Hematopoietic stem cell transplantation has been used in medicine for 30 years. The term “stem cell” was first used by A.A. Maksimov, the great Russian scientist, in 1908. The term described the unique ability of blood stem cells to self-renew.
Stem cells have been first used in clinical practice in the 1950s, when full body irradiation followed by transfusion of a donor’s brain marrow proved to be effective in treatment of leukemia in mice.
Later, E.D. Thomas proved that full body irradiation in combination with a high-dose chemotherapy increased chances for a successful engraftment of a donor’s bone marrow in human patients. Such combination helps to suppress the immune system and, at the same time, to ensure the eradication of a leukemic clone. It was the beginning of the clinical transplantation.
There were lots of changes in the field over the past years. The lethality rate has decreased, while the long-term survival rate has increased. Having being recently considered the salvage therapy, today hematopoietic stem cell transportation is a routine procedure, which is used as an intensive therapy to consolidate remission in the patients with hematopoietic malignancies. The number of procedures is growing, so does the number of healthcare providers, who offer hematopoietic stem cell transplantation.
According to the reports of the European Bone Marrow Transplant Group the number of the members of the European Register have increased from 142 (1990) to 622 (2005), and the number of hematopoietic stem cell transplantations – from 4234 to 24168, in the last fifteen years.
8890 (37%) of allogeneic and 15278 (63%) of autologous hematopoietic stem cell transplantations were carried out in the European countries, including 3773 re-transplantations or repeat transplantation. 57% of all transplantations were those for lymphomas, 31% ‑ for leukemia, 7% ‑ for solid tumors and 5% ‑ for noncancerous diseases.
In 1996-2006, 13 centers for transplantation, included in the Interregional Register, of the Russian Federation carried out 1174 hematopoietic stem cell transplantations: 901 (76%) autologous and 273 (24%) allogeneic. The most common type of autologous transplantations is the transplantations for lymphoproliferative diseases (66%). Other indications were for leukemia (16%), for autoimmune disorders (13.5%) and for solid tumors (4.5%). 88% of all allogeneic transplantations were made in the patients with leukemia, 5% ‑ with lymphomas and 4% ‑ with aplastic anemia.
In our country, the first hematopoietic stem cell transplantation was made in October 1993. The first department of transplantation was opened in the 9th City Clinical Hospital. The capacity of the department was 7 beds. Today, we successfully use hematopoietic stem cell transplantation to treat hematological disorders, cancer and autoimmune diseases.