A Comprehensive Review of Hematopoietic Stem Cell Transplantation

College of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, 510006, No. 232, Outer Ring East Road, Gu angzhou University, Panyu District, Guangzhou City, Guangdong Province, China

^* Corresponding author: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Leukemia is a malignant clonal disease originating from hematopoietic stem cells. The incidence rate of leukemia is 3 to 5 per 100,000 people. Hematopoietic stem cell transplantation (HSCT) is the most common clinical therapy for leukemia. This article details the molecular biological processes and functions of HSCT, including donor-recipient matching, preconditioning-induced microenvironment changes, stem cell homing, engraftment, and reconstruction of the hematopoietic and immune systems. During matching, it is required that the human leukocyte antigens (HLA) of the donor and recipient be as fully matched as possible. The higher the matching degree, the lower the risk of graft-versus-host disease (GVHD) after transplantation, and the higher the success rate. Before transplantation, patients undergo high-dose chemotherapy and radiation therapy for preconditioning to eliminate tumor cells in the body. After being transplanted into the body. hematopoietic stem cells migrate directionally to the bone marrow niche and establish contact with supportive cells. Under the stimulation of microenvironment signals, they begin to self-renew and produce all types of blood cells. The new immune cells differentiated from donor HSCs gradually replace the patient’s original immune system, which may be dysfunctional, restoring the defense capability against pathogens.