Hematopoetic stem cells

11 important questions on Hematopoetic stem cells

Which two forms of leukemia are there?

Myeloid leukemia and lymphoid leukemia

What are the characteristics of hematological malignancies

  • Uncontrolled growth of blood cells
  • often immature non-functional cells which invade the whole circulation (within the bone marrow, within lymph nodes & spleen, within the blood)
  • They suppress the development of normal blood cells, leading to anemia, more bleedings and persistent infections.
  • Treatment of these hematological malignancies is dependent on disease risk and health status of a patient (less harsh therapy is used for people with co-morbidities/people of old age)

What is a treatment option for leukemia patients?

Allogenic stem cells transplantation. First, chemotherapy is used as a standard therapy, in order to remove most of the leukemic cells. Then, donor blood is infused into the patient and the hematopoietic stem cells automatically go to the bone marrow. This method is also used to cure HIV.
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What is the main difference between leukemia and (solid) tumors?

Leukemia is a systemic process (takes over the whole blood circulation) while tumors are very local developments (usually within one organ).

From which 3 sources can stem cells obtained?

Bone barrow, peripheral blood stem cells and cord blood

What are the pros and cons of obtaining stem cells from bone marrow?

Pros: possibly less GVHD (graft-versus-host-disease)
Cons: slow reconstitution, higher relapse chance, painful for donor

How are peripheral blood stem cells isolated from donors?

Treating of donor with growth factor G-CSF, so the CD34+ cells will move from the bone marrow to the peripheral blood. Then an automated apheresis will take place, including centrifugation and enrichment of mononuclear cells.

What are the pros and cons of obtaining stem cells from peripheral blood?

Pros: easy to collect, quicker repopulation
cons: possibly higher GVHD, possibly higher relapse chance

How are stem cells from cord blood collected?

Cord blood is taken from the placenta. When a baby is born, the hematopoietic stem cells are not yet within the bone marrow of the child, they are present within the regular normal blood ciruclation (thus also within the placenta). This can be collected.

What are the pros and cons of isolating stem cells from cord blood?

Pros: easy to collect, and this blood can be stored within a cord blood bank
cons: often not enough cells, because small volume

How and why is the processing of allogeneic apheresis products done?

This processing is done for the enrichment of hematopoietic stem cells.
  1. spin down apheresis cells, remove plasma
  2. immunophenotyping of CD34+ cells and cell count
  3. possible manipulation (selecting CD34+ cells / depleting T cells)

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