Chapter 23 - Bone Marrow-Derived Stem Cells

Abstract

Bone marrow (BM) is one source of hematopoietic stem cells. BM-derived stem cell products contain stem cells and hematopoietic progenitor cells that are committed to particular hematopoietic lineages; hence, the term “hematopoietic progenitor cells” (HPC) is more accurate than “stem cells.” There are two major sources of human BM HPCs. Autologous BM transplants are performed using BM HPCs donated by the person who is also the recipient of the transplant. Allogeneic BM transplants use BM HPCs donated by a person other than the recipient. BM cell transplants are still relatively new when compared with transfusions of other commonly used blood products and derivatives. Gene transfer into repopulating hematopoietic cells to correct or regulate blood cell related disease would create many therapeutic opportunities;but, still bioethical issues have haunted this process. In some cases, it also presents several adverse effects. Acute adverse reactions to allogeneic BM transplant infusions include hemolytic reactions, allergic reactions (mild or anaphylactic), reactions to rapid volume changes, febrile nonhemolytic reactions, fluid overload reactions, and sepsis or endotoxic shock. Graft-versus-host Disease is another potentially serious adverse reaction of allogeneic BM-HPC transplants. Allogeneic transplants may also transmit the same infectious diseases that can potentially be transmitted by blood transfusions.