Autologous hematopoietic stem cell transplantation in the clinical setting

Autologous hematopoietic stem cell transplantation (AHSCT) refers to the collection of a patient’s own hematopoietic stem cells at a specific time, preservation or special treatment (e.g., purification, transgenesis, etc.) outside the body, and return transfusion after the patient receives high-dose chemotherapy or radiation therapy to promote hematopoietic recovery or hematopoietic reconstruction. Autologous hematopoietic stem cell transplantation has been widely used in the treatment of hematopoietic malignancies and bone marrow transplantation after high-dose radiotherapy for solid tumors, and also for the treatment of some malignant diseases. Zhu Chuansheng, Department of Hematology, Shandong Qianfo Mountain Hospital Advantages compared with allogeneic hematopoietic transplantation: 1. AHSCT is not restricted by HLA mapping and has obvious advantages in case selection. There is no graft-versus-host disease (GVHD), the pretreatment program only needs to target the primary disease and does not require the immune system of the transplant recipient, no need to adopt measures to prevent and treat GVHD, short recovery period for leukocytes and platelets, and significantly lower transplantation complications and mortality. 3. Patients tolerate autologous stem cell transplantation well, and the age of transplantation is more relaxed and acceptable to elderly patients. 4. The hospitalization time and cost are lower. According to the source of hematopoietic stem cells, autologous hematopoietic stem cell transplantation is divided into autologous bone marrow transplantation and autologous peripheral hematopoietic stem cell transplantation. Peripheral hematopoietic stem cells are easy to collect, patients do not need anesthesia, and can be collected from patients who have metastases in the bone marrow or have received damage from radiotherapy. There is no significant difference between the two in terms of efficacy. AHSCT can be used for the treatment of a variety of hematopoietic malignancies and solid tumors. It is commonly used for acute leukemia, malignant lymphoma with intermediate and high risk prognostic indicators, relapsed and primary resistant low-grade malignant lymphoma, multiple myeloma, myelodysplastic syndrome, high-risk primary or metastatic breast cancer, ovarian cancer, and small cell lung cancer. Autologous hematopoietic stem cell transplantation is also used clinically for the treatment of severe autoimmune diseases including multiple sclerosis, systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus, juvenile idiopathic arthritis, and dermatomyositis/myositis, among which multiple sclerosis, systemic sclerosis, and rheumatoid arthritis have achieved