82 – Hematopoietic stem cell transplantation for malignant diseases

Abstract Hematopoietic stem cell transplantation (HSCT) is an effective treatment for most hematological malignancies. Autologous HSCT targets malignancies in a dose-responsive manner, but regimen-related toxicities limit the intensity of the treatment regimen that can be given. Autologous HSCT may serve as a platform for subsequent therapies. Allogeneic HSCT offers a form of immunotherapy against malignancies, as demonstrated by a powerful graft-versus-tumor (GvT) effect in some malignancies. Allogeneic HSCT, however, has a higher incidence of morbidity and mortality from the similar graft-versus-host disease (GvHD), and maintaining a fine balance between GvT and GvHD is a continuing area of evolution, expertise, and research. The subtle nuances of donor selection, degree of human leukocyte antigen (HLA) disparity, type of conditioning regimen, and the choice of stem cell source all influence the outcome of allogeneic HSCT. Relapse is the most common cause of failure of autologous and allogeneic HSCT, and the use of immunotherapy during and/or after HSCT is the focus of research in this decade.