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Hematopoietic stem cell transplantation - Wikipedia

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<li id="toc-Indications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Indications"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Indications</span> </div> </a> <ul id="toc-Indications-sublist" class="vector-toc-list"> <li id="toc-Malignant_(cancerous)" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Malignant_(cancerous)"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1.1</span> <span>Malignant (cancerous)</span> </div> </a> <ul id="toc-Malignant_(cancerous)-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Nonmalignant_(noncancerous)" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Nonmalignant_(noncancerous)"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1.2</span> <span>Nonmalignant (noncancerous)</span> </div> </a> <ul id="toc-Nonmalignant_(noncancerous)-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Number_of_procedures" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Number_of_procedures"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Number of procedures</span> </div> </a> <ul id="toc-Number_of_procedures-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Graft_types" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Graft_types"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>Graft types</span> </div> </a> <button aria-controls="toc-Graft_types-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Graft types subsection</span> </button> <ul id="toc-Graft_types-sublist" class="vector-toc-list"> <li id="toc-Autologous" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Autologous"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Autologous</span> </div> </a> <ul id="toc-Autologous-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Allogeneic" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Allogeneic"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Allogeneic</span> </div> </a> <ul id="toc-Allogeneic-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Sources_and_storage_of_cells" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Sources_and_storage_of_cells"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Sources and storage of cells</span> </div> </a> <button aria-controls="toc-Sources_and_storage_of_cells-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Sources and storage of cells subsection</span> </button> <ul id="toc-Sources_and_storage_of_cells-sublist" class="vector-toc-list"> <li id="toc-Bone_marrow" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Bone_marrow"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.1</span> <span>Bone marrow</span> </div> </a> <ul id="toc-Bone_marrow-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Peripheral_blood_stem_cells" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Peripheral_blood_stem_cells"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Peripheral blood stem cells</span> </div> </a> <ul id="toc-Peripheral_blood_stem_cells-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Amniotic_fluid" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Amniotic_fluid"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.3</span> <span>Amniotic fluid</span> </div> </a> <ul id="toc-Amniotic_fluid-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Storage_of_HSC" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Storage_of_HSC"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.4</span> <span>Storage of HSC</span> </div> </a> <ul id="toc-Storage_of_HSC-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Conditioning_regimens" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Conditioning_regimens"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Conditioning regimens</span> </div> </a> <button aria-controls="toc-Conditioning_regimens-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Conditioning regimens subsection</span> </button> <ul id="toc-Conditioning_regimens-sublist" class="vector-toc-list"> <li id="toc-Myeloablative" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Myeloablative"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.1</span> <span>Myeloablative</span> </div> </a> <ul id="toc-Myeloablative-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Nonmyeloablative" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Nonmyeloablative"> <div class="vector-toc-text"> <span class="vector-toc-numb">4.2</span> <span>Nonmyeloablative</span> </div> </a> <ul id="toc-Nonmyeloablative-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Engraftment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Engraftment"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Engraftment</span> </div> </a> <ul id="toc-Engraftment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Complications" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Complications"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>Complications</span> </div> </a> <button aria-controls="toc-Complications-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Complications subsection</span> </button> <ul id="toc-Complications-sublist" class="vector-toc-list"> <li id="toc-Infection" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Infection"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.1</span> <span>Infection</span> </div> </a> <ul id="toc-Infection-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Veno-occlusive_disease" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Veno-occlusive_disease"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.2</span> <span>Veno-occlusive disease</span> </div> </a> <ul id="toc-Veno-occlusive_disease-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Mucositis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mucositis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.3</span> <span>Mucositis</span> </div> </a> <ul id="toc-Mucositis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Hemorrhagic_cystitis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Hemorrhagic_cystitis"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.4</span> <span>Hemorrhagic cystitis</span> </div> </a> <ul id="toc-Hemorrhagic_cystitis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Graft-versus-host_disease" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Graft-versus-host_disease"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.5</span> <span>Graft-versus-host disease</span> </div> </a> <ul id="toc-Graft-versus-host_disease-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Graft-versus-tumor_effect" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Graft-versus-tumor_effect"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.6</span> <span>Graft-versus-tumor effect</span> </div> </a> <ul id="toc-Graft-versus-tumor_effect-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Malignancies" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Malignancies"> <div class="vector-toc-text"> <span class="vector-toc-numb">6.7</span> <span>Malignancies</span> </div> </a> <ul id="toc-Malignancies-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Prognosis" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Prognosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>Prognosis</span> </div> </a> <ul id="toc-Prognosis-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Risks_to_donor" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Risks_to_donor"> <div class="vector-toc-text"> <span class="vector-toc-numb">8</span> <span>Risks to donor</span> </div> </a> <button aria-controls="toc-Risks_to_donor-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Risks to donor subsection</span> </button> <ul id="toc-Risks_to_donor-sublist" class="vector-toc-list"> <li id="toc-Drug_risks" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Drug_risks"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.1</span> <span>Drug risks</span> </div> </a> <ul id="toc-Drug_risks-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Access_risks" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Access_risks"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.2</span> <span>Access risks</span> </div> </a> <ul id="toc-Access_risks-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Clinical_observations" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Clinical_observations"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.3</span> <span>Clinical observations</span> </div> </a> <ul id="toc-Clinical_observations-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Severe_reactions" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Severe_reactions"> <div class="vector-toc-text"> <span class="vector-toc-numb">8.4</span> <span>Severe reactions</span> </div> </a> <ul id="toc-Severe_reactions-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-History" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#History"> <div class="vector-toc-text"> <span class="vector-toc-numb">9</span> <span>History</span> </div> </a> <ul id="toc-History-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Donor_registration_and_recruitment" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Donor_registration_and_recruitment"> <div class="vector-toc-text"> <span class="vector-toc-numb">10</span> <span>Donor registration and recruitment</span> </div> </a> <ul id="toc-Donor_registration_and_recruitment-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Research" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Research"> <div class="vector-toc-text"> <span class="vector-toc-numb">11</span> <span>Research</span> </div> </a> <button aria-controls="toc-Research-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Research subsection</span> </button> <ul id="toc-Research-sublist" class="vector-toc-list"> <li id="toc-HIV" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#HIV"> <div class="vector-toc-text"> <span class="vector-toc-numb">11.1</span> <span>HIV</span> </div> </a> <ul id="toc-HIV-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Multiple_sclerosis" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Multiple_sclerosis"> <div class="vector-toc-text"> <span class="vector-toc-numb">11.2</span> <span>Multiple sclerosis</span> </div> </a> <ul id="toc-Multiple_sclerosis-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Other_autoimmune_neurological_diseases" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Other_autoimmune_neurological_diseases"> <div class="vector-toc-text"> <span class="vector-toc-numb">12</span> <span>Other autoimmune neurological diseases</span> </div> </a> <ul id="toc-Other_autoimmune_neurological_diseases-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">13</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Further_reading" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#Further_reading"> <div class="vector-toc-text"> <span class="vector-toc-numb">14</span> <span>Further reading</span> </div> </a> <ul id="toc-Further_reading-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">15</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" title="Table of Contents" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Hematopoietic stem cell transplantation</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 27 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-27" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">27 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%B2%D8%B1%D8%A7%D8%B9%D8%A9_%D9%86%D8%AE%D8%A7%D8%B9_%D8%A7%D9%84%D8%B9%D8%B8%D9%85" title="زراعة نخاع العظم – Arabic" lang="ar" hreflang="ar" data-title="زراعة نخاع العظم" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Trasplantament_de_medul%C2%B7la_%C3%B2ssia" title="Trasplantament de medul·la òssia – Catalan" lang="ca" hreflang="ca" data-title="Trasplantament de medul·la òssia" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Transplantace_kostn%C3%AD_d%C5%99en%C4%9B" title="Transplantace kostní dřeně – Czech" lang="cs" hreflang="cs" data-title="Transplantace kostní dřeně" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/Stammzelltransplantation" title="Stammzelltransplantation – German" lang="de" hreflang="de" data-title="Stammzelltransplantation" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Trasplante_de_m%C3%A9dula_%C3%B3sea" title="Trasplante de médula ósea – Spanish" lang="es" hreflang="es" data-title="Trasplante de médula ósea" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D9%BE%DB%8C%D9%88%D9%86%D8%AF_%D9%85%D8%BA%D8%B2_%D8%A7%D8%B3%D8%AA%D8%AE%D9%88%D8%A7%D9%86" title="پیوند مغز استخوان – Persian" lang="fa" hreflang="fa" data-title="پیوند مغز استخوان" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Transplantation_de_moelle_osseuse" title="Transplantation de moelle osseuse – French" lang="fr" hreflang="fr" data-title="Transplantation de moelle osseuse" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-gl mw-list-item"><a href="https://gl.wikipedia.org/wiki/Transplante_de_medula_%C3%B3sea" title="Transplante de medula ósea – Galician" lang="gl" hreflang="gl" data-title="Transplante de medula ósea" data-language-autonym="Galego" data-language-local-name="Galician" class="interlanguage-link-target"><span>Galego</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%A1%B0%ED%98%88%EB%AA%A8%EC%84%B8%ED%8F%AC_%EC%9D%B4%EC%8B%9D" title="조혈모세포 이식 – Korean" lang="ko" hreflang="ko" data-title="조혈모세포 이식" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Trapianto_di_cellule_staminali_ematopoietiche" title="Trapianto di cellule staminali ematopoietiche – Italian" lang="it" hreflang="it" data-title="Trapianto di cellule staminali ematopoietiche" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%A9%D7%AA%D7%9C%D7%AA_%D7%9E%D7%97_%D7%A2%D7%A6%D7%9D" title="השתלת מח עצם – Hebrew" lang="he" hreflang="he" data-title="השתלת מח עצם" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Kamienini%C5%B3_kraujo_l%C4%85steli%C5%B3_transplantacija" title="Kamieninių kraujo ląstelių transplantacija – Lithuanian" lang="lt" hreflang="lt" data-title="Kamieninių kraujo ląstelių transplantacija" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%9F%D1%80%D0%B5%D1%81%D0%B0%D0%B4%D1%83%D0%B2%D0%B0%D1%9A%D0%B5_%D0%BD%D0%B0_%D0%BA%D0%BE%D1%81%D0%BA%D0%B5%D0%BD%D0%B0_%D1%81%D1%80%D0%B6" title="Пресадување