Current Trends on Haemopoietic Stem Cells

: Advances in single cell technology and genetic mouse models have resulted in the identification of new types of haemopoietic stem cells(HSC) , resulting in baffling observations, suggesting a reconsideration of the long-held notion that all hematopoietic cells in the adult are derived from HSCs. The existence of long-lived HSC-independent hematopoiesis has led to the conclusion that despite the single hierarchical differentiation route that generates functional blood types, other differenciation routes exist invivo. Heterogeneity in the HSC population and the evolving knowledge around HSC has translated to it’s improved application as a therapeutic tool for various blood disorders. The reprogramming of non-hematopoietic somatic and mature blood cells to pluripotency with their subsequent differentiation into hematopoietic stem cells/progenitors cells and the introduction of new generation sequencing holds potential for the resolution of ambiguities involved in HSC bone marrow transplantation. There is a change in the paradigim for HSC transplantation donor selection. Donor choice favours haploidentical HCT than cord blood. This review provides a general overview of the current events around haemopoietic stem cells, with emphasis on the rising trend of HSC transplantation especially haploidentical stem cell transplantation.

Efficacy of nilotinib therapy in patient with CML diagnosed in pre-TKI era and resistant to imatinib

Here we report a case of a 32-year-old man, who was diagnosed as having chronic myeloid leukaemia in 1998. After cytoreduction with hydroxyurea, the patient was submitted to high dose chemotherapy with haemopoietic stem cells rescue and reinfusion, and then he started therapy with IFNα without achievement of a cytogenetic response. On November 2000 he took imatinib 400 mg/day and he reached a complete cytogenetic response (CCyR) at 14 months, but not the major molecular response: therefore he was considered a sub-optimal responder according to European LeukemiaNet criteria of 2006. For this reason he increased imatinib dose to 800 mg/day, but after one year he lost CCyR. Considering the patient as a failure, at this time, he switched to second-generation tyrosine kinase inhibitor, nilotinib at the dose of 800 mg/day. After 3 months he reached complete CCyR and after 6 months the major molecular response, maintained until last molecular evaluation.