Clinical use of hematopoietic stem cells

Abstract

Hematopoietic stem cells (HSC) have been used clinically since the 1950s. Towards the seventies, they have been started to be used routinely for therapeutic purpose in benign disorders of bone marrow (e.g. acquired severe aplastic anemia, Fanconi anemia, Thalassemia major, sickle cell anemia) and for postremission treatment consolidation purpose in malign disorders of bone marrow. Currently, 10 to 80 thousand HSC transplantations are performed annually and the one millionth transplantation was performed recently. Regarding the procedures performed in our country, the number of transplantation centers doubled during the last five years and the total number of transplantations reached 3,000s. The success of this universal and standard treatment method has accelerated studies on regenerative medicine. In this respect, cardiology has led the way, followed by neurological sciences and liver disorders and it was observed that the clinical use of bone marrow or peripheral blood HSCs for experimental purpose in various disorders has increased. In our country, a limited number of clinical research has been conducted on this subject. Hereof, while there is no development involving the standard clinical use of adult stem cells except for mesenchymal stem cells (MSC), researches on MSC and other adult and embryonic stem cells in regenerative medicine are ongoing at full speed. In our country, while HSC transplantation is performed in published standard universal indications and reimbursed, usage of non-hematologic adult HSCs is subject to legal permission from Turkish Republic’s Ministry of Health. On the other hand, clinical use of embryonic stem cells is forbidden completely. In this review, we aimed to overview HSC based regenerative medicine approaches conducted in our country in terms of standard clinical use, indications, types, and frequent complications.