на коскена срж – Macedonian" lang="mk" hreflang="mk" data-title="Пресадување на коскена срж" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Stamceltransplantatie" title="Stamceltransplantatie – Dutch" lang="nl" hreflang="nl" data-title="Stamceltransplantatie" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E9%80%A0%E8%A1%80%E5%B9%B9%E7%B4%B0%E8%83%9E%E7%A7%BB%E6%A4%8D" title="造血幹細胞移植 – Japanese" lang="ja" hreflang="ja" data-title="造血幹細胞移植" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-nn mw-list-item"><a href="https://nn.wikipedia.org/wiki/Hematopoetisk_stamcelletransplantasjon" title="Hematopoetisk stamcelletransplantasjon – Norwegian Nynorsk" lang="nn" hreflang="nn" data-title="Hematopoetisk stamcelletransplantasjon" data-language-autonym="Norsk nynorsk" data-language-local-name="Norwegian Nynorsk" class="interlanguage-link-target"><span>Norsk nynorsk</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Przeszczepienie_szpiku_kostnego" title="Przeszczepienie szpiku kostnego – Polish" lang="pl" hreflang="pl" data-title="Przeszczepienie szpiku kostnego" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Transplante_de_medula_%C3%B3ssea" title="Transplante de medula óssea – Portuguese" lang="pt" hreflang="pt" data-title="Transplante de medula óssea" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Transplant_de_m%C4%83duv%C4%83" title="Transplant de măduvă – Romanian" lang="ro" hreflang="ro" data-title="Transplant de măduvă" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D0%BD%D1%81%D0%BF%D0%BB%D0%B0%D0%BD%D1%82%D0%B0%D1%86%D0%B8%D1%8F_%D0%B3%D0%B5%D0%BC%D0%BE%D0%BF%D0%BE%D1%8D%D1%82%D0%B8%D1%87%D0%B5%D1%81%D0%BA%D0%B8%D1%85_%D1%81%D1%82%D0%B2%D0%BE%D0%BB%D0%BE%D0%B2%D1%8B%D1%85_%D0%BA%D0%BB%D0%B5%D1%82%D0%BE%D0%BA" title="Трансплантация гемопоэтических стволовых клеток – Russian" lang="ru" hreflang="ru" data-title="Трансплантация гемопоэтических стволовых клеток" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D0%BD%D1%81%D0%BF%D0%BB%D0%B0%D0%BD%D1%82%D0%B0%D1%86%D0%B8%D1%98%D0%B0_%D0%BA%D0%BE%D1%88%D1%82%D0%B0%D0%BD%D0%B5_%D1%81%D1%80%D0%B6%D0%B8" title="Трансплантација коштане сржи – Serbian" lang="sr" hreflang="sr" data-title="Трансплантација коштане сржи" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Luuytimensiirto" title="Luuytimensiirto – Finnish" lang="fi" hreflang="fi" data-title="Luuytimensiirto" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv mw-list-item"><a href="https://sv.wikipedia.org/wiki/Stamcellstransplantation" title="Stamcellstransplantation – Swedish" lang="sv" hreflang="sv" data-title="Stamcellstransplantation" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%81%E0%B8%B2%E0%B8%A3%E0%B8%9B%E0%B8%A5%E0%B8%B9%E0%B8%81%E0%B8%96%E0%B9%88%E0%B8%B2%E0%B8%A2%E0%B9%80%E0%B8%8B%E0%B8%A5%E0%B8%A5%E0%B9%8C%E0%B8%95%E0%B9%89%E0%B8%99%E0%B8%81%E0%B8%B3%E0%B9%80%E0%B8%99%E0%B8%B4%E0%B8%94%E0%B8%82%E0%B8%AD%E0%B8%87%E0%B9%80%E0%B8%A1%E0%B9%87%E0%B8%94%E0%B9%80%E0%B8%A5%E0%B8%B7%E0%B8%AD%E0%B8%94" title="การปลูกถ่ายเซลล์ต้นกำเนิดของเม็ดเลือด – Thai" lang="th" hreflang="th" data-title="การปลูกถ่ายเซลล์ต้นกำเนิดของเม็ดเลือด" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A2%D1%80%D0%B0%D0%BD%D1%81%D0%BF%D0%BB%D0%B0%D0%BD%D1%82%D0%B0%D1%86%D1%96%D1%8F_%D0%B3%D0%B5%D0%BC%D0%BE%D0%BF%D0%BE%D0%B5%D1%82%D0%B8%D1%87%D0%BD%D0%B8%D1%85_%D1%81%D1%82%D0%BE%D0%B2%D0%B1%D1%83%D1%80%D0%BE%D0%B2%D0%B8%D1%85_%D0%BA%D0%BB%D1%96%D1%82%D0%B8%D0%BD" title="Трансплантація гемопоетичних стовбурових клітин – Ukrainian" lang="uk" hreflang="uk" data-title="Трансплантація гемопоетичних стовбурових клітин" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/Gh%C3%A9p_t%E1%BA%BF_b%C3%A0o_g%E1%BB%91c_t%E1%BA%A1o_m%C3%A1u" title="Ghép tế bào gốc tạo máu – Vietnamese" lang="vi" hreflang="vi" data-title="Ghép tế bào gốc tạo máu" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E9%80%A0%E8%A1%80%E5%B9%B2%E7%BB%86%E8%83%9E%E7%A7%BB%E6%A4%8D" title="造血干细胞移植 – Chinese" lang="zh" hreflang="zh" data-title="造血干细胞移植" data-language-autonym="中文" data-language-local-name="Chinese" 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</div> </div> <div id="bodyContent" class="vector-body" aria-labelledby="firstHeading" data-mw-ve-target-container> <div class="vector-body-before-content"> <div class="mw-indicators"> </div> <div id="siteSub" class="noprint">From Wikipedia, the free encyclopedia</div> </div> <div id="contentSub"><div id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical procedure to replace blood or immune stem cells</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">"Bone marrow transplant" redirects here. For the journal abbreviated <i>Bone Marrow Transplant</i>, see <a href="/wiki/Bone_Marrow_Transplantation_(journal)" title="Bone Marrow Transplantation (journal)">Bone Marrow Transplantation (journal)</a>.</div> <p class="mw-empty-elt"> </p> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Hematopoietic stem cell transplantation</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:KM_Transplantat.JPEG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/1/16/KM_Transplantat.JPEG/280px-KM_Transplantat.JPEG" decoding="async" width="280" height="373" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/16/KM_Transplantat.JPEG/420px-KM_Transplantat.JPEG 1.5x, //upload.wikimedia.org/wikipedia/commons/1/16/KM_Transplantat.JPEG 2x" data-file-width="480" data-file-height="640" /></a></span><div class="infobox-caption">Bone marrow transplant</div></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-9-CM_Volume_3" title="ICD-9-CM Volume 3">ICD-9-CM</a></th><td class="infobox-data"><a rel="nofollow" class="external text" href="http://icd9cm.chrisendres.com/index.php?srchtype=procs&amp;srchtext=41.0&amp;Submit=Search&amp;action=search">41.0</a></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D018380">D018380</a></span></td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/MedlinePlus" title="MedlinePlus">MedlinePlus</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://medlineplus.gov/ency/article/003009.htm">003009</a></span></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">&#91;<a href="https://www.wikidata.org/wiki/Q1128050" class="extiw" title="d:Q1128050">edit on Wikidata</a>]</div></td></tr></tbody></table> <p><b>Hematopoietic stem-cell transplantation</b> (<b>HSCT</b>) is the <a href="/wiki/Organ_transplantation" title="Organ transplantation">transplantation</a> of <a href="/wiki/Multipotent_hematopoietic_stem_cell" class="mw-redirect" title="Multipotent hematopoietic stem cell">multipotent hematopoietic stem cells</a>, usually derived from <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a>, <a href="/wiki/Peripheral_blood" class="mw-redirect" title="Peripheral blood">peripheral blood</a>, or <a href="/wiki/Umbilical_cord_blood" class="mw-redirect" title="Umbilical cord blood">umbilical cord blood</a>, in order to replicate inside a patient and produce additional normal blood cells.<sup id="cite_ref-Monga_1-0" class="reference"><a href="#cite_note-Monga-1"><span class="cite-bracket">&#91;</span>1<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-auto1_2-0" class="reference"><a href="#cite_note-auto1-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">&#91;</span>3<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-HSCT2_4-0" class="reference"><a href="#cite_note-HSCT2-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-HSCT1_5-0" class="reference"><a href="#cite_note-HSCT1-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">&#91;</span>6<span class="cite-bracket">&#93;</span></a></sup> HSCT may be <a href="/wiki/Autologous_stem_cell_transplantation" class="mw-redirect" title="Autologous stem cell transplantation">autologous</a> (the patient's own stem cells are used), <a href="/wiki/Syngeneic_stem_cell_transplantation" title="Syngeneic stem cell transplantation">syngeneic</a> (stem cells from an <a href="/wiki/Identical_twin" class="mw-redirect" title="Identical twin">identical twin</a>), or <a href="/wiki/Allotransplantation" title="Allotransplantation">allogeneic</a> (stem cells from a donor).<sup id="cite_ref-HSCT2_4-1" class="reference"><a href="#cite_note-HSCT2-4"><span class="cite-bracket">&#91;</span>4<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-HSCT1_5-1" class="reference"><a href="#cite_note-HSCT1-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p><p>It is most often performed for patients with certain <a href="/wiki/Cancer" title="Cancer">cancers</a> of the <a href="/wiki/Blood" title="Blood">blood</a> or bone marrow, such as <a href="/wiki/Multiple_myeloma" title="Multiple myeloma">multiple myeloma</a>, <a href="/wiki/Leukemia" title="Leukemia">leukemia</a>, some types of <a href="/wiki/Lymphoma" title="Lymphoma">lymphoma</a> and <a href="/wiki/Immunodeficiency" title="Immunodeficiency">immune deficiencies</a>.<sup id="cite_ref-HSCT1_5-2" class="reference"><a href="#cite_note-HSCT1-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> In these cases, the recipient's immune system is usually suppressed with <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation</a> or <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a> before the transplantation. Infection and <a href="/wiki/Graft-versus-host_disease" title="Graft-versus-host disease">graft-versus-host disease</a> are major complications of allogeneic HSCT.<sup id="cite_ref-HSCT1_5-3" class="reference"><a href="#cite_note-HSCT1-5"><span class="cite-bracket">&#91;</span>5<span class="cite-bracket">&#93;</span></a></sup> </p><p>HSCT remains a dangerous procedure with many possible complications; it is reserved for patients with life-threatening diseases. As survival following the procedure has increased, its use has expanded beyond cancer to <a href="/wiki/Autoimmune_diseases" class="mw-redirect" title="Autoimmune diseases">autoimmune diseases</a><sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">&#91;</span>7<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">&#91;</span>8<span class="cite-bracket">&#93;</span></a></sup> and hereditary <a href="/wiki/Skeletal_dysplasia" class="mw-redirect" title="Skeletal dysplasia">skeletal dysplasias</a>, notably <a href="/wiki/Malignant_infantile_osteopetrosis" title="Malignant infantile osteopetrosis">malignant infantile osteopetrosis</a><sup id="cite_ref-elsobky2017_9-0" class="reference"><a href="#cite_note-elsobky2017-9"><span class="cite-bracket">&#91;</span>9<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Hashemi2015_10-0" class="reference"><a href="#cite_note-Hashemi2015-10"><span class="cite-bracket">&#91;</span>10<span class="cite-bracket">&#93;</span></a></sup> and <a href="/wiki/Mucopolysaccharidosis" title="Mucopolysaccharidosis">mucopolysaccharidosis</a>.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">&#91;</span>11<span class="cite-bracket">&#93;</span></a></sup> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Medical_uses">Medical uses</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=1" title="Edit section: Medical uses"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">See also: <a href="/wiki/List_of_conditions_treated_with_hematopoietic_stem_cell_transplantation" title="List of conditions treated with hematopoietic stem cell transplantation">List of conditions treated with hematopoietic stem cell transplantation</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:The_spectrum_of_target_antigens_associated_with_tumor_immunity_and_allo-immunity_after_allogeneic_HSCT..jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/The_spectrum_of_target_antigens_associated_with_tumor_immunity_and_allo-immunity_after_allogeneic_HSCT..jpg/220px-The_spectrum_of_target_antigens_associated_with_tumor_immunity_and_allo-immunity_after_allogeneic_HSCT..jpg" decoding="async" width="220" height="154" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/a/a0/The_spectrum_of_target_antigens_associated_with_tumor_immunity_and_allo-immunity_after_allogeneic_HSCT..jpg/330px-The_spectrum_of_target_antigens_associated_with_tumor_immunity_and_allo-immunity_after_allogeneic_HSCT..jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/a/a0/The_spectrum_of_target_antigens_associated_with_tumor_immunity_and_allo-immunity_after_allogeneic_HSCT..jpg/440px-The_spectrum_of_target_antigens_associated_with_tumor_immunity_and_allo-immunity_after_allogeneic_HSCT..jpg 2x" data-file-width="600" data-file-height="421" /></a><figcaption>The spectrum of target antigens associated with tumor immunity and alloimmunity after allogeneic HSCT: Host-derived T and B cells can be induced to recognize tumor-associated antigens, whereas donor-derived B and T cells can recognize both tumor-associated antigens and alloantigens.