Hematopoietic Stem Cell Transplantation

Author: David M. Falleur, M.Ed., MT(ASCP)
Reviewer: Laurie Bjerklie, MA, MLS(ASCP)CM
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Continuing Education Credits

P.A.C.E.® Contact Hours: 1 hour(s)

Florida Board of Clinical Laboratory Science CE Credit Hours

Florida Board of Clinical Laboratory Science CE - General (Hematology): 1 hour(s)

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Hematopoietic stem cell (HSC) transplantation has become a procedure that offers hope to many patients with cancer and other life-threatening diseases. This course aims to provide information about the importance of HSC transplantation and the role played by the clinical laboratory in HSC collection, processing, administration, and the patient's ongoing care after transplant. The sources of HSCs used in transplants, their application in the treatment of malignant and nonmalignant disorders, and the complications associated with HSC transplantation are also discussed.

Objectives

  • Identify the three sources of hematopoietic stem cells (HSCs).
  • Describe the appropriate use of umbilical cord, bone marrow, and peripheral stem cells in the treatment of malignant and nonmalignant disorders.
  • Describe the role of the clinical laboratory in HSC collection, processing, administration, and patient care following transplantation.
  • Recognize complications associated with HSC transplantation and procedures to prevent or minimize them.
  • Summarize the National Marrow Donor Registry campaign and the importance of HSC transplantation.

Course Outline

  • Overview and History
    • History
  • Hematopoietic Stem Cells
    • Hematopoietic Stem Cells
    • Progenitor Cells
    • Important Definitions
    • Which CD antigen is present on hematopoietic stem cells (HSCs)?
  • Sources of Hematopoietic Stem Cells
    • Sources of Hematopoietic Stem Cells: Bone Marrow
    • Sources of Hematopoietic Stem Cells: Peripheral Blood
    • Sources of Hematopoietic Stem Cells: Umbilical Cord Blood
    • What is the most frequent source of HSCs used for transplantation?
    • Which allogeneic HSC donation procedure is most commonly used today?
  • Preservation and Infusion of HSCs
    • Preservation and Infusion of HSCs
    • Preservation and Infusion of HSCs, continued
    • What agent is used as a cryopreservative for long-term storage of HSCs?
    • A transplant patient is tested for T cells after immunosuppression therapy. The following data is obtained by flow cytometry from the patient’s peripheral blood:Total WBC = 2,200/mcL (2.2 × 109/L)Total lymphocytes = 25%T lymphocytes = 12%B lymphocytes = 86%What is the patient’s absolute T cell count?
    • Successful engraftment of a hematopoietic stem cell transplant depends on many factors. Which of the following choices is not associated with graft failure?
  • Human Leukocyte Antigen Testing for HSC Transplantation
    • Human Leukocyte Antigens and HSC Transplantation
    • Table 2: Major Histocompatibility Complex
    • Donor and Recipient Testing of Human Leukocyte Antigens
    • Match the class of the MHC antigens with the appropriate term/description.
    • What type of specimen is used for HLA typing of prospective donors by the National Marrow Donor program?
  • Recruiting and Matching Donors with Patients
    • Finding Donors for Transplant Patients
    • Donor Requirements and Testing
    • Matching Donors with Transplant Recipients
    • What US organization's major goal is the recruitment of donors for allogeneic HSC transplants?
    • Which of the following would exclude a potential HSC donor from the National Marrow Registry?
  • Preparing the Patient for Transplant
    • Preparing the Patient for Transplant
  • Hematopoietic Diseases Treatable by HSCs
    • Treatment of Hematologic Diseases by HSC Transplantation
    • Which of the following would be the treatment of choice for a pediatric patient with acute lymphoblastic leukemia who had acute GVHD from a prior transplant?
    • Which hematologic malignancy is most commonly treated with an allogeneic HSC transplant?
  • Nonhematopoietic Diseases Treated by HSCs
    • HSC Transplants for Nonhematologic Diseases
    • Which nonhematologic disorder has not been treated by an HSC transplant?
  • Complications of HSC Transplantation
    • Graft versus Host Disease
    • Which of the following has a cytotoxic effect on lymphocytes?
    • Graft Failure
    • Relapse
    • Infection
    • Late Effects After HSC Transplantation
    • ABO Incompatibility in HSC Transplants
    • Graft versus Tumor Effect
    • What is the most likely cause of secondary malignancy in HSC transplant patients?
    • What laboratory test result might indicate that a patient is experiencing GVHD?
    • Which of the following factors may precipitate a graft versus host disease (GVHD) reaction to occur?
    • Please match the following terms to their respective definitions.
  • Acknowledgements
    • Acknowledgements
  • References
    • References

Additional Information

Level of Instruction: Basic to intermediate
Intended Audience: Medical laboratory scientists, medical laboratory technicians, and pathology assistants. This course is also appropriate for MLS and MLT students and pathology residents.
Author Information: David Falleur, M.Ed, MT(ASCP), is an Associate Professor in the Clinical Laboratory Science Program at Texas State University in San Marcos, Texas. David has over 40 years of teaching experience in hematology and clinical chemistry. David has been active at the national level, previously serving as Annual Meeting Chair for the ASCLS Annual Meeting and at the state level as President of the Texas Association for Clinical Laboratory Science.
Reviewer Information: Laurie Bjerklie, MA, MLS(ASCP)CM, is currently an Education Developer for MediaLab and LabCE. She earned a B.S. in Medical Laboratory Science from the University of North Dakota and an M.A. in Curriculum and Instruction from Saint Xavier University. She has over 15 years of experience in higher education and has held program director and faculty positions in both MLT and MLS programs.
Course Description: Hematopoietic stem cell (HSC) transplantation has become a procedure that offers hope to many patients with cancer and other life-threatening diseases. This course aims to provide information about the importance of HSC transplantation and the role played by the clinical laboratory in HSC collection, processing, administration, and the patient's ongoing care after transplant. The sources of HSCs used in transplants, their application in the treatment of malignant and nonmalignant disorders, and the complications associated with HSC transplantation are also discussed.