immunology allergic disorders
Hematopoietic Stem Cell Transplantation
Prognosis for Hematopoietic Stem Cell Transplantation
Prognosis after hematopoietic stem cell transplantation varies by the type of transplant (autologous vs allogeneic) and the recipient's disease. Overall, disease relapse occurs in 40 to 75% of recipients of autologous hematopoietic stem cell transplants 10 to 40% of recipients of allogeneic hematopoietic stem cell transplants Overall, success (cancer-free bone marrow) rates are 30 to 40% for patients with relapsed, chemotherapy-sensitive lymphoma 20 to 50% for patients with acute leukemia Compared with chemotherapy alone, hematopoietic stem cell transplantation improves survival of patients with multiple myeloma. Success rates are low for patients with more advanced disease or with responsive solid cancers (eg, germ cell tumors). Relapse rates are reduced in patients with graft-vs-host disease (GVHD), but overall mortality rates are increased if GVHD is severe. Intensive conditioning regimens, effective GVHD prophylaxis,cyclosporine-based regimens, and improved supportive care (eg, antibiotics as needed, herpesvirus and cytomegalovirus prophylaxis) have increased long-term disease-free survival after hematopoietic stem cell transplantation. 