Leukemia patients whose illnesses haven't responded to traditional treatment methods may benefit from a stem cell transplant. Leukemia, a form of blood cancer, will affect an estimated 44,790 people in 2009, according to the National Cancer Institute. While chemotherapy and radiation will help many of these people, others will need to consider a stem cell transplant in order to restore normal blood cell production in the bone marrow.
Identification
Stem cells are cells that develop during the embryonic stage of fetal development and have the capacity to turn into a variety of highly-specialized cells. Because of the cell's unique ability to regenerate, they can be useful in treating several serious diseases and disorders. When a leukemia patient receives a stem cell transplant, the stem cells are used in an attempt to jump start the bone marrow to resume normal cell production. Stem cells were originally obtained only from healthy bone marrow and the process was referred to as a "bone marrow transplant." Today, stem cells can also be obtained from peripheral and umbilical cord blood and "stem cell transplant" is now the preferred term.
Reasons for a Transplant
Chemotherapy and radiation are used in leukemia patients to destroy abnormal white blood cells produced by bone marrow. Unfortunately, these treatments can also destroy the marrow's ability to produce healthy red and white cells and platelets necessary to sustain life. In particularly aggressive cases of leukemia, chemotherapy and radiation may fail to kill the abnormal cells. If this occurs, the only treatment option left is a stem cell transplant. If the transplant is to be effective, the existing malfunctioning marrow must be destroyed with a high dose of chemotherapy.
Transplant Types
An allogenic transplant is one that uses stem cells from a person who has the same tissue type as you do. While this person is often a close relative, in some cases family members don't have compatible tissue types, and the stem cells must be obtained from an anonymous donor through the National Marrow Donor Program Registry. In some cases, you may be able to use your own stored marrow in a procedure called an autologous transplant. Marrow is collected while you are in remission and cleaned with chemotherapy drugs or monoclonal antibodies before it is put back in your body.
Before the Transplant
After pre-procedure testing, an intravenous catheter, called a central line, will be surgically implanted in your chest. The central line will be used to place the new cells from the transplant into your body. Your doctor can also use the central line to give you any necessary chemotherapy drugs, provide blood transfusions or obtain blood samples. Once the central line is in place, you will begin the conditioning phase. During this phase, you will receive chemotherapy drugs designed to kill cancer cells and suppress the immune system in order to avoid rejection of the transplanted cells. In some cases, radiation therapy may also be used. Conditioning can be done while you are a patient in a hospital and can also be performed on an out-patient basis.
The Transplant
During the stem cell transplant, the donor stem cells enter your body through the central line over the course of several hours. Once the cells reach your bloodstream, they gradually make their way to your bone marrow. Over time, the stem cells begin to make both new bone marrow and stem cells. This process takes time and you probably won't notice any changes in your blood count until several weeks after the transplant. If the transplant is successful, your blood count will gradually improve as normal marrow function is restored. You will be carefully monitored in the weeks and months following the transplant to ensure that there are no complications.
Tags: bone marrow, cell transplant, stem cell, stem cell transplant, central line, stem cells