What are stem cells?

Over 40,000 stem cells transplants are performed worldwide each year, providing recovery from ones-fatal diseases. Experts believe that such transplants will be the answer for many of today's incurable diseases.

Stem cells are primitive immature cells which have the ability to self-replicate and differentiate into any formed blood elements: white cells., red cells and platelets. This allows them to act as a repair system for the body, replenishing other cells as long as the organism is alive.

Blood stem cells can be collected from the bone marrow or bloodstream of:

++ Compatible family member or an unrelated donor.
++ An identical twin
++ Patient's own cells previously collected and suitably stored

CURING THE ONES INCURABLE

Dramatic breakthroughs in the field of Haematology and stem cell transplant offer new hope in treating conditions where conventional therapies have proven to be ineffective. These include life-threatening blood disorders such as multiple myeloma, chronic lymphatic leukaemia and Thalassaemia Major, which cannot be cured using conventional therapies such as chemotherapy and radiotherapy.

With allogeneic stem cell transplant (using stem cells from compatible family member or an unrelated donor), cure rates for some of these previously "incurable" disorders are as high as 90%.

Leukaemia, for example, makes up about 40% of paediatric cancers and was ones extremely difficult to cure. Yet, with stem cell transplant, some of South East Asia's leading hospitals enjoys an 80% cure rate for lymphoblatic leukaemia, comparable to leading paediatric cancer centres in USA and Europe. stem cell transplantation also allows for higher doses of chemotherapy then usual resulting in higher success rates.

TYPES OF BLOOD DISORDERS

Thalassaemia Major
A genetic disorder, characterized by the defective production of normal hemoglobin, the protein that enables red blood cells to carry oxygen and carbon dioxide, resulting in anemia.

Multiple Myeloma
Multiple myeloma is a type of cancer which affects plasma cells, whereby the body keeps producing a large number of these abnormally identical cells. The presence of these abnormally large numbers of identical plasma cells and antibodies collecting in many parts of the bone marrow and bones can cause serious medical problems.

Chronic Lymphocytic Leukaemia
Lymphocytes are white blood cells which produce antibodies and are vital parts of the body's immune system. This is the most common form of leukemia in adults. The malignant cells are found in the blood and bone marrow, which collect in and enlarge the lymph nodes. This may crowd out other blood cells in the bone marrow, resulting in a shortage of red blood cells (producing anemia) and platelets (producing easy bruising and bleeding).

TYPES OF STEM CELL TRANSPLANTS

There are 3 basic types of stem cell transplants: autologous, allogeneic and syngeneic. Where the stem cells come from determines the type of transplant.

AUTOLOGOUS STEM CELL TRANSPLANT
Chiefly used to treat lymphomas and multiple myeloma, this transplant uses stem cells from either your bone marrow or circulating blood. Your stem cells are removed before treatment through a process called harvesting, and then frozen. After you have received high doses of chemotherapy, radiation, or both, the stem cells are thawed and given back to you.

ALLOGENEIC STEM CELL TRANSPLANT
This type of transplant is commonly used to treat leukemia and other bone marrow disorders. here, the stem cells come from a donor whose tissue type best matches the patient. This is usually a family member.

One advantage of allogeneic stem cell transplant is that the donor stem cells produce their own immune cells, which may help destroy any cancer cells that remain after high-dose treatment. Another possible advantage is that the donor can often be recalled if needed to donate more stem cells. Stem cells from healthy donors are also free of cancer cells.

SYNGENEIC STEM CELL TRANSPLANT
A rare type of allogeneic transplant where the donor is an identical twin.

PROCEDURE FOR STEM CELL TRANSPLANT

Like any major medical procedure, stem cell transplants have several associated risks. To ensure that a transplant is the best available option for a patient, doctors in leading Institutions where stem cell research is carried out follow a strict evaluation process before approving any case.

The patient must first be reviewed for indications to see if his medical condition needs a transplant.

After that, HLA (Human Leucocytes Antigen) tissue typing for the patient and his siblings is carried out. If there is no sibling, unrelated donors are tested for matches. Ones there is a matched donor - sibling or unrelated - planning and discussion can begin.

Besides intensive medical assessments, pre-transplant evaluation for the patient and donor includes blood tests and other investigations like X-Rays.

When the date is scheduled, the patient undergoes a conditioning regimen which includes taking medication to cleanse the body system.

Two days after completing the conditioning regimen, the stem cells will be infused via the patient's central line much like a blood transfusion. This infusion rarely causes any side effects.

After the infusion of stem cells, doctors will wait for the growth of the new blood cells. It takes about two to three weeks before the first white cells re-appear.

What follows is a recovery period nd intensive follow-up lasting the first three months.