Page 313 - Essential Haematology

Donor Patient
(HLA-matched sibling or unrelated donor) (recipient)

Bone marrow OR Leucopheresis of High-dose chemotherapy
aspirated from stem cells from ± total body irradiation
iliac crest peripheral blood
after G-CSF injections

± T-cell depletion

Donor stem cells Intensive support therapy,
infused intravenously e.g. red cells and platelets,
antibiotics + prophylaxis
against GVHD,
e.g. cyclosporin
± methotrexate
(a)

Patient Patient

Bone marrow OR Leucopheresis of High-dose chemotherapy
aspirated from stem cells from ± total body irradiation
iliac crest peripheral blood
after chemotherapy
and G-CSF injections

± attempts to remove
residual tumour cells, e.g.
by monoclonal antibodies

Stem cells Intensive support therapy,
infused intravenously e.g. red cells and platelets,
(after storage) antibiotics
(b)
Figure 23.1 Procedures for (a) allogeneic, and (b) autologous stem cell transplantation. G - CSF, granulocyte

colony - stimulating factor; GVHD, graft - versus - host disease; HLA, human leucocyte antigen. For non - myeloblative
(reduced intensity) allogeneic SCT, lower doses of chemotherapy with or without radiotherapy are used.