Haemopoietic stem cell transplant: principles, indications and complications
Autologous versus allogeneic transplant, HLA matching and donor choice, conditioning intensity and the graft-versus-leukaemia effect, CD34 dose and engraftment numbers, the main indications, and the timeline of infections and non-infective complications from mucositis and SOS/VOD to CMV, GVHD and late effects.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Haemopoietic stem cell transplant (HSCT) replaces a patient's marrow with stem cells from themselves (autologous) or a donor (allogeneic).
- Autologous transplant is a support measure for high-dose chemotherapy. Allogeneic transplant adds an immune therapy: donor T cells attack residual tumour (graft-versus-leukaemia, GVL) and, unhelpfully, host tissues (GVHD).
- Stem cells are CD34+. Most grafts are now peripheral blood stem cells mobilised with G-CSF. Bone marrow harvest and umbilical cord blood are the alternatives.
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Sources
- The EBMT Handbook: Hematopoietic Cell Transplantation and Cellular Therapies (8th ed.)Sureda A, Corbacioglu S, Greco R, Kröger N, Carreras E (eds), Springer, 2024
- Revised diagnosis and severity criteria for sinusoidal obstruction syndrome/veno-occlusive disease in adult patients: a new classification from the European Society for Blood and Marrow TransplantationMohty M et al., Bone Marrow Transplant 2016;51:906-12, 2016
- Letermovir prophylaxis for cytomegalovirus in hematopoietic-cell transplantationMarty FM et al., N Engl J Med 2017;377:2433-44, 2017
- Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCTSorror ML et al., Blood 2005;106:2912-9, 2005
- High-resolution donor-recipient HLA matching contributes to the success of unrelated donor marrow transplantationLee SJ et al., Blood 2007;110:4576-83, 2007
- Post-transplantation cyclophosphamide-based graft-versus-host disease prophylaxis (BMT CTN 1703)Bolaños-Meade J et al., N Engl J Med 2023;388:2338-48, 2023
- Australian Immunisation Handbook: vaccination for people who are immunocompromisedAU/NZAustralian Government Department of Health, Disability and Ageing, 2025
- eviQ cancer treatments online (haematology and BMT protocols)AU/NZCancer Institute NSW, 2026
- Last updated
- 14 November 2026
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