Cell Sources and Transplant Types

As a payor providing approval for a hematopoietic cell transplant (HCT), it is helpful to understand transplant terminology, the different sources of hematopoietic cells and the transplant type.

HCT, HSCT or BMT

• Hematopoietic stem cell transplant (HSCT)
• Blood or marrow transplant (BMT)

• Bone marrow transplant
• Peripheral blood stem cell (PBSC) transplant
• Cord blood transplant
  
  

Three cell sources

• Bone marrow, the soft tissue inside of bones, contains a large number of blood-forming cells or stem cells.
• PBSC are blood-forming cells collected from the bloodstream.
• Cord blood, which contains a large number of blood-forming cells, is collected from the umbilical cord and placenta immediately after a baby’s birth and is stored frozen in a cord blood bank.
  Depending upon the weight of the patient and cell dose (the number of stem cells) in a cord blood unit, more than one cord blood unit may be needed.

Choosing marrow, PBSC or cord blood

• Published data
• Availablility of a closely matched donor or cord blood unit
• Disease, disease stage, patient's age and co-morbidities
• Urgency of the transplant

For clinical information and references describing each cell source, see Hematopoietic cell sources tailored to the patient (marrow.org).

Transplant type

• An autologous transplant uses cells from the patient. The patient’s hematopoietic cells are collected when the disease is in remission and are stored for transplant.
• An allogeneic transplant uses cells from a family member (related allogeneic) or a volunteer donor or cord blood unit (unrelated allogeneic). The success of an allogeneic transplant is highly dependent upon the co-morbidities of the patient, disease stage and timing of the transplant and the degree of match between the human leukocyte antigen (HLA) type of the donor and patient.