1. Table 23.1 Stem cell transplantation: potential
donors.
HLA-matching sibling
Unrelated HLA-matching volunteer Allogeneic
Umbilical cord blood
Identical twin Syngeneic
Self Autologous
HLA, human leucocyte antigen.
Table 23.2 Stem cell transplantation:
indications.
Allogeneic (or
syngeneic) Autologous
Acute lymphoblastic or
myeloid leukaemia.
Other malignant
disorders of the
marrow (e.g. chronic
myeloid leukaemia,
myelodysplasia,
multiple myeloma,
lymphoma, severe
aplastic anaemia
including Fanconi’s
anaemia)
Hodgkin lymphoma and
non-Hodgkin
lymphoma, multiple
myeloma, AML,
primary amyloidosis
Inherited disorders:
thalassaemia major,
sickle cell anaemia,
immune deficiencies,
inborn errors of
metabolism in the
haemopoietic and
mesenchymal system
(e.g. osteopetrosis)
Other acquired severe
marrow diseases (e.g.
paroxysmal nocturnal
haemoglobinuria, red
cell aplasia,
myelofibrosis)
AML, acute myeloid leukaemia.

2. Table 23.3 The human leucocyte antigens (HLA).
Class I Class II
Antigens HLA-A, -B, -C HLA-DR, -DP, -DQ
Distribution All nucleated cells, platelets B lymphocytes
Monocytes
Macrophages
Activated T cells
Structure Large polypeptide chain (MHC coded)
and a β2-microglobulin
Two polypeptide chains (α and β) both
MHC coded
Interacts with CD8 lymphocytes CD4 lymphocytes
MHC, major histocompatibility complex.
Table 23.4 Complications of stem cell
transplantation.
Early (usually <100
days)
Late (usually >100
days)
Infections, especially
bacterial, fungal,
herpes simplex virus,
CMV
Infections, especially
varicella-zoster,
capsulate bacteria
Haemorrhage Chronic pattern GVHD
(arthritis,
malabsorption,
hepatitis, scleroderma,
sicca syndrome,
lichen planus,
pulmonary disease,
serous effusions)
Acute pattern GVHD
(skin, liver, gut)
Chronic pulmonary
disease
Graft failure Autoimmune disorders
Haemorrhagic cystitis Cataract
Interstitial pneumonitis Infertility
Others: veno-occlusive
disease,
cardiac failure
Second malignancies
CMV, cytomegalovirus; GVHD, graft-versus-host disease.
Table 23.5 Acute pattern graft-versus-host disease: clinical staging (Seattle system).
Stage Skin Liver (bilirubin, μmol/L) Gut (diarrhoea, L/day)
I Rash <25% 20–35 0.5–1.0
II Rash 25–50% 35–80 1.0–1.5
III Erythroderma 80–150 1.5–2.5
IV Bullae, desquamation >150 >2.5; severe pain, ileus