February 6, 2009

Understanding Stem Cell Transplants

High-dose chemotherapy and bone marrow or blood stem cell transplantation (SCT) remains the best treatment available for selected patients with certain types of leukemia. The SCT process was developed more than 36 years ago and was considered such a major development of biomedical science that the individuals responsible were awarded the Nobel Prize for Medicine in 1990. Continued refinement has made SCT safer and more widely available.

The Basic Strategy

Higher doses of chemotherapy and radiation therapy kill more cancer cells than lower doses in certain types of cancer. Unfortunately, the higher doses of therapy used to destroy cancer cells also damage normal cells. The body’s normal cells that are most sensitive to destruction by high-dose therapy are the blood-producing stem cells in the bone marrow. To “rescue” the bone marrow and hasten blood cell production and immune system recovery, high-dose therapy is followed by an infusion of stem cells.

Stem cell transplants are classified based on which individual donates the stem cells and from where the stem cells are collected. Stem cells may come from the patient (autologous), an identical twin (syngeneic), or someone other than the patient or a twin (allogeneic). Allogeneic stem cells are further classified by whether the individual donating the stem cells is related or unrelated to the patient.

Stem cells can be collected from bone marrow, peripheral blood, or umbilical cord blood. There are important advantages and disadvantages to using stem cells collected from these different sources.

In summary, high-dose chemotherapy is the best treatment for certain types of leukemia. To deliver high-dose chemotherapy, stem cells must be collected before treatment and infused into the patient after treatment. The stem cell infusion supports the recovery of the patient’s bone marrow.

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