Talk:Hematopoietic stem cell transplantation

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[edit] Risks to donor

How does the donor feel after donating? Any side-effects to Donor? Any scars or hints or surgery to donor? Weakness??

Thanks. —Preceding unsigned comment added by 67.175.105.145 (talk) 23:52, 16 May 2008 (UTC)

[edit] BMT article history

Older versions of this article (prior to having it's title changed from BMT to HSCT) can be viewed on the old BMT history page. Mfero 16:31, 1 March 2007 (UTC)

Ouch! That is not the preferred way to do it... I'll see if I can get an admin to merge the histories. // habj 09:27, 26 June 2007 (UTC)
Page historied merged by AzaToth. // habj 21:18, 26 June 2007 (UTC)

Vandalism? I took out the words "don't read this if you want to live..." from the "Types of donors" section while I was reading this page. 74.12.210.220 23:58, 3 May 2007 (UTC) A wikipedia reader

[edit] BMT article title

I've expanded most of the sections on the Bone Marrow Transplant page. My apologies if I messed anything up.

I'd like to know if anyone has an opinion about moving the page to "Hematopoietic Stem Cell Transplant"? "Bone mone marrow transplant" would then be a redirect. Even though HSCT is more modern and accurate than BMT for the topic it is still a little more awkward. Also there are a huge number of links to this page and probably many of them should be changed.Mfero

No, keep it here. Most lay readers will not have a clue what a haematopoeitic stem cell is, and the fine distinctions between BMT and HSCT. Just redirect HSCT here. JFW | T@lk 06:48, 11 July 2005 (UTC)
I totally agree with the first guy, that this article really should be titled HSCT, with a redirect from the bone marrow transplant title to HSCT main page. Very few patients get bone marrow transplants anymore, since peripheral blood stem cell transplants are safer and more effective...I think I'm going to do it tonight, since this doesn't seem like a very active concern--64.166.186.217 23:33, 15 February 2007 (UTC)

I'd be fine with moving it - this comes up a lot: whether to use the more medically exact and correct term, or the one more likely to be recognizable to a wide audience. I think moving the page to HSCT, and leaving "bone marrow transplant" as a redirect would be fine. To quibble, stem cells are more effective for a lot of indications, but in conditions where graft-vs.-tumor is not a consideration (eg aplastics), bone marrow is still a preferred source. MastCell 23:46, 15 February 2007 (UTC)

Hi--I moved and updated the BMT page to the HSCT page, updated links and talk page. Someone had to move HSCT into the 1990s! I think MastCell is correct about the preference for BMT in AA, and that's an excellent point that somehow should be inserted in the mainpage. I will verify this with my friendly neighborhood transplanter.--Dr.michael.benjamin 06:55, 20 February 2007 (UTC)

[edit] Merge with 'Stem Cell Transplant'?

This page currently has a large disclaimer stating that it has been suggested to merge it with the article entitled Stem cell transplantation. The latter article is not a really a new article but is derived from the Bone marrow transplant article that I contributed to several years ago. The biggest change seems to be the photograph showing bone marrow being aspirated in the operating room.

IMO the current (HSCT) article is has become messy. I don't mind the aspiration photo on the SCT page but it should be made clear that this refers to the older method of harvesting marrow under anesthesia as opposed to a peripheral blood stem cell harvest. I suppose the real question is whether this the name of this article should be renamed from 'Hematopoietic Stem Cell Transplantation' to simply 'Stem Cell Transplantation'. Even though I think the Stem Cell Transplant version looks better I would argue that the name should not be changed. The reason is that the term stem cell transplant could, in theory, refer to organs other than the blood and bone marrow and is not specific enough for this article.

Thus I would be in favor of the following: 1. Keep Hematopoeitic Stem Cell Transplantation as the primary article. 2. Adopt the text (and photo) from 'Stem Cell Transplant' --or at least clean up the current version of HSCT. 3. Delete the (redundant) 'Stem Cell Transplantation' page. 4. Make 'Stem Cell Transplantation' redirect here.

