We all know the fear and anxiety that comes with hearing from the doctor that a family member or friend has a serious blood disorder or blood cancer. But thanks to the advancements in medicine today, there are powerful treatments that can cure such diseases. One such life-saving treatment is called an "Allogeneic Stem Cell Transplant." Although the name may sound complicated, let's talk about what happens in this very simply.
What exactly is an allogeneic stem cell transplant?
Simply put, this involves removing diseased, dysfunctional stem cells from your body and replacing them with healthy, compatible stem cells from someone else (a donor).
Now let's explain this a little more.
- Stem Cells: We can also call these "mother cells" because these cells are like the factory that makes all the other blood cells in our body (red blood cells, white blood cells, platelets). These stem cells are mostly found in our bone marrow.
- Allogeneic: This word means "received from someone else." This means that the treatment uses cells from a healthy, compatible donor, not your own.
Imagine that our bone marrow is like a fertile field with good soil. It is in this field that our blood cells grow. But in a disease like leukemia, this field becomes spoiled, and weeds (cancer cells) grow instead of the good crops. So, in this treatment, that spoiled soil (the diseased bone marrow) is completely removed and replaced with new, healthy, fertile soil (the donor's stem cells). Then, healthy blood cells start growing in that new soil.
This treatment is a powerful one that can completely cure some serious diseases. Doctors usually resort to this treatment when other treatments have failed or when the disease recurs.
What types of conditions is this treatment used for?
It is often used for diseases related to the blood and immune system. Here are some of the main diseases.
| Medical condition | A simple explanation |
|---|---|
| Acute Lymphoblastic Leukemia (ALL) | Lymphocytes, a type of white blood cell found in the blood and bone marrow, become cancer cells. |
| Acute Myeloid Leukemia (AML) | Cancer of blood cells that develop from myeloid stem cells. |
| Aplastic Anemia | Damage to the bone marrow prevents the body from producing enough new blood cells. |
| Lymphoma | A cancer that occurs in the lymphatic system. |
| Myelodysplastic Syndrome | Irregular production of healthy blood cells in the bone marrow. |
| Sickle Cell Disease | A hereditary disease in which the shape of red blood cells changes and their function is impaired. |
How do you prepare for treatment?
Because this is a major treatment, the medical team will do several tests beforehand to make sure your body can tolerate it.
- Blood tests: Things like a complete blood count (CBC) are done to check the levels of red blood cells, white blood cells, and platelets.
- Heart tests: An echocardiogram (to see how well the heart is working) and an electrocardiogram (EKG) to see the heart's rhythm.
- Tests are done to check liver and kidney function .
- Bone Marrow Biopsy: If you have cancer, a small sample of bone marrow is taken and tested to assess the nature of the disease and the risk of recurrence.
Once all these tests have been done and it is determined that you are a good candidate, the most important part of the treatment, called "pre-transplant conditioning," begins. This involves high-dose chemotherapy or radiation therapy to the whole body. This can be a difficult time. But it is essential.
Why is this pre-treatment so important?
- It destroys any remaining cancer cells in your body.
- It removes old, diseased cells from your bone marrow and makes room for new cells to come in and grow.
- It temporarily weakens your immune system. This is done to stop your body from attacking and rejecting the newly donated cells.
You will have to stay in the hospital for one or two weeks for this treatment.
What happens on the day of the cell transplant?
The process of cell transplantation is actually very simple and painless , just like donating blood.
The medical team will insert a special tube into a large vein in your upper chest. This is called a Central Venous Catheter (CVC) . The bag containing the healthy stem cells from the donor is connected to this tube. The cells are then slowly infused into your body, through your bloodstream, and into your bone marrow, like a saline solution.
This process takes about 30 minutes to an hour. During this time, the medical team will sit next to you and monitor your blood pressure and heart rate. Sometimes, minor side effects may occur.
- Feeling cold
- Slight difficulty breathing
- A fever
But these are usually not serious.
What happens after treatment?
The most important recovery period begins after the stem cell transplant. You will need to stay in the hospital or close to it for a few more weeks.
- Immune control: You will continue to be given immunosuppressants to prevent your body from attacking the new cells and to prevent the new cells from attacking your body.
- Blood transfusions: It takes some time for the new stem cells to start working and make new red cells and platelets. During that time, you may need blood transfusions.
- Protection from infections: Your immune system is very weak during this time, so special attention is paid to protecting yourself from bacterial and viral infections.
The process by which the new cells travel to the bone marrow, settle there, and begin making new blood cells is called "engraftment." This can take about 10 to 14 days.
How long does it take to fully recover?
This is a long process. It can take two years or more to fully recover. It can take about a year for your immune system to recover.
Special risk to be aware of: Graft vs. Host Disease (GVHD)
This is the most common complication of an allogeneic transplant. Simply put, it occurs when the new immune cells from the donor (the graft) attack your own body's own cells and tissues (the host) . It's like a "guest attacking the host."
This can be mild or severe. That's why immunosuppressant medications are given continuously. You need to be very aware of the symptoms of this condition.
Symptoms that should be reported to your doctor immediately
When you go home after treatment, you should be very careful about certain symptoms. If any of these appear, call your medical team immediately.
| Symptom category | Features to look out for |
|---|---|
| Symptoms of Graft vs. Host Disease (GVHD) may include: | |
| Abdominal | Stomach ache, nausea and vomiting, diarrhea (bloating) |
| Skin and eyes | Itchy skin rash, yellowing of the skin and/or eyes (jaundice) |
| Could be signs of an infection | |
| General characteristics | Fever of 38 Celsius (100.4 Fahrenheit) or higher, chills |
| Respiratory system | Coughing, sneezing, runny nose, difficulty breathing |
| Other features | Dizziness, frequent urination, or burning when urinating |
The difference between "allogeneic" and "autologous" transplants
You may have also heard of autologous stem cell transplant. The main difference between the two is the source of the cells.
- Allogeneic: Cells are obtained from someone else (a donor).
- Autologous: The cells are taken from the patient . This means that the patient's own healthy stem cells are collected first and then given back to them after high-dose chemotherapy.
An allogeneic transplant can completely cure some life-threatening diseases. Often, these life-saving transplants are performed by unknown donors we have never met. Sometimes, family members become donors. While there are risks to this treatment, the benefits are also very high. Your doctor will explain all of this to you and help you make the decision that is best for you.
Take-Home Message
- An allogeneic stem cell transplant is the replacement of diseased bone marrow with stem cells from a healthy donor.
- This is a powerful treatment used for severe blood diseases such as leukemia, lymphoma, and aplastic anemia.
- It is essential to prepare the body with high-dose chemotherapy or radiation therapy before treatment.
- The main complication that can occur after treatment is Graft vs. Host Disease (GVHD), and it is important to always be aware of this and the signs of infection.
- This is a long healing process, and it is very important to inform your doctor or medical team immediately of any problems.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න