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Hematopoietic Stem Cell Transplantation (HSCT)

A complex, potentially curative treatment in hematologic malignancies and bone marrow failure.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Hematoloji department. Book Appointment →

What is Hematopoietic Stem Cell Transplantation (HSCT)?

Hematopoietic stem cell transplantation (HSCT) is the procedure in which the bone marrow is eradicated by high-dose chemotherapy and/or radiotherapy and replaced through the infusion of healthy hematopoietic stem cells. HSCT has two main forms: autologous (the patient's own stem cells) and allogeneic (from a donor — fully HLA-matched sibling, unrelated donor, or cord blood). It is one of the most important treatment modalities in modern hematology and oncology.

Autologous HSCT is used in multiple myeloma, lymphomas, certain solid tumors (germ cell tumors, neuroblastoma), autoimmune diseases, and some hereditary conditions. Because the patient's own stem cells are used, there is no risk of graft-versus-host disease (GVHD). The aim is to maximize the antitumor effect of high-dose chemotherapy while rescuing the bone marrow with stem cell infusion.

Allogeneic HSCT is used in acute leukemias (AML, ALL), myelodysplastic syndromes, aplastic anemia, hereditary blood disorders (thalassemia, sickle cell), chronic myeloid leukemia (rarely), and other diseases. The major advantage is the graft-versus-leukemia (GVL) effect: donor immune cells mount a response against the patient's cancer. The principal complication is acute and chronic GVHD. Allogeneic HSCT is the only curative option in some diseases.

Symptoms

Conditioning regimen side effects: nausea, mucositis, alopecia
Pancytopenia until engraftment: infection and bleeding
Graft-versus-host disease (acute: skin, GI tract, liver; chronic: multiple organs)
Engraftment syndrome: fever, rash, dyspnea
Infection: bacterial, viral (CMV, HSV, VZV), fungal, PCP
Veno-occlusive disease (sinusoidal obstruction syndrome): jaundice, ascites, weight gain
Pulmonary complications: idiopathic pneumonia syndrome
Late effects: secondary malignancy, infertility, endocrine disorders

Risk Factors

Older age (typically over 60 for autologous, over 65 for allogeneic)
Poor performance status
Comorbidities (cardiac, renal, hepatic)
HLA mismatch (GVHD risk in allogeneic transplant)
CMV serostatus (donor-recipient mismatch)
Intensity of prior treatment
Active infection
Refractory disease before transplant

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Evaluation at an HSCT center for hematologic malignancy or marrow failure
  • Fever, bleeding, or neurological symptoms after HSCT — urgent
  • Signs of GVHD (rash, diarrhea, jaundice) — admission
  • Long-term post-transplant follow-up: endocrine, cardiac, skin screening
  • Lifelong surveillance for secondary malignancy

Treatment Methods

01
Conditioning regimens: high-dose (myeloablative) or reduced-intensity
02
Stem cell sources: peripheral blood, bone marrow, cord blood
03
GVHD prophylaxis: cyclosporine/tacrolimus + methotrexate/MMF, PT-Cy
04
Infection prophylaxis: acyclovir, trimethoprim-sulfamethoxazole, fluconazole
05
Post-transplant monitoring: engraftment, chimerism, MRD, GVHD
06
Haploidentical transplant: half-matched relative — broad donor pool
07
Supportive care: transfusion, G-CSF, mucosal protectants
08
Long-term: gradual immunosuppression taper and revaccination

Which Department to Visit?

You can visit our Hematoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.