Bone marrow transplantation (BMT) and hematopoietic cell …

What are hematopoietic cell transplantation (HCT) and peripheral blood stem cell transplantation (PBSCT)?

HCT and PBSCT are procedures that use stem cells to treat a patient's malignancy or to repair diseased or defective bone marrow. A patient receives intensive chemotherapy with or without total body irradiation therapy in an attempt to kill all cancerous cells, but which also destroy his/her own bone marrow function. This therapy also causes immunosuppression, which prevents rejection of the newly transplanted stem cells from a related or unrelated donor.

There is little risk of rejection of a patient's own stem cells following autologous transplant. After transplantation, the new stem cells replace the damaged bone marrow and cells of the immune system.

HCT and PBSCT allow a patient to receive very high doses of chemotherapy and radiation designed to kill cancer cells. The high doses of therapy lead to the destruction of a patient's own marrow and immune system, which is then replaced by marrow from a donor or from peripheral blood stem cells that have been harvested before therapy.

City of Hope has performed more than 12,000 transplants for patients from virtually every state as well as from numerous countries. HCT and PBSCT patients at City of Hope have ranged in age from less than 1 year old to 79 years old. City of Hope's HCT program is one of America's largest, dedicated solely to the traditional and newer uses of this procedure.

Patients receive one of two types of stem cell-based transplants: autologous, in which a patient donates and receives back his/her own stem cells; or allogeneic, in which bone marrow-derived stem cells come from a related or unrelated donor whose human leukocyte antigens (HLA) are genetically matched with those of a patient.

Peripheral blood stem cells are generally used in autologous transplantations, while either marrow or peripheral blood stem cells are used in allogeneic transplantations.

This process was first used in the early 1970s. City of Hope's HCT Program began in 1976. City of Hope began performing PBSCTs in 1988.

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