Allogeneic and autologous transplantation have been used with great success over the past 3 decades in the management of patients with otherwise incurable malignant disorders. Increasingly, transplantation is used for nonmalignant conditions as well. Its role continues to evolve as modifications in conditioning, graft-versus-host disease (GVHD) management, supportive care, and stem cell source widen its applicability.


Allogeneic transplantation
 
Stem cell sources
Bone marrow harvest was the original method for acquiring hematopoietic stem cells (HSCs) for clinical transplantation, but mobilized blood stem cells and cord cells are now commonly used. Many now use the term "hematopoietic stem cell transplantation" (SCT) instead of the term "bone marrow . . . [Full Text of this Article]

Histocompatibility and HLA typing
Class I
Class II
Typing
Donor types
Related donors
Unrelated donors
Cord blood
Haploidentical-related donors
Peripheral blood versus bone marrow
Conditioning regimens
Myeloablative regimens
Nonmyeloablative conditioning
Conditioning for benign hematologic disorders
Complications of allogeneic transplantation (Table 14-2)
Graft-versus-host disease: features, risk factors, prophylaxis, and treatment
Acute GVHD
Chronic GVHD
Failure of sustained engraftment
Infections
Venoocclusive disease/sinusoidal obstruction syndrome
Cardiac and pulmonary toxicity
Idiopathic pneumonia syndrome
Diffuse alveolar hemorrhage
Transplant-related obstructive airway disease
Thrombotic microangiopathy
Bleeding

Autologous transplantation
 
Stem cell collection and manipulation
Conditioning regimens for autologous transplantation
Complications of autologous transplantation

Transplantation for specific diseases
 
Non-Hodgkin lymphoma
Aggressive lymphomas
Indolent lymphoma
Hodgkin lymphoma
Plasma cell dyscrasia
Acute myelogenous leukemia
Acute lymphoblastic leukemia
Chronic myelogenous leukemia and chronic lymphocytic leukemia (CLL)
Aplastic anemia and other autoimmune diseases
Hemoglobinopathies
Thalassemia major
Sickle cell disease
Immune deficiency disorders
Inherited metabolic disorders
Stem cell transplantation for solid tumors
Renal carcinoma
Breast cancer
Germ cell cancer
Pediatric solid tumors
Neuroblastoma
Ewing sarcoma
Rhabdomyosarcoma
Late effects and long-term follow-up after transplantation
Endocrine side effects
Musculoskeletal complications
Psychosocial considerations
Second malignancies and PTLD

Summary