HSC Transplantation

Transplantation is nothing more than the infusion of HSC into the patient. Before infusion, the graft can be treated to deplete the T cells as GVHD prophylaxis. In case of an ABO blood group incompatibilty, the bulk of the erythrocytes can be removed to avoid massive hemolysis. The donor stem cells will replace the recipient cells destroyed by conditioning.
The number of HSC in a graft is usually below 1%. CD34 is a cell surface molecule which may be used as a marker to measure the number of HSC in the graft.

After transplantation, the donor’s HSC migrate to the bone marrow, where they start to produce the precursors of all hematopoietic lineages. Thereafter, the recipient will have a new hematopoietic system as well as a new immune system of donor origin. By contrast, the non-lymphoid stromal cells in the primary and secondary lymphoid organs will remain of the recipient type. Several factors have influence on reconstitution of hematopoiesis and immunity.