</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Indications">Indications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=2" title="Edit section: Indications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Indications for stem-cell transplantation are: </p> <div class="mw-heading mw-heading4"><h4 id="Malignant_(cancerous)"><span id="Malignant_.28cancerous.29"></span>Malignant (cancerous)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=3" title="Edit section: Malignant (cancerous)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Acute_myeloid_leukemia" title="Acute myeloid leukemia">Acute myeloid leukemia</a></li> <li><a href="/wiki/Chronic_myeloid_leukemia" class="mw-redirect" title="Chronic myeloid leukemia">Chronic myeloid leukemia</a></li> <li><a href="/wiki/Acute_lymphoblastic_leukemia" title="Acute lymphoblastic leukemia">Acute lymphoblastic leukemia</a></li> <li><a href="/wiki/Juvenile_myelomonocytic_leukemia" title="Juvenile myelomonocytic leukemia">Juvenile myelomonocytic leukemia</a></li> <li><a href="/wiki/Hodgkin_lymphoma" title="Hodgkin lymphoma">Hodgkin lymphoma</a> (relapsed, refractory)</li> <li><a href="/wiki/Non-Hodgkin_lymphoma" title="Non-Hodgkin lymphoma">Non-Hodgkin lymphoma</a> (relapsed, refractory)</li> <li><a href="/wiki/Neuroblastoma" title="Neuroblastoma">Neuroblastoma</a></li> <li><a href="/wiki/Ewing_sarcoma" title="Ewing sarcoma">Ewing sarcoma</a></li> <li><a href="/wiki/Multiple_myeloma" title="Multiple myeloma">Multiple myeloma</a></li> <li><a href="/wiki/Myelodysplastic_syndrome" title="Myelodysplastic syndrome">Myelodysplastic syndromes</a></li> <li><a href="/wiki/Glioma" title="Glioma">Gliomas</a>, other <a href="/wiki/Solid_tumor" class="mw-redirect" title="Solid tumor">solid tumors</a></li></ul> <div class="mw-heading mw-heading4"><h4 id="Nonmalignant_(noncancerous)"><span id="Nonmalignant_.28noncancerous.29"></span>Nonmalignant (noncancerous)</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=4" title="Edit section: Nonmalignant (noncancerous)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Thalassemia" title="Thalassemia">Thalassemia</a></li> <li><a href="/wiki/Sickle_cell_anemia" class="mw-redirect" title="Sickle cell anemia">Sickle cell anemia</a></li> <li><a href="/wiki/Aplastic_anemia" title="Aplastic anemia">Aplastic anemia</a></li> <li><a href="/wiki/Fanconi_anemia" title="Fanconi anemia">Fanconi anemia</a></li> <li><a href="/wiki/Malignant_infantile_osteopetrosis" title="Malignant infantile osteopetrosis">Malignant infantile osteopetrosis</a></li> <li><a href="/wiki/Mucopolysaccharidosis" title="Mucopolysaccharidosis">Mucopolysaccharidosis</a></li> <li><a href="/wiki/Paroxysmal_nocturnal_hemoglobinuria" title="Paroxysmal nocturnal hemoglobinuria">Paroxysmal nocturnal hemoglobinuria</a></li> <li><a href="/wiki/Pyruvate_kinase_deficiency" title="Pyruvate kinase deficiency">Pyruvate kinase deficiency</a></li> <li>Immune deficiency syndromes</li> <li><a href="/wiki/Autoimmune_disease" title="Autoimmune disease">Autoimmune diseases</a>,<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">&#91;</span>12<span class="cite-bracket">&#93;</span></a></sup> including <a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">multiple sclerosis</a><sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">&#91;</span>13<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">&#91;</span>14<span class="cite-bracket">&#93;</span></a></sup></li></ul> <p>Many recipients of HSCTs are <a href="/wiki/Multiple_myeloma" title="Multiple myeloma">multiple myeloma</a><sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">&#91;</span>15<span class="cite-bracket">&#93;</span></a></sup> or <a href="/wiki/Leukemia" title="Leukemia">leukemia</a> patients<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">&#91;</span>16<span class="cite-bracket">&#93;</span></a></sup> who would not benefit from prolonged treatment with, or are already resistant to, <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a>. Candidates for HSCTs include <a href="/wiki/Pediatric" class="mw-redirect" title="Pediatric">pediatric</a> cases where the patient has an inborn defect such as <a href="/wiki/Severe_combined_immunodeficiency" title="Severe combined immunodeficiency">severe combined immunodeficiency</a> or <a href="/wiki/Neutropenia" title="Neutropenia">congenital neutropenia</a> with defective stem cells, and also children or adults with <a href="/wiki/Aplastic_anemia" title="Aplastic anemia">aplastic anemia</a><sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">&#91;</span>17<span class="cite-bracket">&#93;</span></a></sup> who have lost their stem cells after birth. Other conditions<sup id="cite_ref-urlCIBMTR_Summary_Slides_I_18-0" class="reference"><a href="#cite_note-urlCIBMTR_Summary_Slides_I-18"><span class="cite-bracket">&#91;</span>18<span class="cite-bracket">&#93;</span></a></sup> treated with stem cell transplants include <a href="/wiki/Sickle_cell_disease" title="Sickle cell disease">sickle cell disease</a>, <a href="/wiki/Myelodysplastic_syndrome" title="Myelodysplastic syndrome">myelodysplastic syndrome</a>, <a href="/wiki/Neuroblastoma" title="Neuroblastoma">neuroblastoma</a>, <a href="/wiki/Lymphoma" title="Lymphoma">lymphoma</a>, <a href="/wiki/Ewing%27s_sarcoma" class="mw-redirect" title="Ewing&#39;s sarcoma">Ewing's sarcoma</a>, <a href="/wiki/Desmoplastic_small_round_cell_tumor" class="mw-redirect" title="Desmoplastic small round cell tumor">desmoplastic small round cell tumor</a>, <a href="/wiki/Chronic_granulomatous_disease" title="Chronic granulomatous disease">chronic granulomatous disease</a>, <a href="/wiki/Hodgkin%27s_disease" class="mw-redirect" title="Hodgkin&#39;s disease">Hodgkin's disease</a> and <a href="/wiki/Wiskott%E2%80%93Aldrich_syndrome" title="Wiskott–Aldrich syndrome">Wiskott–Aldrich syndrome</a>. Non-myeloablative, so-called <a href="/wiki/Microtransplantation" title="Microtransplantation">mini transplant (microtransplantation)</a> procedures, have been developed requiring smaller doses of preparative chemotherapy and <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>, allowing HSCT to be conducted in the elderly and other patients who would otherwise be considered too weak to withstand a conventional treatment regimen.<sup id="cite_ref-pmid30148720_19-0" class="reference"><a href="#cite_note-pmid30148720-19"><span class="cite-bracket">&#91;</span>19<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Number_of_procedures">Number of procedures</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=5" title="Edit section: Number of procedures"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2006, 50,417 first HSCTs were recorded worldwide, according to a global survey of 1,327 centers in 71 countries conducted by the Worldwide Network for Blood and Marrow Transplantation. Of these, 28,901 (57%) were autologous and 21,516 (43%) were allogeneic (11,928 from family donors and 9,588 from unrelated donors). The main indications for transplant were lymphoproliferative disorders (55%) and leukemias (34%), and many took place in either Europe (48%) or the Americas (36%).<sup id="cite_ref-Gratwohl_20-0" class="reference"><a href="#cite_note-Gratwohl-20"><span class="cite-bracket">&#91;</span>20<span class="cite-bracket">&#93;</span></a></sup> </p><p>The Worldwide Network for Blood and Marrow Transplantation reported the millionth transplant to have been undertaken in December 2012.<sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">&#91;</span>21<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 2014, according to the <a href="/wiki/Bone_Marrow_Donors_Worldwide" class="mw-redirect" title="Bone Marrow Donors Worldwide">World Marrow Donor Association</a>, stem-cell products provided for unrelated transplantation worldwide had increased to 20,604 (4,149 bone-marrow donations, 12,506 peripheral blood stem-cell donations, and 3,949 cord-blood units).<sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">&#91;</span>22<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Graft_types">Graft types</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=6" title="Edit section: Graft types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Autologous">Autologous</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=7" title="Edit section: Autologous"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Autologous HSCT requires the extraction (<a href="/wiki/Apheresis" title="Apheresis">apheresis</a>) of hematopoietic stem cells (HSCs) from the patient and storage of the harvested cells in a freezer. The patient is then treated with high-dose <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a> with or without <a href="/wiki/Radiotherapy" class="mw-redirect" title="Radiotherapy">radiotherapy</a> with the intention of eradicating the patient's malignant cell population at the cost of partial or complete <a href="/wiki/Bone_marrow" title="Bone marrow">bone marrow</a> ablation (destruction of patient's bone marrow's ability to grow new blood cells). The patient's own stored stem cells are then transfused into his/her bloodstream, where they replace destroyed tissue and resume the patient's normal blood-cell production.<sup id="cite_ref-auto1_2-1" class="reference"><a href="#cite_note-auto1-2"><span class="cite-bracket">&#91;</span>2<span class="cite-bracket">&#93;</span></a></sup> Autologous transplants have the advantage of lower risk of infection during the immune-compromised portion of the treatment, since the recovery of immune function is rapid. Also, the incidence of patients experiencing rejection is very rare (and graft-versus-host disease impossible) due to the donor and recipient being the same individual. These advantages have established autologous HSCT as one of the standard second-line treatments for such diseases as <a href="/wiki/Lymphoma" title="Lymphoma">lymphoma</a>.<sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">&#91;</span>23<span class="cite-bracket">&#93;</span></a></sup> </p><p>For other cancers such as <a href="/wiki/Acute_myeloid_leukemia" title="Acute myeloid leukemia">acute myeloid leukemia</a>, though, the reduced mortality of the autogenous relative to allogeneic HSCT may be outweighed by an increased likelihood of cancer relapse and related mortality, so the allogeneic treatment may be preferred for those conditions.<sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">&#91;</span>24<span class="cite-bracket">&#93;</span></a></sup> </p><p>Researchers have conducted small studies using nonmyeloablative HSCT as a possible treatment for <a href="/wiki/Diabetes_mellitus_type_1" class="mw-redirect" title="Diabetes mellitus type 1">type I (insulin dependent) diabetes</a> in children and adults. Results have been promising, but as of 2019<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit">&#91;update&#93;</a></sup>, speculating whether these experiments will lead to effective treatments for diabetes is premature.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">&#91;</span>25<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">&#91;</span>26<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">&#91;</span>27<span class="cite-bracket">&#93;</span></a></sup> Autologous HSCT is an effective treatment against aggressive Multiple Sclerosis.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">&#91;</span>28<span class="cite-bracket">&#93;</span></a></sup> The type of autologous HSCT used as a Multiple Sclerosis treatment is considered safe and the serious adverse events rare.<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">&#91;</span>29<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Allogeneic">Allogeneic</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=8" title="Edit section: Allogeneic"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Allogeneic HSCT involves two people – the (healthy) donor and the (patient) recipient. Allogeneic HSC donors must have a tissue (<a href="/wiki/Human_leukocyte_antigen" title="Human leukocyte antigen">human leukocyte antigen</a>, HLA) type that matches the recipient. Matching is performed on the basis of variability at three or more <a href="/wiki/Locus_(genetics)" title="Locus (genetics)">loci</a> of the HLA gene, and a perfect match at these loci is preferred. Even if a good match exists at these critical <a href="/wiki/Allele" title="Allele">alleles</a>, the recipient will require <a href="/wiki/Immunosuppression" title="Immunosuppression">immunosuppressive</a> medications to mitigate graft-versus-host disease. Allogeneic transplant donors may be related (usually a closely HLA-matched sibling), syngeneic (a <a href="/wiki/Monozygotic" class="mw-redirect" title="Monozygotic">monozygotic</a> or identical twin of the patient – necessarily extremely rare since few patients have an identical twin, but offering a source of perfectly HLA-matched stem cells), unrelated (donor who is not related and found to have very close degree of HLA matching), or, as in the case of Haploidentical Transplantation, a half-matched relative such as a parent, child, or sibling. Unrelated donors may be found through a registry of bone-marrow donors, such as the <a href="/wiki/National_Marrow_Donor_Program" title="National Marrow Donor Program">National Marrow Donor Program</a> (NMDP) in the U.S. A "<a href="/wiki/Savior_sibling" title="Savior sibling">savior sibling</a>" may be intentionally selected by <a href="/wiki/Preimplantation_genetic_diagnosis" title="Preimplantation genetic diagnosis">preimplantation genetic diagnosis</a> to match a child both regarding HLA type and being free of any obvious inheritable disorder. Allogeneic transplants are also performed using umbilical <a href="/wiki/Cord_blood" title="Cord blood">cord blood</a> as the source of stem cells. In general, by transfusing healthy stem cells to the recipient's bloodstream to reform a healthy immune system, allogeneic HSCTs appear to improve chances for cure or long-term remission once the immediate transplant-related complications are resolved.<sup id="cite_ref-Russell_N,_Bessell_E,_Stainer_C,_Haynes_A,_Das-Gupta_E,_Byrne_J_2000_837–41_30-0" class="reference"><a href="#cite_note-Russell_N,_Bessell_E,_Stainer_C,_Haynes_A,_Das-Gupta_E,_Byrne_J_2000_837–41-30"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Nivison-Smith_I,_Bradstock_KF,_Dodds_AJ,_Hawkins_PA,_Szer_J_2005_18–27_31-0" class="reference"><a href="#cite_note-Nivison-Smith_I,_Bradstock_KF,_Dodds_AJ,_Hawkins_PA,_Szer_J_2005_18–27-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">&#91;</span>32<span class="cite-bracket">&#93;</span></a></sup> </p><p>A compatible donor is found by doing additional HLA testing from the blood of potential donors. The HLA genes fall in two categories (types I and II). In general, mismatches of the type-I genes (i.e. <i><a href="/wiki/HLA-A" title="HLA-A">HLA-A</a>, <a href="/wiki/HLA-B" title="HLA-B">HLA-B</a></i>, or <i><a href="/wiki/HLA-C" title="HLA-C">HLA-C</a></i>) increase the risk of graft rejection. A mismatch of an HLA type II gene (i.e. <i><a href="/wiki/HLA-DR" title="HLA-DR">HLA-DR</a></i> or<i> <a href="/wiki/HLA-DQB1" title="HLA-DQB1">HLA-DQB1</a></i>) increases the risk of graft-versus-host disease. In addition, a genetic mismatch as small as a single <a href="/wiki/DNA" title="DNA">DNA</a> <a href="/wiki/Base_pair" title="Base pair">base pair</a> is significant, so perfect matches require knowledge of the exact DNA sequence of these genes for both donor and recipient. Leading transplant centers currently perform testing for all five of these HLA genes before declaring that a donor and recipient are HLA-identical.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">&#91;<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2022)">citation needed</span></a></i>&#93;</sup> </p><p><a href="/wiki/Race_(classification_of_human_beings)" class="mw-redirect" title="Race (classification of human beings)">Race</a> and <a href="/wiki/Ethnicity" title="Ethnicity">ethnicity</a> are known to play a major role in donor recruitment drives, as members of the same ethnic group are more likely to have matching genes, including the genes for HLA.<sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">&#91;</span>33<span class="cite-bracket">&#93;</span></a></sup> </p><p>As of 2013<sup class="plainlinks noexcerpt noprint asof-tag update" style="display:none;"><a class="external text" href="https://en.wikipedia.org/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit">&#91;update&#93;</a></sup>, at least two commercialized allogeneic cell therapies have been developed, <a href="/wiki/Prochymal" title="Prochymal">Prochymal</a> and <a href="/w/index.php?title=Cartistem&amp;action=edit&amp;redlink=1" class="new" title="Cartistem (page does not exist)">Cartistem</a>.<sup id="cite_ref-simaria2013_34-0" class="reference"><a href="#cite_note-simaria2013-34"><span class="cite-bracket">&#91;</span>34<span class="cite-bracket">&#93;</span></a></sup> <a href="/wiki/Omidubicel" title="Omidubicel">Omidubicel</a> was approved for medical use in the United States in April 2023.<sup id="cite_ref-FDA_20230417_35-0" class="reference"><a href="#cite_note-FDA_20230417-35"><span class="cite-bracket">&#91;</span>35<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Sources_and_storage_of_cells">Sources and storage of cells</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=9" title="Edit section: Sources and storage of cells"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>To limit the risks of transplanted stem-cell <a href="/wiki/Transplant_rejection" title="Transplant rejection">rejection</a> or of severe graft-versus-host disease in allogeneic HSCT, the donor should preferably have the same HLA-typing as the recipient. About 25 to 30% of allogeneic HSCT recipients have an HLA-identical sibling. Even so-called "perfect matches" may have mismatched minor alleles that contribute to graft-versus-host disease. With recent advances in <a href="/wiki/T-cell" class="mw-redirect" title="T-cell">T-cell</a>-depleting therapies such as post-transplant <a href="/wiki/Cyclophosphamide" title="Cyclophosphamide">cyclophosphamide</a>, <a href="/w/index.php?title=Haploidentical&amp;action=edit&amp;redlink=1" class="new" title="Haploidentical (page does not exist)">haploidentical</a> (half-matched) transplants have permitted successful transplantation of many patients who would otherwise have lacked a donor.<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">&#91;</span>36<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Bone_marrow">Bone marrow</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=10" title="Edit section: Bone marrow"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Bone_marrow_biopsy.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/cb/Bone_marrow_biopsy.jpg/220px-Bone_marrow_biopsy.jpg" decoding="async" width="220" height="144" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/cb/Bone_marrow_biopsy.jpg/330px-Bone_marrow_biopsy.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/cb/Bone_marrow_biopsy.jpg/440px-Bone_marrow_biopsy.jpg 2x" data-file-width="2000" data-file-height="1312" /></a><figcaption>Bone marrow harvest</figcaption></figure> <p>In the case of a bone-marrow transplant, the HSCs are removed from a large bone of the donor, typically the <a href="/wiki/Pelvis" title="Pelvis">pelvis</a>, through a large <a href="/wiki/Hypodermic_needle" title="Hypodermic needle">needle</a> that reaches the center of the bone. The technique is referred to as a bone-marrow harvest and is performed under <a href="/wiki/Local_anesthesia" title="Local anesthesia">local</a> or <a href="/wiki/General_anesthesia" class="mw-redirect" title="General anesthesia">general anesthesia</a>.<sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">&#91;</span>37<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Peripheral_blood_stem_cells">Peripheral blood stem cells</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=11" title="Edit section: Peripheral blood stem cells"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Peripheral_stem_cell_transplantation" title="Peripheral stem cell transplantation">Peripheral stem cell transplantation</a></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Hematopoietic_stem_cell.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/Hematopoietic_stem_cell.jpg/220px-Hematopoietic_stem_cell.jpg" decoding="async" width="220" height="330" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/3/37/Hematopoietic_stem_cell.jpg/330px-Hematopoietic_stem_cell.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/3/37/Hematopoietic_stem_cell.jpg/440px-Hematopoietic_stem_cell.jpg 2x" data-file-width="1000" data-file-height="1500" /></a><figcaption>Peripheral blood stem cells</figcaption></figure> <p>Peripheral blood stem cells<sup id="cite_ref-Cutler_38-0" class="reference"><a href="#cite_note-Cutler-38"><span class="cite-bracket">&#91;</span>38<span class="cite-bracket">&#93;</span></a></sup> are now the most common source of stem cells for HSCT. They are collected from the blood through a process known as <a href="/wiki/Apheresis" title="Apheresis">apheresis</a>. The donor's blood is withdrawn through a sterile needle in one arm and passed through a machine that removes <a href="/wiki/White_blood_cells" class="mw-redirect" title="White blood cells">white blood cells</a>. The <a href="/wiki/Red_blood_cell" title="Red blood cell">red blood cells</a> are returned to the donor. The peripheral stem cell yield is boosted with daily <a href="/wiki/Subcutaneous_injection" class="mw-redirect" title="Subcutaneous injection">subcutaneous injections</a> of <a href="/wiki/Granulocyte-colony_stimulating_factor" class="mw-redirect" title="Granulocyte-colony stimulating factor">granulocyte-colony stimulating factor</a>, serving to mobilize stem cells from the donor's bone marrow into the peripheral circulation.<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">&#91;</span>39<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Amniotic_fluid">Amniotic fluid</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=12" title="Edit section: Amniotic fluid"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Extracting stem cells from <a href="/wiki/Amniotic_fluid" title="Amniotic fluid">amniotic fluid</a> is possible and may have applications for <a href="/wiki/Autotransplantation" title="Autotransplantation">autologous</a> and <a href="/wiki/Xenotransplantation" title="Xenotransplantation">heterologous</a> use.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">&#91;</span>40<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Storage_of_HSC">Storage of HSC</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=13" title="Edit section: Storage of HSC"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Unlike other organs, bone-marrow cells can be frozen (<a href="/wiki/Cryopreserved" class="mw-redirect" title="Cryopreserved">cryopreserved</a>) for prolonged periods without damaging too many cells. This is a necessity with autologous HSCs because the cells must be harvested from the recipient months in advance of the transplant treatment. In the case of <a href="/wiki/Allogeneic" class="mw-redirect" title="Allogeneic">allogeneic transplants</a>, fresh HSCs are preferred to avoid cell loss that might occur during the freezing and thawing process. Allogeneic cord blood is stored frozen at a <a href="/wiki/Cord_blood_bank" title="Cord blood bank">cord blood bank</a> because it is only obtainable at the time of <a href="/wiki/Childbirth" title="Childbirth">childbirth</a>. To cryopreserve HSCs, a preservative, <a href="/wiki/Dimethyl_sulfoxide" title="Dimethyl sulfoxide">dimethyl sulfoxide</a>, must be added, and the cells must be cooled very slowly in a controlled-rate freezer to prevent <a href="/wiki/Osmosis" title="Osmosis">osmotic</a> cellular injury during ice-crystal formation. HSCs may be stored for years in a cryofreezer, which typically uses <a href="/wiki/Liquid_nitrogen" title="Liquid nitrogen">liquid nitrogen</a>.<sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">&#91;</span>41<span class="cite-bracket">&#93;</span></a></sup> </p><p><span class="anchor" id="conditioning"></span> </p> <div class="mw-heading mw-heading2"><h2 id="Conditioning_regimens">Conditioning regimens</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=14" title="Edit section: Conditioning regimens"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Myeloablative">Myeloablative</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=15" title="Edit section: Myeloablative"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The chemotherapy or irradiation given immediately prior to a transplant is called the conditioning regimen, the purpose of which is to help eradicate the patient's disease prior to the infusion of HSCs and to suppress immune reactions. The bone marrow can be ablated (destroyed) with dose-levels that cause minimal injury to other tissues. In allogeneic transplants, a combination of <a href="/wiki/Cyclophosphamide" title="Cyclophosphamide">cyclophosphamide</a> with <a href="/wiki/Total_body_irradiation" title="Total body irradiation">total body irradiation</a> is conventionally employed. This treatment also has an <a href="/wiki/Immunosuppressive" class="mw-redirect" title="Immunosuppressive">immunosuppressive</a> effect that prevents rejection of the HSCs by the recipient's <a href="/wiki/Immune_system" title="Immune system">immune system</a>. The post-transplant prognosis often includes acute and chronic graft-versus-host disease that may be life-threatening. In certain leukemias, though, this can coincide with protection against cancer relapse owing to the <a href="/wiki/Graft-versus-tumor_effect" title="Graft-versus-tumor effect">graft-versus-tumor effect</a>.<sup id="cite_ref-auto_42-0" class="reference"><a href="#cite_note-auto-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> Autologous transplants may also use similar conditioning regimens, but many other chemotherapy combinations can be used depending on the type of disease. </p> <div class="mw-heading mw-heading3"><h3 id="Nonmyeloablative">Nonmyeloablative</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=16" title="Edit section: Nonmyeloablative"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A newer treatment approach, nonmyeloablative allogeneic transplantation, also termed reduced-intensity conditioning (RIC), uses doses of chemotherapy and radiation too low to eradicate all the bone-marrow cells of the recipient.<sup id="cite_ref-Williams_2010_8_43-0" class="reference"><a href="#cite_note-Williams_2010_8-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup><sup class="reference nowrap"><span title="Page / location: 320–321">&#58;&#8202;320–321&#8202;</span></sup> Instead, nonmyeloablative transplants run lower risks of serious infections and transplant-related mortality while relying upon the graft versus tumor effect to resist the inherent increased risk of cancer relapse.<sup id="cite_ref-44" class="reference"><a href="#cite_note-44"><span class="cite-bracket">&#91;</span>44<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Alyea_EP,_Kim_HT,_Ho_V,_et_al._2005_1810–4_45-0" class="reference"><a href="#cite_note-Alyea_EP,_Kim_HT,_Ho_V,_et_al._2005_1810–4-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup> Also significantly, while requiring high doses of <a href="/wiki/Immunosuppressive_agents" class="mw-redirect" title="Immunosuppressive agents">immunosuppressive agents</a> in the early stages of treatment, these doses are less than for conventional transplants.<sup id="cite_ref-46" class="reference"><a href="#cite_note-46"><span class="cite-bracket">&#91;</span>46<span class="cite-bracket">&#93;</span></a></sup> This leads to a state of mixed <a href="/wiki/Chimera_(genetics)" title="Chimera (genetics)">chimerism</a> early after transplant where both recipient and donor HSC coexist in the bone marrow space.<sup id="cite_ref-47" class="reference"><a href="#cite_note-47"><span class="cite-bracket">&#91;</span>47<span class="cite-bracket">&#93;</span></a></sup> </p><p>Decreasing doses of immunosuppressive therapy then allow donor <a href="/wiki/T-cell" class="mw-redirect" title="T-cell">T-cells</a> to eradicate the remaining recipient HSCs and to induce the graft-versus-tumor effect. This effect is often accompanied by mild graft-versus-host disease, the appearance of which is often a surrogate marker for the emergence of the desirable graft versus tumor effect, and also serves as a signal to establish an appropriate dosage level for sustained treatment with low levels of immunosuppressive agents.<sup id="cite_ref-48" class="reference"><a href="#cite_note-48"><span class="cite-bracket">&#91;</span>48<span class="cite-bracket">&#93;</span></a></sup> </p><p>Because of their gentler conditioning regimens, these transplants are associated with a lower risk of transplant-related mortality, so allow patients who are considered too high-risk for conventional allogeneic HSCT to undergo potentially curative therapy for their disease. The optimal conditioning strategy for each disease and recipient has not been fully established, but RIC can be used in elderly patients unfit for myeloablative regimens, for whom a higher risk of cancer relapse may be acceptable.<sup id="cite_ref-Williams_2010_8_43-1" class="reference"><a href="#cite_note-Williams_2010_8-43"><span class="cite-bracket">&#91;</span>43<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Alyea_EP,_Kim_HT,_Ho_V,_et_al._2005_1810–4_45-1" class="reference"><a href="#cite_note-Alyea_EP,_Kim_HT,_Ho_V,_et_al._2005_1810–4-45"><span class="cite-bracket">&#91;</span>45<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Engraftment">Engraftment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=17" title="Edit section: Engraftment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>After several weeks of growth in the bone marrow, expansion of HSCs and their progeny is sufficient to normalize the blood cell counts and reinitiate the immune system. The offspring of donor-derived HSCs have been documented to populate many different organs of the recipient, including the <a href="/wiki/Heart" title="Heart">heart</a>, <a href="/wiki/Liver" title="Liver">liver</a>, and <a href="/wiki/Muscle" title="Muscle">muscle</a>, and these cells had been suggested to have the abilities of regenerating injured tissue in these organs. However, recent research has shown that such lineage infidelity does not occur as a normal phenomenon.