Overview of Hematopoietic Stem Cell Transplantation

Hematopoietic stem cell transplantation (HSCT) is currently a standard-of-care procedure for many disorders to provide a potential cure in situations where no other curative treatment options exist. The key element in HSCT is the replacement of the host (recipient) marrow function by another source of hematopoietic stem cells (HSC), from either the patient or a human leukocyte antigen (HLA)-compatible family member or unrelated donor. In the setting of a donor HSCT, products are preferentially matched at major histocompatibility complex (MHC) HLA class I and II molecules located on chromosome 6, which guide immunologic recognition as self or nonself. Advances across the field have contributed to improvements in disease control and overall survival, resulting in a marked increase in the number of procedures performed annually worldwide. It is also recognized that these patients still face a significant morbidity and mortality substantiating the continued need for ongoing research. There are many areas of active research encompassing all phases of the transplant procedure. However, with the advancements in technology comes challenges including workforce shortages and challenge in provision of long-term and survivorship care.