Abstract:
The growing need for haematopoietic stem cell transplantation (HSCT) is reflected in the increasing number of transplants performed
globally each year. HSCT provides life-changing and potentially curative therapy for a range of pathologies including haematological
malignancies; other indications include certain congenital and acquired disorders of the haematopoietic system, autoimmune conditions
and hereditary diseases. The primary goals of HSCT are either to replace haematopoietic stem and progenitor cells (HSPC) following
myeloablative chemotherapy or to cure the original pathology with allogeneic HSPCs. Success depends on optimal outcomes at various
stages of the procedure including mobilisation of marrow stem/progenitor cells for harvesting from the patient or donor, long-term and
sustainable engraftment of these cells in the recipient, and prevention of graft-versus-host disease in the case of allogeneic HSCT. Challenges
in South Africa include high cost, limited infrastructure and lack of appropriately trained staff, as well as limitations in securing suitable
haematopoietic stem cell donors. This review aims to provide an overview of HSCT and some of the challenges that are faced in the South
African context.
