Original articles

Haematopoietic stem cell transplantation in South Africa: Current limitations and future perspectives

S Grobbelaar, A E Mercier, E Verburgh, D Brittain, M S Pepper

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.


Authors' affiliations

S Grobbelaar, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

A E Mercier, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

E Verburgh, Division of Clinical Haematology, Department of Medicine, School of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa

D Brittain, The Alberts Cellular Therapy Centre, Netcare Pretoria East Hospital, Pretoria, South Africa

M S Pepper, Institute for Cellular and Molecular Medicine, Department of Immunology, and SAMRC Extramural Unit for Stem Cell Research and Therapy, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa

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Cite this article

South African Medical Journal 2019;109(8b):46-52. DOI:10.7196/SAMJ.2019.v109i8b.013888

Article History

Date submitted: 2019-09-10
Date published: 2019-09-10

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