What are the types of Haematolopoietic Stem Cell Transplant (HSCT)/Bone Marrow Transplants (BMT), and what are the implications relating to each of those types of bone marrow transplants?
BMT can be classified according to the origin of the cells (peripheral or bone marrow); the donor of the cells (autologous or allogenic); and the intensity of the conditioning (myeloablative or reduced intensity conditioning).2
Stem cells are derived from one of two sources: firstly, from the patient (an autologous transplant) or from a human leukocyte antigen (HLA) matched donor (an allogenic transplant) such as a twin or other relation (the better the quality of the match, e.g. identical twin, the lower the risk of complication). An allogenic transplant can also come from a matched unrelated donor (MUD).3 The less well matched the source of the transplant, the more intensive the conditioning that occurs pre-transplantation. This leads to a higher rate of complications; therefore, allogenic transplants are associated with a higher rate of morbidity and mortality. Furthermore, more intense immunosuppression is required with allogenic transplants to prevent rejection