Any thoughts? --Mfero 00:43, 25 October 2007 (UTC)

I just got the SHOCK - I was editting this page yesterday and never noticed the "merge" suggestion, and there it is, the mirror page. I definitely agree that it should be sone, and the re-direct solves any issue of technical correctness or popularity for readers. But have the technical difficulties prevented the merge all these months? I take it that there is no wiki tool to accomplish this. If consensus exists already, I would try maybe at the weekend (if the tax returns dont get in the way) - any volunteers to assist in proofreading?io_editor (talk) 02:05, 9 April 2008 (UTC)

HSCT/BMT should stand alone. The field developed in a very specific manner, and its history and unique characteristics should be preserved 141.106.78.144 (talk) 21:01, 23 May 2008 (UTC)Rimas

[edit] Conditions treated with BMT

Myelodysplasia is a common indication for allogeneic transplants in adults, second only to AML in terms of frequency. The risk/benefit ratio depends on the age of the patient, donor availability, features indicating a high risk of transformation to AML, and the expertise level of the transplant center. Mfero 20:59, 17 September 2005 (UTC)

[edit] General anesthetic?

"In the case of a bone marrow transplant (BMT), the HSC are removed from a large bone of the donor, typically the pelvis, through a large needle that reaches the center of the bone. The technique is referred as a bone marrow harvest and is performed with general anesthesia because literally hundreds of insertions of the needle are required to obtain sufficient material."

I thought this was actually done under a local, which would explain why people say that donating bone marrow is extremely painful. Can someone clear this up for me? --El Zilcho 17:18, 22 March 2006 (UTC)

Bone marrow harvests are generally done in the operating room under general anesthesia. On the other hand, a stem cell transplant can be also done through a peripheral blood collection of stem cells (after the bone marrow has been stimulated with medication). Andrew73 19:32, 22 March 2006 (UTC)

[edit] Forensic Post

ChristineD, please site a credible reference for your last edit. A fictional one will not suffice as an accurate source. Ktinga

Agreed... I've heard of this happening on, say, Law and Order, but I'm not aware of any real-life cases. If one could be cited, then by all means let's include it. Until then, I think describing it as an "eventuality" is a little inappropriate. MastCell 21:47, 16 October 2006 (UTC)


[Mammalian Red Blood] Do not have DNA or a nucleus so it appears to be fiction. Ktinga 16:13 17 Oct 2006 (UTC)
To be fair, after a transplant all cellular elements of the blood are replaced by donor cells, including the white cells, which contain DNA and are presumably the substrate for forensic DNA testing. MastCell 18:16, 17 October 2006 (UTC)

The fictional reference wasn't intended as a source, just as an example (could do a section BMT in literature?). I read an article in a newspaper (but I have no memory of where or when) in which a real life police person said this was a real problem. That was the basis for including this section. I hoped that once it was out there the reference could be added by someone who knows more.

Anyway I've looked it up on Pub med now and the abstract for this article (What do the X and Y chromosomes tell us about sex and gender in forensic case analysis? ) mentions it ('Problems may arise not only from false detection (or non-detection) of amelogenin-specific fragments, but also in cases of chimerism (bone marrow transplants) or micro chimerism (pregnant women carrying male fetuses)...'). I don't have online access to the papers from home to find an original source for this particular question, however, I will see to it soonest and then revert

but I'm not aware of any real-life cases

I think the idea of thinking about eventualites is so that it doesn't happen in real life. This is a real issue but hopefully by increasing awareness of it, any real life cases can be resolved quickly and not end up reported in the media as a miscarriage of justice. ChristineD 21:06, 29 October 2006 (UTC)

[edit] External Links

Hi. I tried to add an external link to the EBMT website, but it was removed. I would just like to know why it doesn't qualify and where could it be added? Thanks. Melisa —The preceding unsigned comment was added by Mfero (talk • contribs).

A link to EBMT should be fine. Not sure why it was removed (perhaps an innocent casualty of a mass spam deletion), but go ahead and re-add it. MastCell 17:23, 1 March 2007 (UTC)
Is it just me, or is the third external link an advertisement for a company that wants your stem cells? Advertising has to be against some sort of wikipedia policy. If nothing else then for writing the description in the first person. SkaryMonk (talk) 17:26, 27 May 2008 (UTC)

[edit] Autologous as its own section?

Just wondering. The side effects of autologous and allogeneic stem cell transplantation are reasonably different. This is intimated in the paragraph about autologous transplant but I'm wondering if this neds to be clarified, say after the section on allogeneic stem cell complications.. ie. indications, method, outcomes and complications for autologous so that readers don't get them confused? Markjohndaley 14:43, 14 June 2007 (UTC)

I think that's a good suggestion. Feel free to go for it; I've been meaning to work on this page for awhile but not sure when I'll get around to it. MastCell Talk 16:22, 14 June 2007 (UTC)
I agree. Autologous SCT has sufficiently different indications, processes and results (side effects etc.) from Allogenic to warrant its own section (if not its own full blown page). Go for it. Lorangriel 16:25, 14 June 2007 (UTC)

[edit] History

The article lacks a history section. When was the first bone marrow transplant performed, etc. // habj 06:03, 26 June 2007 (UTC)

[edit] Historymerge

History merge completed! →AzaToth 18:33, 26 June 2007 (UTC)

[edit] Who can donate?

