bone marrow transplantation, because the haematopoietic stem cells were obtained from the bone marrow. Currently, however, the cells are mostly extracted from the blood and occasionally from the umbilical cord and placenta.

These cells are normally found in the interior of the bone marrow (especially in the hip, vertebrae and ribs) but occasionally are increased in number in the circulation, and can therefore also be obtained from the veins.

The objective of haematopoietic stem cell transplantation is to restore the function of the bone marrow (haematopoietic tissue) so that it can produce blood cells normally.

Bone marrow function needs to be replaced when it is defective due to a disease, such as multiple myeloma, leukaemia, aplastic anaemia, immunodeficiency and certain types of lymphomas, or to repair damage to the bone marrow by the administration of a highly toxic treatment for cancer or immune system disease.

Infections, haemorrhaging and rejection are the main complications of transplantation.

Prior to the transplantation, a conditioning treatment needs to be administered, which generally consists of high-dose chemotherapy, combined or not with radiation therapy. Thus, the disease to be treated is eliminated and, in the case of allogeneic transplantation, the patient’s immune system is suppressed so as not to reject the donor cells.

Haematopoietic stem cells are then administered as if it were a blood transfusion.

Due to the previous treatment, the patient enters a phase of aplasia, characterised by a reduced number of blood cells (leukocytes, red blood cells and platelets), which can cause infections, haemorrhaging and other complications. As a result, patients must remain hospitalised under special conditions until the infused stem cells regenerate and produce a sufficient number of cells to substitute those that have been destroyed by the treatment. This period depends on the type of transplantation and the conditioning treatment but usually lasts between 2 and 4 weeks.

Other potential complications result from the patient's immune system rejection (by defensive cells) of the donor cells, which will be more powerful the greater the incompatibility between the recipient and donor.

The patients will then remain hospitalised for a variable length of time, depending on the type of transplantation, until the immune system recovers completely.

Before performing haematopoietic stem cell transplantation, a treatment known as conditioning will need to be administered. This generally consists of high-dose chemotherapy (combined or not with radiation therapy), which is necessary to eradicate the disease to be treated. In the case of allogeneic transplantation (donor other than the patient), this conditioning is also needed to suppress the patient’s immune system so that it does not reject the donor cells.

Haematopoietic stem cells are then administered as if it were a blood transfusion.

The Clinic's Haematopoietic Transplantation Area is currently conducting open clinical trials for pretransplant conditioning with radioimmunotherapy (for both autologous and allogeneic transplantation) and for the treatment of graft-versus-host disease using mesenchymal bone marrow stem cells produced in the GMP Laboratory.

Patients who have undergone haematopoietic transplantation must remain hospitalised under special conditions until the infused stem cells regenerate and produce a sufficient number of cells to substitute those that have been destroyed by the treatment. This period depends on the type of transplantation and the conditioning treatment but usually lasts between 2 and 4 weeks.

Other potential complications result from the patient's immune system rejection (by defensive cells) of the donor cells, which will be more powerful the greater the incompatibility between the recipient and donor.

The patients will remain hospitalised for a variable length of time, depending on the type of transplantation, until the immune system recovers completely.

The processing of cell products for transplantation is conducted in the Cell Therapy GMP Laboratory under a strict quality assurance system".

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