<sup id="cite_ref-49" class="reference"><a href="#cite_note-49"><span class="cite-bracket">&#91;</span>49<span class="cite-bracket">&#93;</span></a></sup> </p><p><a href="/wiki/Chimera_(genetics)" title="Chimera (genetics)">Chimerism</a> monitoring is a method to monitor the balance between the patient's own stem cells and the new stem cells from a donor. In cases where the patient's own stem cells are increasing in number after treatment, the treatment may potentially not have worked as intended.<sup id="cite_ref-50" class="reference"><a href="#cite_note-50"><span class="cite-bracket">&#91;</span>50<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Complications">Complications</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=18" title="Edit section: Complications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>HSCT is associated with a high treatment-related <a href="/wiki/Mortality_rate" title="Mortality rate">mortality</a> in the recipient, which limits its use to conditions that are themselves life-threatening. (The one-year survival rate has been estimated to be roughly 60%, although this figure includes deaths from the underlying disease, as well as from the transplant procedure.)<sup id="cite_ref-51" class="reference"><a href="#cite_note-51"><span class="cite-bracket">&#91;</span>51<span class="cite-bracket">&#93;</span></a></sup> Major complications include <a href="/wiki/Veno-occlusive_disease" class="mw-redirect" title="Veno-occlusive disease">veno-occlusive disease</a>, <a href="/wiki/Mucositis" title="Mucositis">mucositis</a>, infections (<a href="/wiki/Sepsis" title="Sepsis">sepsis</a>), graft-versus-host disease, and the development of new <a href="/wiki/Cancer" title="Cancer">malignancies</a>.<sup id="cite_ref-52" class="reference"><a href="#cite_note-52"><span class="cite-bracket">&#91;</span>52<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Infection">Infection</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=19" title="Edit section: Infection"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Bone-marrow transplantation usually requires that the recipient's own bone marrow be destroyed (myeloablation). Prior to the administration of new cells (engraftment), patients may go for several weeks without appreciable numbers of white blood cells to help fight <a href="/wiki/Infection" title="Infection">infection</a>. This puts a patient at high risk of infections, sepsis, and <a href="/wiki/Septic_shock" title="Septic shock">septic shock</a>, despite <a href="/wiki/Prophylactic" class="mw-redirect" title="Prophylactic">prophylactic</a> <a href="/wiki/Antibiotic" title="Antibiotic">antibiotics</a>. However, <a href="/wiki/Antiviral_drug" title="Antiviral drug">antiviral</a> <a href="/wiki/Medication" title="Medication">medications</a>, such as <a href="/wiki/Acyclovir" class="mw-redirect" title="Acyclovir">acyclovir</a> and <a href="/wiki/Valacyclovir" class="mw-redirect" title="Valacyclovir">valacyclovir</a>, are quite effective in prevention of HSCT-related outbreak of <a href="/wiki/Herpes_simplex" class="mw-redirect" title="Herpes simplex">herpetic</a> infection in <a href="/wiki/Serostatus" title="Serostatus">seropositive</a> patients.<sup id="cite_ref-HSV_53-0" class="reference"><a href="#cite_note-HSV-53"><span class="cite-bracket">&#91;</span>53<span class="cite-bracket">&#93;</span></a></sup> The immunosuppressive agents employed in allogeneic transplants for the prevention or treatment of graft-versus-host disease further increase the risk of <a href="/wiki/Opportunistic_infection" title="Opportunistic infection">opportunistic infection</a>. Immunosuppressive drugs are given for a minimum of six months after a transplantation, or much longer if required for the treatment of graft-versus-host disease. Transplant patients lose their acquired immunity, for example immunity to childhood diseases such as <a href="/wiki/Measles" title="Measles">measles</a> or <a href="/wiki/Poliomyelitis" class="mw-redirect" title="Poliomyelitis">polio</a>. So, transplant patients must be retreated with childhood <a href="/wiki/Vaccines" class="mw-redirect" title="Vaccines">vaccines</a> once they are off immunosuppressive medications.<sup id="cite_ref-54" class="reference"><a href="#cite_note-54"><span class="cite-bracket">&#91;</span>54<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Veno-occlusive_disease">Veno-occlusive disease</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=20" title="Edit section: Veno-occlusive disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Severe liver injury can result from hepatic veno-occlusive disease (VOD), newly termed sinusoidal obstruction syndrome (SOS).<sup id="cite_ref-55" class="reference"><a href="#cite_note-55"><span class="cite-bracket">&#91;</span>55<span class="cite-bracket">&#93;</span></a></sup> Elevated levels of <a href="/wiki/Bilirubin" title="Bilirubin">bilirubin</a>, <a href="/wiki/Hepatomegaly" title="Hepatomegaly">hepatomegaly</a>, and fluid retention are clinical hallmarks of this condition. The appreciation of the generalized cellular injury and obstruction in <a href="/wiki/Hepatic_veins" title="Hepatic veins">hepatic vein</a> sinuses is now greater. Severe cases of SOS are associated with a high mortality rate. <a href="/wiki/Anticoagulant" title="Anticoagulant">Anticoagulants</a> or <a href="/wiki/Defibrotide" title="Defibrotide">defibrotide</a> may be effective in reducing the severity of VOD but may also increase bleeding complications. <a href="/wiki/Ursodiol" class="mw-redirect" title="Ursodiol">Ursodiol</a> has been shown to help prevent VOD, presumably by facilitating the flow of <a href="/wiki/Bile" title="Bile">bile</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Mucositis">Mucositis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=21" title="Edit section: Mucositis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The injury of the mucosal lining of the mouth and throat is a common regimen-related toxicity following ablative HSCT regimens. It is usually not life-threatening, but is very painful, and prevents eating and drinking. Mucositis is treated with pain medications plus intravenous infusions to prevent dehydration and malnutrition.<sup id="cite_ref-56" class="reference"><a href="#cite_note-56"><span class="cite-bracket">&#91;</span>56<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Hemorrhagic_cystitis">Hemorrhagic cystitis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=22" title="Edit section: Hemorrhagic cystitis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The mucosal lining of the bladder is affected in about 5% of children undergoing HSCT. This causes <a href="/wiki/Hematuria" title="Hematuria">hematuria</a> (blood in urine), frequent urination, abdominal pain and <a href="/wiki/Thrombocytopenia" title="Thrombocytopenia">thrombocytopenia</a>.<sup id="cite_ref-57" class="reference"><a href="#cite_note-57"><span class="cite-bracket">&#91;</span>57<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Graft-versus-host_disease">Graft-versus-host disease</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=23" title="Edit section: Graft-versus-host disease"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Graft-versus-host_disease" title="Graft-versus-host disease">Graft-versus-host disease</a></div> <p>Graft-versus-host disease (GvHD) is an inflammatory disease that is unique to allogeneic transplantation. It is an attack by the "new" bone marrow's immune cells against the recipient's tissues. This can occur even if the donor and recipient are HLA-identical because the immune system can still recognize other differences between their tissues. It is named graft-versus-host disease because the transplanted cells must accept the body rather than the body accepting the new cells.<sup id="cite_ref-HSCT3_58-0" class="reference"><a href="#cite_note-HSCT3-58"><span class="cite-bracket">&#91;</span>58<span class="cite-bracket">&#93;</span></a></sup> </p><p>Acute GvHD typically occurs in the first three months after transplantation and may involve the <a href="/wiki/Skin" title="Skin">skin</a>, <a href="/wiki/Intestine" class="mw-redirect" title="Intestine">intestine</a>, or <a href="/wiki/Liver" title="Liver">liver</a>. High-dose <a href="/wiki/Corticosteroids" class="mw-redirect" title="Corticosteroids">corticosteroids</a>, such as <a href="/wiki/Prednisone" title="Prednisone">prednisone</a>, are a standard treatment, but this immunosuppressive treatment often leads to deadly infections. Chronic GvHD may also develop after allogeneic transplant. It is the major source of late treatment-related complications, although it less often results in death. In addition to inflammation, chronic GvHD may lead to the development of <a href="/wiki/Fibrosis" title="Fibrosis">fibrosis</a>, or scar tissue, similar to <a href="/wiki/Scleroderma" title="Scleroderma">scleroderma</a>; it may cause functional disability and require prolonged immunosuppressive therapy. GvHD is usually mediated by T cells, which react to foreign peptides presented on the <a href="/wiki/Major_histocompatibility_complex" title="Major histocompatibility complex">major histocompatibility complex</a> of the host.<sup id="cite_ref-59" class="reference"><a href="#cite_note-59"><span class="cite-bracket">&#91;</span>59<span class="cite-bracket">&#93;</span></a></sup> </p><p>Further research is needed to determine whether mesenchymal stromal cells can be use for prophylaxis and treatment of GvHD.<sup id="cite_ref-60" class="reference"><a href="#cite_note-60"><span class="cite-bracket">&#91;</span>60<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Graft-versus-tumor_effect">Graft-versus-tumor effect</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=24" title="Edit section: Graft-versus-tumor effect"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Graft-versus-tumor_effect" title="Graft-versus-tumor effect">Graft-versus-tumor effect</a></div> <p>Graft-versus-tumor effect (GVT), or "graft versus leukemia" effect, is the beneficial aspect of the GvHD phenomenon. For example, HSCT patients with either acute, or in particular chronic, GvHD after an allogeneic transplant tend to have a lower risk of cancer relapse.<sup id="cite_ref-61" class="reference"><a href="#cite_note-61"><span class="cite-bracket">&#91;</span>61<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-auto_42-1" class="reference"><a href="#cite_note-auto-42"><span class="cite-bracket">&#91;</span>42<span class="cite-bracket">&#93;</span></a></sup> This is due to a therapeutic immune reaction of the grafted donor T lymphocytes against the diseased bone marrow of the recipient. This lower rate of relapse accounts for the increased success rate of allogeneic transplants, compared to transplants from identical twins, and indicates that allogeneic HSCT is a form of immunotherapy. GVT is the major benefit of transplants that do not employ the highest immunosuppressive regimens. </p><p>Graft versus tumor is mainly beneficial in diseases with slow progress, e.g. chronic leukemia, low-grade lymphoma, and in some cases multiple myeloma, but is less effective in rapidly growing acute leukemias.<sup id="cite_ref-Kettering_62-0" class="reference"><a href="#cite_note-Kettering-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup> </p><p>If cancer relapses after HSCT, another transplant can be performed, infusing the patient with a greater quantity of donor white blood cells (<a href="/wiki/Donor_lymphocyte_infusion" title="Donor lymphocyte infusion">donor lymphocyte infusion</a>).<sup id="cite_ref-Kettering_62-1" class="reference"><a href="#cite_note-Kettering-62"><span class="cite-bracket">&#91;</span>62<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Malignancies">Malignancies</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=25" title="Edit section: Malignancies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Patients after HSCT are at a higher risk for <a href="/wiki/Mouth" title="Mouth">oral</a> <a href="/wiki/Squamous_cell_carcinoma" class="mw-redirect" title="Squamous cell carcinoma">carcinoma</a>. Post-HSCT <a href="/wiki/Oral_cancer" title="Oral cancer">oral cancer</a> may have more aggressive behavior with poorer prognosis, when compared to oral cancer in non-HSCT patients.<sup id="cite_ref-Oral_63-0" class="reference"><a href="#cite_note-Oral-63"><span class="cite-bracket">&#91;</span>63<span class="cite-bracket">&#93;</span></a></sup> </p><p>A meta-analysis showed that the risk of secondary cancers such as <a href="/wiki/Bone_cancer" class="mw-redirect" title="Bone cancer">bone cancer</a>, <a href="/wiki/Head_and_neck_cancers" class="mw-redirect" title="Head and neck cancers">head and neck cancers</a>, and <a href="/wiki/Melanoma" title="Melanoma">melanoma</a>, with standardized incidence ratios of 10.04 (3.48–16.61), 6.35 (4.76–7.93), and 3.52 (2.65–4.39), respectively, was significantly increased after HSCT. So, diagnostic tests for these cancers should be included in the screening program of these patients for the prevention and early detection of these cancers.<sup id="cite_ref-64" class="reference"><a href="#cite_note-64"><span class="cite-bracket">&#91;</span>64<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=26" title="Edit section: Prognosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Prognosis" title="Prognosis">Prognosis</a> in HSCT varies widely dependent upon disease type, stage, stem-cell source, HLA-matched status (for allogeneic HSCT), and conditioning regimen. A transplant offers a chance for cure or long-term remission if the inherent complications of graft versus host disease, immunosuppressive treatments and the spectrum of opportunistic infections can be survived.