There could be a section on what conditions are prohibitive in marrow donors. For example, I think the British NHS does not accept donors with rheumatic conditions e.g. lupus, rheumatoid arthritis etc. 212.179.71.70 (talk) 08:48, 31 December 2007 (UTC)

While there are some absolute barriers to donation, which vary from organization to organization, most cases are a bit more fluid. The decision about whether to use a donor with certain health conditions may be individualized to take into account the known risks to the donor and recipient as well as the seriousness of the donor's condition and how serious and immediate the need for a transplant is, as well as the availability of alternate donors or stem cell sources. That said, any sourced info you can dig up would be useful to add. MastCell Talk 20:27, 31 December 2007 (UTC)

[edit] Someone was trying to say something

In graft v tumor effect, someone was trying to say something, and it came out wrong: "This lower rate of relapse accounts for the increased success rate of allogeneic transplants compared to transplants from identical twins, and indicates that allogeneic HSCT is a form of immunotherapy." Am referring mainly to fist clause, did they mean HLA-mis-matched v HLA-matched allogeneics? And where is the source?? New to me....io_editor (talk) 02:32, 9 April 2008 (UTC)

If you compare syngeneic transplants (that is, from one identical twin to another) with allogeneic transplants (between HLA-matched or mismatched individuals), the allogeneics will have lower relapse rates (of course, they'll also get GVHD). This difference in relapse rates between syngeneic and allogeneic transplants was one of the main pieces of clinical evidence for the existence of an immunologic graft-vs.-tumor effect. Does that make sense? It needs to be written more clearly. This article has been on my list for awhile; hopefully I can help out on it soon. MastCell Talk 04:49, 9 April 2008 (UTC)
Well, my brain registered just siblings, not identical twins, when the comparator wasn't autologous. There must be on the order of 100-300 per year of such HSCTs worldwide. Funny ordering of logic (general plus the obscure) but all is correct, so am inclined to leave it. Actually I think this is a great WikiMed page (although it could have a dozen more cites) - simply because it manages to avoid going off-tangent, except for such interesting details.io_editor (talk) 01:03, 12 April 2008 (UTC)

[edit] Indications

It doesnt really work that Indications is up the page, and that this is down the page. Suggestions? Cant think of any, other than to move the list up, even if that means removing some prose. Will leave it alone for now.io_editor (talk) 02:43, 15 April 2008 (UTC)

[edit] Merge with 'Stem Cell Transplant'? (proposal copied from above)

This page currently has a large disclaimer stating that it has been suggested to merge it with the article entitled Stem cell transplantation. The latter article is not a really a new article but is derived from the Bone marrow transplant article that I contributed to several years ago. The biggest change seems to be the photograph showing bone marrow being aspirated in the operating room.

IMO the current (HSCT) article is has become messy. I don't mind the aspiration photo on the SCT page but it should be made clear that this refers to the older method of harvesting marrow under anesthesia as opposed to a peripheral blood stem cell harvest. I suppose the real question is whether this the name of this article should be renamed from 'Hematopoietic Stem Cell Transplantation' to simply 'Stem Cell Transplantation'. Even though I think the Stem Cell Transplant version looks better I would argue that the name should not be changed. The reason is that the term stem cell transplant could, in theory, refer to organs other than the blood and bone marrow and is not specific enough for this article.

Thus I would be in favor of the following: 1. Keep Hematopoeitic Stem Cell Transplantation as the primary article. 2. Adopt the text (and photo) from 'Stem Cell Transplant' --or at least clean up the current version of HSCT. 3. Delete the (redundant) 'Stem Cell Transplantation' page. 4. Make 'Stem Cell Transplantation' redirect here.

Any thoughts? --Mfero 00:43, 25 October 2007 (UTC)

Many months later, its time to do it, exactly as was suggested above. Step 2 is done, and Steps 1, 3 and 4 can be done now. Bone marrow transplantation would remain separate. I assume an Admin is needed to formalize.io_editor (talk) 16:55, 19 April 2008 (UTC)

[edit] Risks to donor

How does the donor feel after donating? Any side-effects to Donor? Any scars or hints or surgery to donor? Weakness??

Thanks. —Preceding unsigned comment added by 67.175.105.145 (talk) 23:51, 16 May 2008 (UTC)