To determine whether a transplant is appropriate, several factors are taken into account. These include (in no specific order):
Overall Health
Because stem cell transplants are very taxing on the body they are not usually done in patients that cannot handle the stresses involved.
Age of the Patient
Transplants are most often performed on younger patients because the procedure is physically demanding. Patients over the age of 50 are more likely to have complications, including graft-versus-host disease (GVHD)(1). They are also less likely to tolerate the side effects of the conditioning regimen (learn about the conditioning regimen).
Medical Condition and Likelihood of Response
Although ongoing research and advances have increased the success of stem cell transplantation, it can still be a difficult procedure and should only be used when there is a strong likelihood of response(1).
Availability of Donor Cells
This is the most important factor. If there are no available matching donor cells, then a transplant is not possible. When the patient is donating their own cells (autologous transplants) a sufficient amount of healthy cells must be available. For procedures in which the patient is NOT the donor (allogenic transplants), a close HLA match (discussed below) is necessary(2). A close HLA match is defined as at least 5 out of 6 HLA markers matching for adults getting donor stem cells and 4 out of 6 for children getting stem cells from cord blood. These guidelines are set by the National Marrow Donor Program (an international organization).
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