<sup id="cite_ref-Russell_N,_Bessell_E,_Stainer_C,_Haynes_A,_Das-Gupta_E,_Byrne_J_2000_837–41_30-1" class="reference"><a href="#cite_note-Russell_N,_Bessell_E,_Stainer_C,_Haynes_A,_Das-Gupta_E,_Byrne_J_2000_837–41-30"><span class="cite-bracket">&#91;</span>30<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Nivison-Smith_I,_Bradstock_KF,_Dodds_AJ,_Hawkins_PA,_Szer_J_2005_18–27_31-1" class="reference"><a href="#cite_note-Nivison-Smith_I,_Bradstock_KF,_Dodds_AJ,_Hawkins_PA,_Szer_J_2005_18–27-31"><span class="cite-bracket">&#91;</span>31<span class="cite-bracket">&#93;</span></a></sup> In recent years, survival rates have been gradually improving across almost all populations and subpopulations receiving transplants.<sup id="cite_ref-65" class="reference"><a href="#cite_note-65"><span class="cite-bracket">&#91;</span>65<span class="cite-bracket">&#93;</span></a></sup> </p><p>Mortality for allogeneic stem cell transplantation can be estimated using the prediction model created by Sorror <i>et al</i>.,<sup id="cite_ref-pmid15994282_66-0" class="reference"><a href="#cite_note-pmid15994282-66"><span class="cite-bracket">&#91;</span>66<span class="cite-bracket">&#93;</span></a></sup> using the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI). The HCT-CI was derived and validated by investigators at the <a href="/wiki/Fred_Hutchinson_Cancer_Research_Center" class="mw-redirect" title="Fred Hutchinson Cancer Research Center">Fred Hutchinson Cancer Research Center</a> in the U.S. The HCT-CI modifies and adds to a well-validated comorbidity index, the <a href="/wiki/Charlson_Comorbidity_Index" title="Charlson Comorbidity Index">Charlson Comorbidity Index</a> (CCI) (Charlson, <i>et al</i>.)<sup id="cite_ref-pmid3558716_67-0" class="reference"><a href="#cite_note-pmid3558716-67"><span class="cite-bracket">&#91;</span>67<span class="cite-bracket">&#93;</span></a></sup> The CCI was previously applied to patients undergoing allogeneic HCT, but appears to provide less survival prediction and discrimination than the HCT-CI scoring system. </p><p>Patients who were successfully treated with HSCT and total body irradiation in childhood were found to have increased fat mass percentage, leading to significantly decreased exercise capacity in adulthood. This suggests patients who underwent successful treatment with HSCT have an increased predisposition to cardiovascular disease later in life.<sup id="cite_ref-68" class="reference"><a href="#cite_note-68"><span class="cite-bracket">&#91;</span>68<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Risks_to_donor">Risks to donor</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=27" title="Edit section: Risks to donor"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The risks of a complication depend on patient characteristics, health care providers, and the apheresis procedure, and the colony-stimulating factor used (<a href="/wiki/G-CSF" class="mw-redirect" title="G-CSF">G-CSF</a>). G-CSF drugs include <a href="/wiki/Filgrastim" title="Filgrastim">filgrastim</a> (Neupogen, Neulasta), and <a href="/wiki/Lenograstim" title="Lenograstim">lenograstim</a> (Graslopin). </p> <div class="mw-heading mw-heading3"><h3 id="Drug_risks">Drug risks</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=28" title="Edit section: Drug risks"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Filgrastim is typically dosed in the 10 microgram/kg level for 4–5 days during the harvesting of stem cells. The documented adverse effects of filgrastim include <a href="/wiki/Splenic_rupture" class="mw-redirect" title="Splenic rupture">splenic rupture</a>, <a href="/wiki/Acute_respiratory_distress_syndrome" title="Acute respiratory distress syndrome">acute respiratory distress syndrome</a>, alveolar hemorrhage, and allergic reactions (usually experienced in first 30 minutes).<sup id="cite_ref-AmgenRx_69-0" class="reference"><a href="#cite_note-AmgenRx-69"><span class="cite-bracket">&#91;</span>69<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Donor-Risk1_70-0" class="reference"><a href="#cite_note-Donor-Risk1-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-Donor-Risk3_71-0" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> In addition, platelet and hemoglobin levels dip postprocedurally, not returning to normal until after a month.<sup id="cite_ref-Donor-Risk3_71-1" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> </p><p>The question of whether geriatrics (patients over 65) react the same as patients under 65 has not been sufficiently examined. Coagulation issues and inflammation of atherosclerotic plaques are known to occur as a result of G-CSF injection. G-CSF has also been described to induce genetic changes in <a href="/wiki/Agranulocyte" title="Agranulocyte">agranulocytes</a> of normal donors.<sup id="cite_ref-Donor-Risk1_70-1" class="reference"><a href="#cite_note-Donor-Risk1-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> There is no statistically significant evidence either for or against the hypothesis that myelodysplasia (MDS) or acute myeloid leukaemia (AML) can be induced by G-CSF in susceptible individuals.<sup id="cite_ref-Donor-Risk2_72-0" class="reference"><a href="#cite_note-Donor-Risk2-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Access_risks">Access risks</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=29" title="Edit section: Access risks"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Blood is drawn from a peripheral vein in a majority of patients, but a central line to the jugular, subclavian, and femoral veins may be used. Adverse reactions during apheresis were experienced in 20% of women and 8% of men, these adverse events primarily consisted of numbness/tingling, multiple line attempts, and nausea.<sup id="cite_ref-Donor-Risk3_71-2" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Clinical_observations">Clinical observations</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=30" title="Edit section: Clinical observations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A study involving 2,408 donors (aged 18–60 years) indicated that <a href="/wiki/Bone_pain" title="Bone pain">bone pain</a> (primarily back and hips) as a result of filgrastim treatment is observed in 80% of donors.<sup id="cite_ref-Donor-Risk3_71-3" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> Donation is not recommended for those with a history of back pain.<sup id="cite_ref-Donor-Risk3_71-4" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> Other symptoms observed in more than 40 percent of donors include muscle pain, headache, fatigue, and difficulty sleeping.<sup id="cite_ref-Donor-Risk3_71-5" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> These symptoms all returned to baseline 1 month after donation in the majority of patients.<sup id="cite_ref-Donor-Risk3_71-6" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> </p><p>In one meta-study that incorporated data from 377 donors, 44% of patients reported having adverse side effects after peripheral blood HSCT.<sup id="cite_ref-Donor-Risk2_72-1" class="reference"><a href="#cite_note-Donor-Risk2-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> Side effects included pain prior to the collection procedure as a result of G-CSF injections, and postprocedural generalized skeletal pain, fatigue, and reduced energy.<sup id="cite_ref-Donor-Risk2_72-2" class="reference"><a href="#cite_note-Donor-Risk2-72"><span class="cite-bracket">&#91;</span>72<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Severe_reactions">Severe reactions</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=31" title="Edit section: Severe reactions"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>A study that surveyed 2,408 donors found that serious adverse events (requiring prolonged hospitalization) occurred in 15 donors (at a rate of 0.6%), although none of these events was fatal.<sup id="cite_ref-Donor-Risk3_71-7" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> Donors were not observed to have higher than normal rates of cancer with up to 4–8 years of follow-up.<sup id="cite_ref-Donor-Risk3_71-8" class="reference"><a href="#cite_note-Donor-Risk3-71"><span class="cite-bracket">&#91;</span>71<span class="cite-bracket">&#93;</span></a></sup> One study based on a survey of medical teams covered about 24,000 peripheral blood HSCT cases between 1993 and 2005, and found a serious cardiovascular adverse reaction rate of about one in 1,500.<sup id="cite_ref-Donor-Risk1_70-2" class="reference"><a href="#cite_note-Donor-Risk1-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> This study reported a cardiovascular-related fatality risk within the first 30 days of HSCT of about two in 10,000.<sup id="cite_ref-Donor-Risk1_70-3" class="reference"><a href="#cite_note-Donor-Risk1-70"><span class="cite-bracket">&#91;</span>70<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="History">History</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=32" title="Edit section: History"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 1939, a woman with aplastic anaemia received the first human bone marrow transfusion. This patient received regular blood transfusions, and an attempt was made to increase her leukocyte and platelet counts by intravenous bone marrow injection without unexpected reaction.<sup id="cite_ref-73" class="reference"><a href="#cite_note-73"><span class="cite-bracket">&#91;</span>73<span class="cite-bracket">&#93;</span></a></sup> </p><p>Stem-cell transplantation was pioneered using bone marrow-derived stem cells by a team at the <a href="/wiki/Fred_Hutchinson_Cancer_Research_Center" class="mw-redirect" title="Fred Hutchinson Cancer Research Center">Fred Hutchinson Cancer Research Center</a> from the 1950s through the 1970s led by <a href="/wiki/E._Donnall_Thomas" title="E. Donnall Thomas">E. Donnall Thomas</a>, whose work was later recognized with a <a href="/wiki/Nobel_Prize_in_Physiology_or_Medicine" title="Nobel Prize in Physiology or Medicine">Nobel Prize in Physiology or Medicine</a>. Thomas' work showed that bone-marrow cells infused intravenously could repopulate the bone marrow and produce new blood cells. His work also reduced the likelihood of developing a life-threatening graft-versus-host disease.<sup id="cite_ref-74" class="reference"><a href="#cite_note-74"><span class="cite-bracket">&#91;</span>74<span class="cite-bracket">&#93;</span></a></sup> Collaborating with <a href="/wiki/Eloise_Giblett" title="Eloise Giblett">Eloise Giblett</a>, a professor at the <a href="/wiki/University_of_Washington" title="University of Washington">University of Washington</a>, he discovered genetic markers that could confirm donor matches. </p><p>The first physician to perform a successful human bone-marrow transplant on a disease other than cancer was <a href="/wiki/Robert_A._Good" title="Robert A. Good">Robert A. Good</a> at the <a href="/wiki/University_of_Minnesota" title="University of Minnesota">University of Minnesota</a> in 1968.<sup id="cite_ref-75" class="reference"><a href="#cite_note-75"><span class="cite-bracket">&#91;</span>75<span class="cite-bracket">&#93;</span></a></sup> In 1975, John Kersey, also of the University of Minnesota, performed the first successful bone-marrow transplant to cure lymphoma. His patient, a 16-year-old-boy, is today the longest-living lymphoma transplant survivor.<sup id="cite_ref-76" class="reference"><a href="#cite_note-76"><span class="cite-bracket">&#91;</span>76<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Donor_registration_and_recruitment">Donor registration and recruitment</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=33" title="Edit section: Donor registration and recruitment"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>At the end of 2012, 20.2 million people had registered their willingness to be a bone-marrow donor with one of the 67 registries from 49 countries participating in <a href="/wiki/Bone_Marrow_Donors_Worldwide" class="mw-redirect" title="Bone Marrow Donors Worldwide">Bone Marrow Donors Worldwide</a>. Around 17.9 million of these registered donors had been ABDR typed, allowing easy matching. A further 561,000 cord blood units had been received by one of 46 cord blood banks from 30 countries participating. The highest total number of bone-marrow donors registered were those from the U.S. (8.0 million), and the highest number per capita were those from Cyprus (15.4% of the population).<sup id="cite_ref-BMDW2012_77-0" class="reference"><a href="#cite_note-BMDW2012-77"><span class="cite-bracket">&#91;</span>77<span class="cite-bracket">&#93;</span></a></sup> </p><p>Within the U.S., racial minority groups are the least likely to be registered, so are the least likely to find a potentially life-saving match. In 1990, only six African Americans were able to find a bone-marrow match, and all six had common European genetic signatures.<sup id="cite_ref-McNeil_78-0" class="reference"><a href="#cite_note-McNeil-78"><span class="cite-bracket">&#91;</span>78<span class="cite-bracket">&#93;</span></a></sup> </p><p>Africans are more genetically diverse than people of European descent, which means that more registrations are needed to find a match. Bone marrow and cord blood banks exist in <a href="/wiki/South_Africa" title="South Africa">South Africa</a>, and a new program is beginning in <a href="/wiki/Nigeria" title="Nigeria">Nigeria</a>.<sup id="cite_ref-McNeil_78-1" class="reference"><a href="#cite_note-McNeil-78"><span class="cite-bracket">&#91;</span>78<span class="cite-bracket">&#93;</span></a></sup> Many people belonging to different races are requested to donate as a shortage of donors exists in African, mixed race, Latino, aboriginal, and many other communities. </p><p>Two registries in the U.S. recruit unrelated allogeneic donors: NMDP or Be the Match, and the <a href="/wiki/Gift_of_Life_Marrow_Registry" title="Gift of Life Marrow Registry">Gift of Life Marrow Registry</a>. </p> <div class="mw-heading mw-heading2"><h2 id="Research">Research</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=34" title="Edit section: Research"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="HIV">HIV</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=35" title="Edit section: HIV"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In 2007, a team of doctors in Berlin, Germany, including <a href="/wiki/Gero_H%C3%BCtter" title="Gero Hütter">Gero Hütter</a>, performed a stem-cell transplant for <a href="/wiki/Acute_myeloid_leukemia" title="Acute myeloid leukemia">leukemia</a> patient <a href="/wiki/Timothy_Ray_Brown" title="Timothy Ray Brown">Timothy Ray Brown</a>, who was also <a href="/wiki/HIV" title="HIV">HIV</a>-positive.