Allogeneic hematopoietic stem cell transplantation (allo HSCT)

Allogeneic hematopoietic cell transplantation (allo-HCT) can be a curative therapy for patients with hematological malignancies. However, it poses a significant risk for post-transplant mortality due to graft-versus-host disease (GVHD). The number of allogeneic hematopoietic stem cell transplants performed worldwide is steadily increasing. Consequently, the absolute number of complications, particularly GVHD, also rises.

Allogeneic hematopoietic stem cell transplantation (HSCT) involves:

1. Administration of a conditioning regimen that includes chemotherapy (CT) drugs, with or without radiation.


2. Infusion of hematopoietic progenitor cells from healthy donors.

Hematopoietic stem cell transplantation allows for maximal chemoradiotherapy and subsequent bone marrow regeneration. However, it also involves specific and nonspecific immune responses known as graft-versus-leukemia (GvL) effects.

In summary, while allo-HCT offers a potential cure for hematological malignancies, it comes with significant risks, particularly GVHD, which necessitates careful management and monitoring.

References:
Copelan 2006 N Engl J Med 354(17): 1813-26
Tschiedel et al. 2008
Noor et al. 2019
Shouval et al. 2019 Clinical Hematology International 1(1): 28-35
Bilinski et al. 2022 Biomedicines 10: 837
Paredes et al. 2023 Cancer Res 83 (7_Supplement): 643

In people who receive a donor stem cell transplant (HCT) or have acute myeloid leukemia (AML), damage to gut bacteria has been linked to worse health results.
Rashidi et al. 2023 Journal of Clinical Oncology 41(34):

Immune reconstitution following allogeneic hematopoietic stem cell transplantation (allo-HSCT) sets the stage for the goal of a successful transplant - the prevention of disease relapse without graft versus host disease (GvHD) and opportunistic infection
Fiorenza & Turtle 2021

see also:
Adverse Events / Safety & Allogeneic hematopoietic stem cell transplantation (allo HSCT)
Graft-Versus-Host Disease (GVHD)