Hematopoietic stem cell transplantation is divided into autologous and allogeneic hematopoietic stem cell transplantation, depending on the individual source of the hematopoietic stem cells.
Autologous hematopoietic stem cell transplantation (auto-HSCT)
Autologous hematopoietic stem cell transplantation means that the patient is treated with hematopoietic stem cells derived from the patient himself. Because the stem cells are derived from the patient’s own, there is generally no rejection and few complications of transplantation. There are no donor source restrictions, low transplant-related mortality, and good post-transplant quality of life, but a high relapse rate because of the lack of graft antitumor effects and the potential for residual tumor cells to be mixed with the grafts.
Autologous hematopoietic stem cell transplantation is indicated for the following patients:
- Patients with lymphoma and multiple myeloma who are sensitive to chemotherapy;
- Patients with certain low-risk acute leukemias.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT)
Allogeneic hematopoietic stem cell transplantation refers to the origin of hematopoietic stem cells from a healthy donor, such as a related relative or an unrelated donor. The allogeneic stem cell transplantation is the only way to cure some diseases because of the low recurrence rate, high cure rate, and wide indications because the stem cells are derived from healthy donors without tumor cell contamination and the anti-tumor effect of the grafts. However, the donor source is restricted and prone to graft versus host disease (GVHD), and transplantation complications are numerous, resulting in high transplantation-related mortality and the need for immunosuppression of patients.
Allogeneic hematopoietic stem cell transplantation is indicated for patients with the following diseases:
- Acute leukemia with moderate or high risk;
- chronic granulocytic leukemia;
- myelodysplastic syndromes
- highly aggressive lymphoma that is relatively ineffective for chemotherapy;
- Huge aplastic anemia;
- Thalassemia;
- Congenital immunodeficiency.