Oncology & Hematology Coding Alert

Stem cells are "parent blood cells" found in a large concentration in the bone marrow and in a much lower concentration in the blood. Although unremarkable in appearance, stem cells can perform "acts of biological resurrection," repopulating bone marrow, reconstituting an entire repertory of differentiated, mature blood cells of all types including red blood cells, various types of white blood cells and platelets, and restoring the immune system. While research horizons expand almost daily, the current standard of practice for clinical stem cell use is overwhelmingly for transplantation, says Myrlena Lee, patient account supervisor for transplant programs at St. Luke's Hospital in Kansas City, Mo. The procedure goes under several names: Lee says the current Foundation for the Accreditation of Cellular Therapy (FACT) guidelines now call it HPC-A (hematopoietic progenitor cell-apheresis) rather than the older PBPC (peripheral blood progenitor cell). The goal of stem cell transplantation is to counter a loss of blood cells by transfusing "parent" cells into the patient to rebuild the blood supply after high-dose chemotherapy destroys malignant cells.

A patient may receive his or her own stem cells (known as an autologous transplant), or stem cells taken from a suitable, matching donor (known as an allogenic transplant), either of which can be collected, or harvested, from blood or bone marrow and stored until needed for transplantation. Allogenic stem cell transplantation provides the opportunity for treatment to patients who might be unsuitable for autologous transplant because of tumor involvement in the bone marrow or previous irradiation that compromised stem cell production.