<sup id="cite_ref-ghivberlin_79-0" class="reference"><a href="#cite_note-ghivberlin-79"><span class="cite-bracket">&#91;</span>79<span class="cite-bracket">&#93;</span></a></sup> From 60 matching donors, they selected a <a href="/wiki/CCR5" title="CCR5">[CCR5]-Δ32 homozygous</a> individual with two <a href="/wiki/Allele" title="Allele">genetic copies</a> of a rare variant of a <a href="/wiki/Cell_surface_receptor" title="Cell surface receptor">cell surface receptor</a>. This genetic trait confers resistance to HIV infection by blocking attachment of HIV to the cell. Roughly one in 1,000 people of European ancestry have this inherited <a href="/wiki/Mutation" title="Mutation">mutation</a>, but it is rarer in other populations.<sup id="cite_ref-80" class="reference"><a href="#cite_note-80"><span class="cite-bracket">&#91;</span>80<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-81" class="reference"><a href="#cite_note-81"><span class="cite-bracket">&#91;</span>81<span class="cite-bracket">&#93;</span></a></sup> The transplant was repeated a year later after a leukemia relapse. Over three years after the initial transplant, and despite discontinuing <a href="/wiki/Antiretroviral_medication" class="mw-redirect" title="Antiretroviral medication">antiretroviral therapy</a>, researchers cannot detect HIV in the transplant recipient's blood or in various biopsies of his tissues.<sup id="cite_ref-82" class="reference"><a href="#cite_note-82"><span class="cite-bracket">&#91;</span>82<span class="cite-bracket">&#93;</span></a></sup> Levels of HIV-specific antibodies have also declined, leading to speculation that the patient may have been functionally cured of HIV, but scientists emphasise that this is an unusual case.<sup id="cite_ref-83" class="reference"><a href="#cite_note-83"><span class="cite-bracket">&#91;</span>83<span class="cite-bracket">&#93;</span></a></sup> Potentially fatal transplant complications (the "Berlin patient" developed graft-versus-host disease and <a href="/wiki/Leukoencephalopathy" title="Leukoencephalopathy">leukoencephalopathy</a>) mean that the procedure could not be performed in others with HIV, even if sufficient numbers of suitable donors were found.<sup id="cite_ref-NEJMLevy_84-0" class="reference"><a href="#cite_note-NEJMLevy-84"><span class="cite-bracket">&#91;</span>84<span class="cite-bracket">&#93;</span></a></sup><sup id="cite_ref-85" class="reference"><a href="#cite_note-85"><span class="cite-bracket">&#91;</span>85<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 2012, <a href="/wiki/Daniel_Kuritzkes" title="Daniel Kuritzkes">Daniel Kuritzkes</a> reported results of two stem-cell transplants in patients with HIV. They did not, however, use donors with the Δ32 deletion. After their transplant procedures, both were put on antiretroviral therapies, during which neither showed traces of HIV in their blood plasma and purified <a href="/wiki/Cd4%2B_t_cells" class="mw-redirect" title="Cd4+ t cells">CD4<sup>+</sup> T cells</a> using a sensitive culture method (less than 3 copies/ml). The virus was once again detected in both patients some time after the discontinuation of therapy.<sup id="cite_ref-86" class="reference"><a href="#cite_note-86"><span class="cite-bracket">&#91;</span>86<span class="cite-bracket">&#93;</span></a></sup> </p><p>In 2019, a British man became the second to be cleared of HIV after receiving a bone-marrow transplant from a virus-resistant (Δ32) donor. This patient is being called "the London patient" (a reference to the famous Berlin patient).<sup id="cite_ref-87" class="reference"><a href="#cite_note-87"><span class="cite-bracket">&#91;</span>87<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Multiple_sclerosis">Multiple sclerosis</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=36" title="Edit section: Multiple sclerosis"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Since McAllister's 1997 report on a patient with <a href="/wiki/Multiple_sclerosis" title="Multiple sclerosis">multiple sclerosis</a> (MS) who received a bone-marrow transplant for chronic myelogenous leukemia (CML),<sup id="cite_ref-88" class="reference"><a href="#cite_note-88"><span class="cite-bracket">&#91;</span>88<span class="cite-bracket">&#93;</span></a></sup> over 600 reports have been published describing HSCTs performed primarily for MS.<sup id="cite_ref-Atkins_89-0" class="reference"><a href="#cite_note-Atkins-89"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> These have been shown to "reduce or eliminate ongoing clinical relapses, halt further progression, and reduce the burden of disability in some patients" who have aggressive, highly active MS, "in the absence of chronic treatment with disease-modifying agents".<sup id="cite_ref-Atkins_89-1" class="reference"><a href="#cite_note-Atkins-89"><span class="cite-bracket">&#91;</span>89<span class="cite-bracket">&#93;</span></a></sup> A randomized clinical trial including 110 patients showed that HSCT significantly prolonged time to disease progression compared to disease-modifying therapy.<sup id="cite_ref-90" class="reference"><a href="#cite_note-90"><span class="cite-bracket">&#91;</span>90<span class="cite-bracket">&#93;</span></a></sup> Long-term outcome in patients with severe disease has showed that complete disease remission after HSCT is possible.<sup id="cite_ref-91" class="reference"><a href="#cite_note-91"><span class="cite-bracket">&#91;</span>91<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Other_autoimmune_neurological_diseases">Other autoimmune neurological diseases</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=37" title="Edit section: Other autoimmune neurological diseases"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>HSCT can also be used for treating selected, severe cases of other autoimmune neurological diseases such as <a href="/wiki/Neuromyelitis_optica" class="mw-redirect" title="Neuromyelitis optica">neuromyelitis optica</a>, <a href="/wiki/Chronic_inflammatory_demyelinating_polyneuropathy" title="Chronic inflammatory demyelinating polyneuropathy">chronic inflammatory demyelinating polyneuropathy</a>, and <a href="/wiki/Myasthenia_gravis" title="Myasthenia gravis">myasthenia gravis</a>.<sup id="cite_ref-92" class="reference"><a href="#cite_note-92"><span class="cite-bracket">&#91;</span>92<span class="cite-bracket">&#93;</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=38" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist 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data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFMongaKaurDhanda2022" class="citation journal cs1">Monga I, Kaur K, Dhanda S (March 2022). "Revisiting hematopoiesis: applications of the bulk and single-cell transcriptomics dissecting transcriptional heterogeneity in hematopoietic stem cells". <i>Briefings in Functional Genomics</i>. <b>21</b> (3): <span class="nowrap">159–</span>176. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fbfgp%2Felac002">10.1093/bfgp/elac002</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35265979">35265979</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Briefings+in+Functional+Genomics&amp;rft.atitle=Revisiting+hematopoiesis%3A+applications+of+the+bulk+and+single-cell+transcriptomics+dissecting+transcriptional+heterogeneity+in+hematopoietic+stem+cells&amp;rft.volume=21&amp;rft.issue=3&amp;rft.pages=%3Cspan+class%3D%22nowrap%22%3E159-%3C%2Fspan%3E176&amp;rft.date=2022-03&amp;rft_id=info%3Adoi%2F10.1093%2Fbfgp%2Felac002&amp;rft_id=info%3Apmid%2F35265979&amp;rft.aulast=Monga&amp;rft.aufirst=I&amp;rft.au=Kaur%2C+K&amp;rft.au=Dhanda%2C+S&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHematopoietic+stem+cell+transplantation" class="Z3988"></span></span> </li> <li id="cite_note-auto1-2"><span class="mw-cite-backlink">^ <a href="#cite_ref-auto1_2-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-auto1_2-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFNabarretePereiraGarófoloSeber2021" class="citation journal cs1">Nabarrete, J. 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class="Z3988"></span></span> </li> <li id="cite_note-91"><span class="mw-cite-backlink"><b><a href="#cite_ref-91">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTolfFagiusCarlsonÅkerfeldt2019" class="citation journal cs1">Tolf A, Fagius J, Carlson K, Åkerfeldt T, Granberg T, Larsson EM, Burman J (November 2019). <a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fane.13147">"Sustained remission in multiple sclerosis after hematopoietic stem cell transplantation"</a>. <i>Acta Neurologica Scandinavica</i>. <b>140</b> (5): <span class="nowrap">320–</span>327. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fane.13147">10.1111/ane.13147</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID 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title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Acta+Neurologica+Scandinavica&amp;rft.atitle=Sustained+remission+in+multiple+sclerosis+after+hematopoietic+stem+cell+transplantation&amp;rft.volume=140&amp;rft.issue=5&amp;rft.pages=%3Cspan+class%3D%22nowrap%22%3E320-%3C%2Fspan%3E327&amp;rft.date=2019-11&amp;rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A195894616%23id-name%3DS2CID&amp;rft_id=info%3Apmid%2F31297793&amp;rft_id=info%3Adoi%2F10.1111%2Fane.13147&amp;rft.aulast=Tolf&amp;rft.aufirst=A&amp;rft.au=Fagius%2C+J&amp;rft.au=Carlson%2C+K&amp;rft.au=%C3%85kerfeldt%2C+T&amp;rft.au=Granberg%2C+T&amp;rft.au=Larsson%2C+EM&amp;rft.au=Burman%2C+J&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.1111%252Fane.13147&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHematopoietic+stem+cell+transplantation" class="Z3988"></span></span> </li> <li id="cite_note-92"><span class="mw-cite-backlink"><b><a 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href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800332">5800332</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28866625">28866625</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Journal+of+Neurology%2C+Neurosurgery%2C+and+Psychiatry&amp;rft.atitle=Autologous+haematopoietic+stem+cell+transplantation+for+neurological+diseases&amp;rft.volume=89&amp;rft.issue=2&amp;rft.pages=%3Cspan+class%3D%22nowrap%22%3E147-%3C%2Fspan%3E155&amp;rft.date=2018-02&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5800332%23id-name%3DPMC&amp;rft_id=info%3Apmid%2F28866625&amp;rft_id=info%3Adoi%2F10.1136%2Fjnnp-2017-316271&amp;rft.aulast=Burman&amp;rft.aufirst=J&amp;rft.au=Tolf%2C+A&amp;rft.au=H%C3%A4gglund%2C+H&amp;rft.au=Askmark%2C+H&amp;rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC5800332&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHematopoietic+stem+cell+transplantation" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="Further_reading">Further reading</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Hematopoietic_stem_cell_transplantation&amp;action=edit&amp;section=39" title="Edit section: Further reading"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFCoteHochbergMuzikanskyHochberg2012" class="citation journal cs1">Cote GM, Hochberg EP, Muzikansky A, Hochberg FH, Drappatz J, McAfee SL, et&#160;al. (January 2012). <a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.bbmt.2011.07.006">"Autologous stem cell transplantation with thiotepa, busulfan, and cyclophosphamide (TBC) conditioning in patients with CNS involvement by non-Hodgkin lymphoma"</a>. <i>Biology of Blood and Marrow Transplantation</i>. <b>18</b> (1): <span class="nowrap">76–</span>83. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.bbmt.2011.07.006">10.1016/j.bbmt.2011.07.006</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/21749848">21749848</a>.</cite><span title="ctx_ver=Z39.88-2004&amp;rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&amp;rft.genre=article&amp;rft.jtitle=Biology+of+Blood+and+Marrow+Transplantation&amp;rft.atitle=Autologous+stem+cell+transplantation+with+thiotepa%2C+busulfan%2C+and+cyclophosphamide+%28TBC%29+conditioning+in+patients+with+CNS+involvement+by+non-Hodgkin+lymphoma&amp;rft.volume=18&amp;rft.issue=1&amp;rft.pages=%3Cspan+class%3D%22nowrap%22%3E76-%3C%2Fspan%3E83&amp;rft.date=2012-01&amp;rft_id=info%3Adoi%2F10.1016%2Fj.bbmt.2011.07.006&amp;rft_id=info%3Apmid%2F21749848&amp;rft.aulast=Cote&amp;rft.aufirst=GM&amp;rft.au=Hochberg%2C+EP&amp;rft.au=Muzikansky%2C+A&amp;rft.au=Hochberg%2C+FH&amp;rft.au=Drappatz%2C+J&amp;rft.au=McAfee%2C+SL&amp;rft.au=Batchelor%2C+TT&amp;rft.au=LaCasce%2C+AS&amp;rft.au=Fisher%2C+DC&amp;rft.au=Abramson%2C+JS&amp;rft.au=Armand%2C+P&amp;rft.au=Chen%2C+YB&amp;rft_id=https%3A%2F%2Fdoi.org%2F10.1016%252Fj.bbmt.2011.07.006&amp;rfr_id=info%3Asid%2Fen.wikipedia.org%3AHematopoietic+stem+cell+transplantation" class="Z3988"></span></li></ul> <ul><li><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFAkramGilaniChaudhryIftikhar2024" class="citation journal cs1">Akram A, Gilani M, Chaudhry QU, Iftikhar R, Ghafoor T, Khan MA, Haider M, Nisar H (6 May 2024). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152362">"Real-World Challenges of Haplo-Identical Hematopoietic Stem Cell Transplant in a Developing Country: A Single Center Experience"</a>. <i><a href="/wiki/Cureus" title="Cureus">Cureus</a></i>. <b>16</b> (5): e59744. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.7759%2Fcureus.59744">10.7759/cureus.59744</a></span>. <a href="/wiki/PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a>&#160;<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11152362">11152362</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a>&#160;<a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/38841039">38841039</a>.