What are the requirements for a hematopoietic stem cell transplant?

It is a pre-transplant treatment. This is a measure taken to enable the recipient to accept foreign hematopoietic stem cells and to reduce the burden on their own tumor cells, and the classic regimen is cyclophosphamide 60 mg kg body weight taken for 3 days plus 8 12 gray of one or divided total body irradiation. This scheme is more damaging to the patient, and is mostly used for patients who are in good health, younger in age, have a shorter course of disease, and have good function of major organs.

In order to make hematopoietic stem cell transplantation available to children and older, weaker patients, there is a modification of the classic regimen described above, called nonmyeloablative bone marrow transplant pretreatment, usually by reducing the amount and dose of cytotoxic drugs used, with no or reduced total body irradiation dose. This is relatively safe for patients.

Yes, the recipient and donor should have a matching human leukocyte antigen (HLA) system. It exists on the sixth pair of chromosomes in humans, and doctors call it the HLA-A, B, C, and DR loci, and the HLA-DR loci are particularly related to the success of the transplant, and they must be compatible, so that the chance of success is large and the risk is relatively small.

It is necessary to have a certain number of hematopoietic stem cells. It is not difficult to understand this, since as a seed cell, it is necessary to go to the new "soil" environment suitable for it to take root, germinate, flower and bear fruit, it will not be smooth sailing, and the process will be lost, and it will not work without a certain number. These are mainly for allogeneic hematopoietic stem cell transplantation.

It gives transplant patients a chance of survival, but at the same time is limited by barriers and conditions that lurk at risk, such as complications such as bleeding, infection, rejection, host-versus-host disease, and hepatic vein embolism. However, with the continuous innovation of science and technology, the gradual improvement of imperfections, the gradual recognition of those who have not been recognized, and the more and more experienced, it is believed that more and more patients will receive reasonable treatment and regain their health.

Hematopoietic stem cell transplantation must find a suitable match, and the cost of surgery is staggering, with a total of about 150,000 yuan for universal transplantation among relatives, and 25-300,000 yuan for the Chinese bone marrow bank. 300,000-400,000 haploidentical transplants between relatives. In chemotherapy and radiotherapy, if the patient is fortunate enough to meet the above conditions and pass the first two hurdles, he will have to face three problems, namely, the blow of chemotherapy and radiotherapy, the infection of pathogenic microorganisms, and the rejection of the body.

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<> hematopoietic stem cells are the origin cells of all hematopoietic cells and immune cells, and have the functions of self-renewal, multidirectional differentiation and homing (i.e., directed migration to hematopoietic tissues and organs). It can not only differentiate into red blood cells, white blood cells and platelets, but it has also been found that hematopoietic stem cells can also differentiate into cells of various tissues and organs across systems, so they are pluripotent stem cells.

Under normal circumstances, there are a large number of hematopoietic stem cells inhabited in the red bone marrow in the human body, but only about 5% of hematopoietic stem cells are involved in daily hematopoietic activities to produce blood cells needed to maintain the normal life activities of the human body. The other 95% of hematopoietic stem cells are dormant and ready for battle.

When the human body needs a large amount of hematopoiesis due to massive blood loss, or the number of working bone marrow hematopoietic stem cells is reduced due to the donation of hematopoietic stem cells, the hematopoietic stem cells that are dormant and ready for war will immediately become active to participate in hematopoietic activities.

What is a hematopoietic stem cell transplant?

Citizens of appropriate age and health donate their normal hematopoietic stem cells and infuse them into patients who have failed or destroyed hematopoietic function and immune function to rebuild the patient's hematopoietic function and immune function to achieve the purpose of certain diseases, this process is called hematopoietic stem cell transplantation.

Is "bone marrow transplantation" essentially a hematopoietic stem cell transplant?

There are three main types of hematopoietic stem cells: bone marrow blood, peripheral blood, and umbilical cord blood. The so-called "bone marrow transplant" is actually the collection of bone marrow blood hematopoietic stem cells for transplantation to patients, which is only one of the three hematopoietic stem cell transplantation methods.

The Chinese Bone Marrow Bank mainly collects hematopoietic stem cells from peripheral blood for transplantation to patients. The third way is to collect umbilical cord blood hematopoietic stem cells for transplantation to the patient.

What diseases can hematopoietic stem cell transplantation have?

Hematopoietic stem cell transplantation can lead to nearly 100 fatal diseases such as hematologic malignancies, bone marrow failure, some non-hematologic malignant tumors, and some hereditary diseases. Including leukemia, malignant lymphoma, aplastic anemia, myelodysplastic syndrome, multiple myeloma, acute radiation sickness, myelofibrosis, paroxysmal nocturnal hemoglobinuria, autoimmune diseases, solid tumors, congenital diseases or hereditary diseases, etc.

People used to say that bone marrow transplantation and bone marrow donation are inaccurate and unscientific today, due to the high development of our medical technology, that is to say, what we really collect and donate is actually hematopoietic stem cells. Where do we produce and store hematopoietic stem cells? Generally speaking, there are three parts, most of which are produced and stored in the bone marrow, so we call them bone marrow hematopoietic stem cells.

There is also a small amount of hematopoietic stem cells in the peripheral blood, that is, in the blood vessels. The third is that it is known that when a mother gives birth to a child, there are a large number of abundant hematopoietic stem cells in the umbilical cord. On the other hand, where are the hematopoietic stem cells, hematopoietic stem cells with bone marrow, hematopoietic stem cells with peripheral blood, and hematopoietic stem cells with umbilical cord.

