Peripheral blood stem cell transplantation

Peripheral Blood Stem Cell Transplantation

Peripheral blood stem cell transplantation (PBSCT) is a medical procedure in which hematopoietic stem cells are collected from the peripheral blood of a donor or the patient themselves and then infused into the patient to restore bone marrow function. This procedure is commonly used in the treatment of various hematological malignancies, such as leukemia and lymphoma, as well as some non-malignant conditions.

Overview

PBSCT is an alternative to bone marrow transplantation (BMT) and has become the preferred method of stem cell transplantation due to its less invasive nature and faster recovery times. The process involves mobilizing stem cells from the bone marrow into the peripheral blood, collecting them through apheresis, and then infusing them into the patient after conditioning therapy.

Indications

PBSCT is indicated for:

• Acute myeloid leukemia (AML)
• Acute lymphoblastic leukemia (ALL)
• Chronic myeloid leukemia (CML)
• Non-Hodgkin lymphoma
• Hodgkin lymphoma
• Multiple myeloma
• Severe aplastic anemia
• Certain genetic disorders, such as thalassemia and sickle cell disease

Procedure

Mobilization

Mobilization is the process of stimulating the movement of stem cells from the bone marrow into the peripheral blood. This is typically achieved using growth factors such as granulocyte colony-stimulating factor (G-CSF) or chemotherapy.

Collection

Once mobilized, stem cells are collected from the peripheral blood using a procedure called apheresis. During apheresis, blood is drawn from the donor or patient, processed through a machine that separates the stem cells, and the remaining blood components are returned to the donor.

Conditioning

Before the infusion of stem cells, the patient undergoes conditioning therapy, which may include high-dose chemotherapy and/or radiation therapy. This is done to eradicate any remaining cancer cells and to suppress the immune system to prevent rejection of the transplanted cells.

Infusion

The collected stem cells are infused into the patient’s bloodstream, where they migrate to the bone marrow and begin to produce new blood cells. This process is known as "engraftment" and typically occurs within 2 to 4 weeks after transplantation.

Advantages

PBSCT offers several advantages over traditional bone marrow transplantation:

• Less invasive collection process
• Faster engraftment and recovery
• Reduced risk of complications such as graft-versus-host disease (GVHD)
• Ability to collect a larger number of stem cells

Risks and Complications

While PBSCT is generally safe, it is not without risks. Potential complications include:

• Infection due to immunosuppression
• GVHD, particularly in allogeneic transplants
• Organ damage from conditioning therapy
• Relapse of the underlying disease

Prognosis

The success of PBSCT depends on several factors, including the type and stage of the disease, the patient’s overall health, and the compatibility of the donor. Advances in transplantation techniques and supportive care have significantly improved outcomes for many patients.

Also see

• Hematopoietic stem cell transplantation
• Bone marrow transplantation
• Graft-versus-host disease
• Apheresis
• Leukemia

Resources

Latest articles - Peripheral blood stem cell transplantation

• Most recent articles
• Ongoing trials

Source: Data courtesy of the U.S. National Library of Medicine. Since the data might have changed, please query MeSH on Peripheral blood stem cell transplantation for any updates.

‎