</cite><span 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transplantation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Thymus" title="Thymus">Thymus</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Thymectomy" title="Thymectomy">Removal</a></li> <li><a href="/wiki/Thymus_transplantation" title="Thymus transplantation">Transplantation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Spleen" title="Spleen">Spleen</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Splenectomy" title="Splenectomy">Removal</a></li> <li><a href="/wiki/Spleen_transplantation" title="Spleen transplantation">Transplantation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Lymph_node" title="Lymph 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pharynx</a></i></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Imaging</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Lymphogram" title="Lymphogram">Lymphogram</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Organ_transplantation276" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Organ_transplantation" title="Template:Organ transplantation"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Organ_transplantation" title="Template talk:Organ transplantation"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Organ_transplantation" title="Special:EditPage/Template:Organ transplantation"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Organ_transplantation276" style="font-size:114%;margin:0 4em"><a href="/wiki/Organ_transplantation" title="Organ transplantation">Organ transplantation</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Types</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Allotransplantation" title="Allotransplantation">Allotransplantation</a> <ul><li><a href="/wiki/ABO-incompatible_transplantation" title="ABO-incompatible transplantation">ABOi</a></li></ul></li> <li><a href="/wiki/Autotransplantation" title="Autotransplantation">Autotransplantation</a></li> <li><a href="/wiki/Xenotransplantation" title="Xenotransplantation">Xenotransplantation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Transplantable_organs_and_tissues" title="Transplantable organs and tissues">Organs and tissues</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bone_grafting" title="Bone grafting">Bone</a></li> <li><a class="mw-selflink selflink">Bone marrow</a></li> <li><a href="/wiki/Brain_transplant" title="Brain transplant">Brain</a></li> <li><a href="/wiki/Corneal_transplantation" title="Corneal transplantation">Corneal</a></li> <li><a href="/wiki/Eye_transplantation" title="Eye transplantation">Eye</a></li> <li><a href="/wiki/Face_transplant" title="Face transplant">Face</a></li> <li><a href="/wiki/Hand_transplantation" title="Hand transplantation">Hand</a></li> <li><a href="/wiki/Head_transplant" title="Head transplant">Head</a></li> <li><a href="/wiki/Heart_transplantation" title="Heart transplantation">Heart</a></li> <li><a href="/wiki/Heart%E2%80%93lung_transplant" title="Heart–lung transplant">Heart–lung</a></li> <li><a href="/wiki/Intestine_transplantation" title="Intestine transplantation">Intestine</a></li> <li><a href="/wiki/Kidney_transplantation" title="Kidney transplantation">Kidney</a></li> <li><a href="/wiki/Liver_transplantation" title="Liver transplantation">Liver</a></li> <li><a href="/wiki/Lung_transplantation" title="Lung transplantation">Lung</a></li> <li><a href="/wiki/Pancreas_transplantation" title="Pancreas transplantation">Pancreas</a> <ul><li><a href="/wiki/Islet_cell_transplantation" title="Islet cell transplantation">islet cell</a></li></ul></li> <li><a href="/wiki/Penis_transplantation" title="Penis transplantation">Penis</a></li> <li><a href="/wiki/Skin_grafting" title="Skin grafting">Skin</a></li> <li><a href="/wiki/Spleen_transplantation" title="Spleen transplantation">Spleen</a></li> <li><a href="/wiki/Thymus_transplantation" title="Thymus transplantation">Thymus</a></li> <li><a href="/wiki/Uterus_transplantation" title="Uterus transplantation">Uterus</a></li> <li><a href="/wiki/Vaginal_transplantation" title="Vaginal transplantation">Vagina</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Graft_(surgery)" title="Graft (surgery)">Medical grafting</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Bone_grafting" title="Bone grafting">Bone grafting</a></li> <li><a href="/wiki/Skin_grafting" title="Skin grafting">Skin grafting</a></li> <li><a href="/wiki/Vascular_bypass" title="Vascular bypass">Vascular bypass</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Organ_donation" title="Organ donation">Organ donation</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Non-heart-beating_donation" title="Non-heart-beating donation">Non-heart-beating donation</a></li> <li><a href="/wiki/Organ_procurement" title="Organ procurement">Organ procurement</a></li> <li><a href="/wiki/Organ_trade" title="Organ trade">Organ trade</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Complications</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Graft-versus-host_disease" title="Graft-versus-host disease">Graft-versus-host disease</a></li> <li><a href="/wiki/Post-transplant_lymphoproliferative_disorder" title="Post-transplant lymphoproliferative disorder">Post-transplant lymphoproliferative disorder</a></li> <li><a href="/wiki/Transplant_rejection" title="Transplant rejection">Transplant rejection</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Transplant networks<br />and government<br /> departments</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Eurotransplant" title="Eurotransplant">Eurotransplant</a></li> <li><a href="/wiki/Gift_of_Life_Marrow_Registry" title="Gift of Life Marrow Registry">Gift of Life Marrow Registry</a></li> <li><a href="/wiki/Human_Tissue_Authority" title="Human Tissue Authority">Human Tissue Authority</a></li> <li><a href="/wiki/LifeSharers" title="LifeSharers">LifeSharers</a></li> <li><a href="/wiki/National_Marrow_Donor_Program" title="National Marrow Donor Program">National Marrow Donor Program</a></li> <li><a href="/wiki/National_Organization_for_Organ_and_Tissues_Donation_and_Transplantation_(Lebanon)" title="National Organization for Organ and Tissues Donation and Transplantation (Lebanon)">NOD-Lb</a></li> <li><a href="/wiki/National_Transplant_Organization" title="National Transplant Organization">National Transplant Organization</a></li> <li><a href="/wiki/NHS_Blood_and_Transplant" title="NHS Blood and Transplant">NHS Blood and Transplant</a></li> <li><a href="/wiki/Trillium_Gift_of_Life_Network" title="Trillium Gift of Life Network">Trillium Gift of Life Network</a></li> <li><a href="/wiki/United_Network_for_Organ_Sharing" title="United Network for Organ Sharing">United Network for Organ Sharing</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Advocacy<br /> organizations</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anthony_Nolan" title="Anthony Nolan">Anthony Nolan</a></li> <li><a href="/wiki/Blood_Cancer_UK" title="Blood Cancer UK">Blood Cancer UK</a></li> <li><a href="/wiki/DKMS" title="DKMS">DKMS</a></li> <li><a href="/wiki/Halachic_Organ_Donor_Society" title="Halachic Organ Donor Society">Halachic Organ Donor Society</a></li> <li><a href="/wiki/Kidney_Foundation_of_Canada" title="Kidney Foundation of Canada">Kidney Foundation of Canada</a></li> <li><a href="/wiki/National_Kidney_Foundation" title="National Kidney Foundation">National Kidney Foundation</a></li> <li><a href="/wiki/ORGANIZE" title="ORGANIZE">ORGANIZE</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Joint societies</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/American_Society_of_Nephrology" title="American Society of Nephrology">American Society of Nephrology</a></li> <li><a href="/wiki/American_Society_of_Transplantation" title="American Society of Transplantation">American Society of Transplantation</a></li> <li><a href="/wiki/Canadian_Society_of_Transplantation" title="Canadian Society of Transplantation">Canadian Society of Transplantation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Countries</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Organ_transplantation_in_China" title="Organ transplantation in China">Organ transplantation in China</a> <ul><li><a href="/wiki/Organ_harvesting_from_Falun_Gong_practitioners_in_China" title="Organ harvesting from Falun Gong practitioners in China">harvesting from Falun Gong</a></li></ul></li> <li><a href="/wiki/Organ_donation_in_India" title="Organ donation in India">Organ donation in India</a> <ul><li><a href="/wiki/Gurgaon_kidney_scandal" title="Gurgaon kidney scandal">Gurgaon kidney scandal</a></li></ul></li> <li><a href="/wiki/Organ_transplantation_in_Israel" title="Organ transplantation in Israel">Organ transplantation in Israel</a></li> <li><a href="/wiki/Organ_transplantation_in_Japan" title="Organ transplantation in Japan">Organ transplantation in Japan</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">People</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Heart</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Christiaan_Barnard" title="Christiaan Barnard">Christiaan Barnard</a></li> <li><a href="/wiki/James_Hardy_(surgeon)" title="James Hardy (surgeon)"> James D. Hardy</a></li> <li><a href="/wiki/Adrian_Kantrowitz" title="Adrian Kantrowitz">Adrian Kantrowitz</a></li> <li><a href="/wiki/Richard_Lower_(surgeon)" title="Richard Lower (surgeon)">Richard Lower</a></li> <li><a href="/wiki/Norman_Shumway" title="Norman Shumway">Norman Shumway</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Kidney</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/J._Hartwell_Harrison" title="J. Hartwell Harrison">J. Hartwell Harrison</a></li> <li><a href="/wiki/John_P._Merrill" title="John P. Merrill">John P. Merrill</a></li> <li><a href="/wiki/Joseph_Murray" class="mw-redirect" title="Joseph Murray">Joseph Murray</a></li> <li><a href="/wiki/Elizabeth_Ward_(British_campaigner)" title="Elizabeth Ward (British campaigner)">Elizabeth Ward</a></li> <li><a href="/wiki/Michael_Woodruff" title="Michael Woodruff">Michael Woodruff</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Liver</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fikri_Alican" title="Fikri Alican">Fikri Alican</a></li> <li><a href="/wiki/James_Hardy_(surgeon)" title="James Hardy (surgeon)"> James D. Hardy</a></li> <li><a href="/wiki/Thomas_Starzl" title="Thomas Starzl">Thomas Starzl</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Lung</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Fikri_Alican" title="Fikri Alican">Fikri Alican</a></li> <li><a href="/wiki/Joel_D._Cooper" title="Joel D. Cooper">Joel D. Cooper</a></li> <li><a href="/wiki/Vladimir_Demikhov" title="Vladimir Demikhov">Vladimir Demikhov</a></li> <li><a href="/wiki/James_Hardy_(surgeon)" title="James Hardy (surgeon)"> James D. Hardy</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pancreas</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Richard_C._Lillehei" title="Richard C. Lillehei">Richard C. Lillehei</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Penis</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Andr%C3%A9_van_der_Merwe" title="André van der Merwe">André van der Merwe</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alexis_Carrel" title="Alexis Carrel">Alexis Carrel</a></li> <li><a href="/wiki/Jean-Michel_Dubernard" title="Jean-Michel Dubernard">Jean-Michel Dubernard</a></li> <li><a href="/wiki/Donna_Mansell" title="Donna Mansell">Donna Mansell</a></li> <li><a href="/wiki/Bruce_Reitz" title="Bruce Reitz">Bruce Reitz</a></li></ul> </div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/List_of_organ_transplant_donors_and_recipients" title="List of organ transplant donors and recipients">List of organ transplant donors and recipients</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Related topics</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Biomedical_tissue" title="Biomedical tissue">Biomedical tissue</a></li> <li><a href="/wiki/Edmonton_protocol" title="Edmonton protocol">Edmonton protocol</a></li> <li><a href="/wiki/Eye_bank" title="Eye bank">Eye bank</a></li> <li><a href="/wiki/Immunosuppressive_drug" title="Immunosuppressive drug">Immunosuppressive drugs</a></li> <li><a href="/wiki/Lung_allocation_score" title="Lung allocation score">Lung allocation score</a></li> <li><a href="/wiki/Machine_perfusion" title="Machine perfusion">Machine perfusion</a></li> <li><a href="/wiki/Total_body_irradiation" title="Total body irradiation">Total body irradiation</a></li> <li><a href="/wiki/Frankenstein%27s_monster" title="Frankenstein&#39;s monster">Frankenstein's monster</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><style data-mw-deduplicate="TemplateStyles:r1038841319">.mw-parser-output .tooltip-dotted{border-bottom:1px dotted;cursor:help}</style><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1038841319"></div><div role="navigation" class="navbox authority-control" aria-label="Navbox962" style="padding:3px"><table class="nowraplinks hlist navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Help:Authority_control" title="Help:Authority control">Authority control databases</a>: National <span class="mw-valign-text-top noprint" typeof="mw:File/Frameless"><a href="https://www.wikidata.org/wiki/Q1128050#identifiers" title="Edit this at Wikidata"><img alt="Edit this at Wikidata" src="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/10px-OOjs_UI_icon_edit-ltr-progressive.svg.png" decoding="async" width="10" height="10" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/15px-OOjs_UI_icon_edit-ltr-progressive.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/8/8a/OOjs_UI_icon_edit-ltr-progressive.svg/20px-OOjs_UI_icon_edit-ltr-progressive.svg.png 2x" data-file-width="20" data-file-height="20" /></a></span></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><ul><li><span class="uid"><a rel="nofollow" class="external text" href="https://id.ndl.go.jp/auth/ndlna/01037811">Japan</a></span></li><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="transplantace kostní dřeně"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&amp;local_base=aut&amp;ccl_term=ica=ph135086&amp;CON_LNG=ENG">Czech Republic</a></span></span><ul><li><span class="uid"><span class="rt-commentedText tooltip tooltip-dotted" title="transplantace krvetvorných buněk"><a rel="nofollow" class="external text" href="https://aleph.nkp.cz/F/?func=find-c&amp;local_base=aut&amp;ccl_term=ica=ph413831&amp;CON_LNG=ENG">2</a></span></span></li></ul></li></ul></div></td></tr></tbody></table></div> <!-- NewPP limit report Parsed by mw‐web.codfw.main‐7dfdf5498‐nnwll Cached time: 20250220113643 Cache expiry: 2592000 Reduced expiry: false Complications: [vary‐revision‐sha1, show‐toc] CPU time usage: 1.080 seconds Real time usage: 1.244 seconds Preprocessor 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