So what is the difference between hematopoietic stem cell collection for bone marrow and hematopoietic stem cell collection for peripheral blood? In the case of hematopoietic stem cells from bone marrow for bone marrow transplantation, the donor is given a general anesthetic or several holes drilled into his bone. Peripheral blood hematopoietic stem cells are used first.

Three or four days of peripheral blood mobilizer mobilizes hematopoietic stem cells in the bone marrow into the blood, and then collects them by blood collection, which is painless for the donor. How to perform a hematopoietic stem cell transplant:

First, a large number of hematopoietic stem cells in the bone marrow are released into the bloodstream, a process called "mobilization". Then, a large number of hematopoietic stem cells are separated by a blood cell separator for transplantation, a method called "peripheral blood hematopoietic stem cell transplantation". In this way, bone marrow donation is no longer a bone marrow extraction, but only a "blood donation".

And, thanks to advances in technology, hematopoietic stem cell "mobilization" techniques now allow a sufficient number of hematopoietic stem cells to be obtained by collecting and isolating only about 50 to 200 ml of peripheral blood. After a sufficient number of hematopoietic stem cells have been collected, the blood can be returned to the donor.

Theoretically, there is no health effect on the body, but in practice there is ***. This effect is present during surgery and blood drawing. According to foreign studies, about 51,024 hematopoietic stem cell heterologous transplants were completed, of which 27,770 were bone marrow transplants and 23,254 were peripheral blood transplants.

Of these 51,024 donors, 5 donors died, including 1 case of Tangerine Ant who died after bone marrow donation and 4 cases died of peripheral blood donation, with a mortality rate of about 10,000 people. There were 37 cases of serious adverse reactions, with a chance of causing illness in about 10,000 people, of which 12 were after bone marrow transplantation (10,000 people) and 25 were after peripheral blood transplantation (10,000 people). In addition, about 20 donors developed malignant hematologic tumors (10,000 people), including 8 donors after bone marrow transplantation and 12 donors after peripheral blood stem cell donation.

The incidence of malignant hematologic tumors is not higher than that of normal age- and sex-related pathogenesis.

Conclusion: There may be a risk of lethality or serious adverse reactions in the donation of bridge-building blood stem cells, which is small but does exist. The human body is a very complex and wonderful organism, and current science is unclear about many functions and mechanisms.

Hematopoietic stem cells are the most mysterious cells, and the onset of leukemia is the result of various factors interfering with it. The collection of hematopoietic stem cells currently requires human interference, so unless science and technology are developed in the future, the collection will be quiet, and it will not interfere with the hematopoietic function at all, and a very small part will be collected from the body, which will be eliminated.

Briefly describe the classification of hematopoietic stem cell transplantation. A:autologous transplantation; Allogeneic transplantation is further divided into sibling donor transplantation and non-blood donor transplantation; Homogeneic transplantation is a transplant of the recipient and the donor's genes that are identical, and in humans it refers only to the transplantation between identical twins.

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The indications for autologous shed blood stem cell transplantation are briefly reviewed.

A:(1) effective consolidation measures after complete remission of acute leukemia;

2) Hodgkin lymphoma and non-Hodgkin lymphoma are the most common diseases of autologous hematopoietic stem cell transplantation;

3) Chronic myeloid leukemia.

4) Breast cancer is the most common case of solid tumors.

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Hematopoietic stem cell transplantation mainly includes bone marrow transplantation, peripheral blood stem cell transplantation, and umbilical cord blood stem cell transplantation.

Because bone marrow is a hematopoietic organ, bone marrow transplantation was performed in the early stages.

In 1958, the French oncologist Mathe first performed a bone marrow transplant on a patient who had been injured by a radiation accident.

In 1968, GATTI successfully applied bone marrow transplantation to a severe combined immunodeficiency patient.

After the 70s of the last century, with the discovery of human leukocyte antigen (HLA), the progress of blood products and antibiotics, the protection of the environment and the wide application of hematopoietic growth factors, hematopoietic stem cell transplantation technology has developed rapidly.

In 1977, Thomas reported that 13 of 100 patients with advanced leukemia had miraculously survived long lives after bone marrow transplantation from HLA-matched siblings.

Since then, the world has achieved great success in the application of bone marrow transplantation for leukemia, aplastic anemia and other serious blood diseases, acute radiation sickness and some malignant tumors, creating a new era of clinical leukemia and malignant tumors.

Transplantation of hematopoietic stem cells: (1) Indications: Allo HSCT has a wide range of indications, which can be used for malignant blood diseases, non-malignant refractory blood diseases, severe hereditary and surrogate diseases, while Auto HSCT mainly has malignant blood diseases, some solid tumors, and severe autoimmune diseases.

For the choice of transplant timing, patients with better conventional chemotherapy effects, such as childhood acute lymphoblastic leukemia, acute promyelocytic leukemia, etc., can be transplanted after **, while other types of leukemia should be carried out in the early stage of the disease, which can improve the efficacy and reduce transplantation-related deaths. For chronic myeloid leukemia and severe hereditary blood diseases, Allo HSCT is the only means and should be transplanted as soon as possible. (2) Contraindications:

Allo HSCT generally requires the recipient to be under the age of 50, and Auto HSCT and syngeneic HSCT can be relaxed to less than 60 years old. Patients who receive transplants should not have severe impairment of the heart, liver, lungs, kidneys and other important organs or severe mental disorders.