Info
autologous_stem_cell_transplantation
Description
High-dose therapy & autologous stem cell transplant (ASCT) rely on cytotoxic effects of HDC/radiation to treat hematologic malignancies followed by infusion of auto stem cells to “rescue” from profound pancytopenia (generally no significant graft-vs.-malignancy effect) Tx intent (curative vs. palliative) depends on dz
- Indications-of-autologous_stem_cell_transplantation
- Pretransplant evaluation
- Stem cell source
- Stem cells should be collected prior to exposure to an alkylator (eg, melphalan), nitrogen mustard or purine analog as these agents are stem cell toxic
- Collection is done by PBSC apheresis following G-CSF ± plerixafor or chemomobilization (BM harvesting only very rarely used for ASCT)
- Collected CD34+ stem cells are cryopreserved until time of transplant
Conditioning regimens
- All conditioning regimens are myeloablative & combine HDC ± radiation given prior to stem cell infusion to eradicate dz
- Melphalan-based regimens are commonly used for the tx of plasma cell dyscrasias & lymphoma (commonly treated w/ BEAM: BCNU, Etoposide, Ara-C, Melphalan)