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The hematopoietic stem cells or HSCs are multipotent, meaning they can differentiate and give rise to all blood and immune cells. HSCs are maintained in the quiescent stage until an external stimulus initiates their differentiation. The multipotent HSCs exist as two heterogeneous populations, long-term repopulating cells (LTRC) and short-term repopulating cells (STRC). The two HSC populations have different surface markers or receptors and are classified based on quiescence and long-term...
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All blood and immune cells are produced from the multipotent hematopoietic stem cells (HSCs) by the process of hematopoiesis. However, they all have a limited life span. In addition, many are depleted in immune surveillance or combatting an injury or infection. This makes blood one of the most regenerative tissues. Hematopoiesis helps replenish these blood and immune cells, restoring the body's normal functioning. However, overproduction of blood and immune cells can make them cancerous or...
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Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
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In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
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Isolation and Transplantation of Hematopoietic Stem Cells HSCs
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Pediatric hematopoietic cell transplantation.

Kathryn Walsh1, Steven Margossian2, Christine N Duncan2

  • 1Department of Anesthesia and Critical Care, Boston Children's Hospital, Boston, MA, USA.

Journal of Pediatric Intensive Care
|June 20, 2019
PubMed
Summary

Hematopoietic cell transplantation offers a cure for many pediatric diseases. This review covers transplantation processes, stem cell sources, complications, and diseases treatable with this therapy.

Keywords:
Hematopoietic cell transplantationbone marrow transplantchildrenhematopoietic stem cell transplantationpediatricsstem cell transplantation

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Area of Science:

  • Pediatric Hematology
  • Oncology
  • Immunology

Background:

  • Hematopoietic cell transplantation (HCT) is a vital curative therapy for pediatric cancers and nonmalignant disorders.
  • HCT has expanded indications and improved supportive care, enhancing its efficacy.
  • Advances in HCT have broadened its application in treating complex pediatric conditions.

Purpose of the Study:

  • To provide a comprehensive overview of pediatric hematopoietic cell transplantation.
  • To detail the evolving landscape of HCT, including indications and supportive care.
  • To summarize key aspects of the transplantation process, donor sources, complications, and treatable diseases.

Main Methods:

  • Literature review of hematopoietic cell transplantation in pediatric patients.
  • Synthesis of current knowledge on HCT procedures, donor selection, and stem cell sources.
  • Analysis of common and severe complications associated with HCT.
  • Compilation of diseases for which HCT is a viable treatment option.

Main Results:

  • Hematopoietic cell transplantation is a well-established treatment for numerous pediatric malignant and nonmalignant conditions.
  • The review details various stem cell sources and donor options for pediatric HCT.
  • Common and rare complications, alongside management strategies, are discussed.
  • A broad spectrum of diseases amenable to HCT is presented.

Conclusions:

  • Hematopoietic cell transplantation remains a cornerstone therapy in pediatric hematology and oncology.
  • Continued advancements in HCT protocols and supportive care are expanding its therapeutic potential.
  • Understanding the process, sources, complications, and indications is crucial for successful pediatric HCT outcomes.