Current indication for hematopoietic cell transplantation in adults

With advances in transplantation technology and supportive care practices, hematopoietic cell transplantation (HCT) has become relatively safer and the applicability of HCT continues to expand. However, appropriate selection of transplant candidates remains challenging. Identifying adult patients who may benefit from HCT involves consideration of patient and disease factors, including overall health, prior therapies, age, comorbidity, and disease/disease risk. The eligibility of transplants should be decided on a case by case basis, based upon a risk-benefit assessment. The advent of the tools for assessing patient factors such as HCT-specific comorbidity index and disease factors such as disease risk index serve as assets for the decision-making process. Besides those approaches, psychosocial assessment to know the candidates' personalities and related issues are crucial in order to maximize patients' participation in their own care and to lay the foundation for a successful return to their personal and professional life after HCT.