Leukemia Stem Cell Transplantation
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Stem Cell Transplantation for Leukemia
Some leukemia patients undergo a Hematopoietic Progenitor Cell Transplantation (commonly referred to as a stem cell transplant). Most often, patients receive high-dose chemotherapy followed by an allogeneic stem cell transplant, which transplants stem cells from a matching donor.
Understanding Stem Cell Transplantation
Stem cells are immature, blood-forming cells that can develop into any of the three main types of blood cells. Stem cells can be found in the bone marrow, circulating (peripheral) blood and umbilical cord blood.
When leukemia develops, a cell in the bone marrow undergoes a change and multiplies into many cells. The leukemia cells grow and, over time, crowd out normal blood and bone marrow cells.
For patients with leukemia, a stem cell transplant can be used to infuse healthy stem cells into the body to stimulate new bone marrow growth, suppress the disease and reduce the possibility of a relapse.
Types of Stem Cell Transplants
There are two main types of stem cell transplantation for leukemia patients:
Allogeneic Stem Cell Transplant
In this type of leukemia stem cell transplant, stem cells are taken from a matching donor. To determine if a donor’s stem cells are the right match, the patient undergoes a human leukocyte antigens (HLA) test. Through this test, we compare the patient’s blood and tissue type against blood samples from the donor.
Donors may include:
HLA-matched relative (most often a sibling)
HLA-matched unrelated donor
HLA miss-matched family member
Unrelated umbilical cord blood
Autologous Stem Cell Transplant
In this type of transplant, stem cells are collected from the patient themselves. The stem cells are then harvested, frozen and stored, and then given back to the patient. This type of transplant is rare for leukemia patients and is typically used in select cases of AML.
The Stem Cell Transplant Process
Before receiving stem cell transplation for leukemia, you will undergo a conditioning regimen, which involves intensive treatment to destroy as many leukemic cells as possible. You may receive high doses of chemotherapy, and in some cases radiation therapy.
You may also receive reduced-intensity conditioning (a “mini-allogeneic transplant”), which uses lower, less toxic doses of chemotherapy and/or Total Body Irradiation (TBI) before the transplant.
Once this preparative regimen is complete, you are ready to undergo the transplant. Much like a blood transfusion, you’ll receive the stem cells intravenously. The procedure takes about an hour.
After entering the bloodstream, the stem cells travel to the bone marrow and begin to produce new blood cells in a process known as engraftment. The transplant restores the supply of normal cells that have been destroyed by the intensive therapies.
In the months following the transplant, your CTCA doctors will check your blood counts on a frequent basis to monitor this process.
Sometimes, the high doses of chemotherapy and radiation you receive before the stem cell transplant can cause side effects, such as infection. Another risk of an allogeneic stem cell transplant is graft-versus-host-disease (GVHD), a condition where the donated cells attack the patient’s tissues. Your doctor may prescribe certain drugs to reduce the risk of infection or GVHD.
Helping You Maintain Your Quality of Life
For patients receiving stem cell transplantation for leukemia, recovery can take several months. Our hematology oncology team will work with the rest of your care team to support you throughout the entire stem cell transplant process.
Your care team will help you maintain your quality of life in the following ways:
Your dietitian will develop a special meal plan to nutritionally fortify your body after the transplant.
Your naturopath will recommend natural therapies to help reduce side effects, such as neuropathy and fatigue.
Your pain specialist will use various techniques to help alleviate discomfort and control your pain, including bone and neuropathic pain.
Your mind-body therapist will provide counseling and stress-management techniques so you can relax.
Your rehabilitation therapist will provide a personalized exercise program to help you stay active and functionally independent.
Your spiritual counselor will help nurture your spiritual well-being.
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