IntroductionA stem cell transplant is a treatmentfor some types of cancer. For example in the case if person might haveleukemia, multiple myeloma, or some types of lymphoma. It also treat some blooddiseases with stem cell transplants.
During those day, patients who needed astem cell transplant received a bone marrow transplant because the stem cellswere collected from the bone marrow but today stem cells are usually collectedfrom the blood instead of the bone marrow. This is reason why now more commonlycalled as stem cell transplants. Stem celltransplants are used to replace bone marrow that has been destroyed by canceror destroyed by the chemo or radiation that is used totreat the cancer and cancers, such as certain leukemias, multiple myeloma, and somelymphomas.
Stem cell transplant can be an important part of treatment. Highdoses of chemo sometime work better than standard doses to kill cancer cells.But when high doses are use than it can also kill all the stem cells and causethe bone marrow to completely stop making blood cells in which need to live.The transplanted stem cells replace the body stem cells after the bone marrowand its stem cells have been destroyed by treatment. Transplant lets doctorsuse much higher doses of chemo to try to kill all of the cancer cells.
Bloodcells in body start out as young or is immature cells called hematopoietic stem cells. Even thoughthey called stem cells butthey are not the same as the embryo stem cells that are studied in cloning andother types of research. Stem cells mostly live in the bone marrow at thespongy center of certain bone and this is where they divide to make new bloodcells. Once blood cells mature, they leave the bone marrow and enter thebloodstream. A small number of stem cells also get into the bloodstream and theseare called peripheral blood stemcells. Stem cell transplants are used to give back stem cells when thebone marrow has been destroyed by disease chemotherapy or radiation. HistoryFirst human bone marrow transfusionwas given to a patient with aplastic anemia in 1939.
This patient receiveddaily blood transfusions and attempt to raise her leukocyte and plateletcounts. It was made using intravenous injection of bone marrow. After World WarII and the use of the atomic bomb, researchers tried to find ways to restorethe bone marrow function in aplasia caused by radiation exposure and in the1950s, it was proven in a mouse model that marrow aplasia secondary toradiation can be overcome by syngeneic marrow graft. In 1956, Barnes andcolleagues published their experiment on two groups of mice with acute leukemiaand both groups were irradiated as anti leukemic therapy and both were salvagedfrom marrow aplasia by bone marrow transplantation. The first group received asyngeneic marrow ( from mice of the same strain ) however, most of the micedied from leukemia relapse. The second group received an allogeneic marrow froma different strain and none of the mice in this group experienced diseaserelapse. Another breakthrough took place with thefirst transplantation done from an HLA matched unrelated donor.
Hematopoieticstem cell transplantation from an unrelated donor dramatically increased theodds for finding a match. For example, it rose from 25% to 75% for Caucasianpatient. International collaboration was mandatory for the establishment oftransplantation centers around the world and for a global donor registry. In1972 the International Bone Marrow Transplant Registry ( IBMTR ) was establishedfor documenting HSCT outcome data and by that time, transplantations were donein 12 centers performing about 50 procedures a year altogether.
In 1974, theEuropean Group for Blood and Marrow Transplantation ( EBMT ) was establishedfor European collaboration in the field of HSCT. The first unrelated donortransplantation inspired in 1986 the foundation of the National Marrow DonorProgram ( NMDP ), and in 1988 Bone Marrow Donors Worldwide ( BMDW ) wasfounded, this organization unifies more than 23 million donors registered in 73countries and 600,000 cord blood units from cord blood banks in 32 countriesDiscussionStem cells make the3 main types of blood cells. Red blood cells, white blood cells, and plateletsand we need all of these types of blood cells to keep us alive.
For these bloodcells to do their jobs, need to have enough of each type in blood. Red blood cells ( RBC ) carryoxygen away from the lungs to all of the cells in the body and they bringcarbon dioxide from the cells back to the lungs to be exhaled. A blood testcalled a hematocrit showhow much of blood is made up of RBC. The normal range is about 35% to 50% foradults. People that have hematocrit below this level have anemia ( Low level of RBC ).
This canmake them look pale and feel tired, short of breath, and weak. White blood cells ( WBC ) helpfight infections caused by fungi, viruses and bacteria. There are differenttype of WBC that is neutrophils arethe most important type in fighting bacterial infections. Absolute neutrophilcount(ANC) is a measure of the neutrophils in blood. When ANC drops below 1,000per cubic millimeter (1,000/mm3) means patient might have neutropenia, and have a higher riskof infection. The danger is greatest when levels are below 500/mm3. Next is lymphocytes are another type ofwhite blood cell. There are different kinds of lymphocytes, such as Tlymphocytes, B lymphocytes, and natural killer cells.
Some lymphocytes makeantibodies to help fight infections and the body depends on lymphocytes torecognize its own cells and reject cells that are foreign to the body. Exampleare invading germs or cells that are transplanted from someone else. Platelets are pieces of cellsthat seal damaged blood vessels and help blood to clot, both of which areimportant in stopping bleeding. A normal platelet count is between 150,000/cubicmm and 450,000/cubic mm. A person whose platelet count drop below normal issaid to have thrombocytopenia,and may bleed longer, bruise more easily, and have bleeding gum or nosebleed.Spontaneous bleeding ( bleeding with no known injury ) can happen when a personplatelet count drops lower than 20,000/mm3.
Can be seen inhemorrhagic dengue fever. This are dangerous if bleeding occurs in the brain orif blood begins to leak into the intestine or stomach.SourceThereare two major sources of stem cells.
The type that getsinto all forms of media daily are embryonic stem cells which are overhyped and are never used clinicallybecause illegal. The legal, moral and ethically correct type of stem cells arebone marrow derived stem cells and umbilical cord stem cells that almost neverreceive any publicity. All forms of stem cells are essentially very similar anddiffer only in fairly minor ways.
Adult Stem Cells have been found in nearlyevery tissue in the body. In addition, umbilical cord stem cells arecategorized as adult stem cells because they have grown beyond the embryonicstage and adult stem cells in fact have been used in transplants for over 30yearsStorage,collection andprocessingblood stem cells can be moved or mobilized out ofthe bone marrow into the bloodstream ( peripheral blood ) where they can beeasily collected. Most transplants these days use stem cells collected from thebloodstream. Receive injections of a drug such as filgrastim or plerixifor overa four to five day period. These drugs move stem cells out of the bone marrowinto the bloodstream. Most people tolerate these drugs well although mild flulike symptoms are common. Symptoms end a few days after the injections stop.
Ifcollecting stem cell for own transplant, chemotherapy drugs may be used to helpmove the stem cells out of bone marrowinto the bloodstream. Procedureused to collect bone marrow for transplant is called a bone marrow harvest. Itis a surgical procedure that takes place in a hospital operating room andtypically done as an outpatient procedure because only takes 30 minutes to bedone.While under anesthesia, a needle will be insertedinto rear pelvic bone where a large quantity of bone marrow islocated. The bone marrow will be extracted with a syringe,several skin and bone punctures are required toextract sufficient bone marrow for transplant. There are no surgical incisions involved and onlyskin punctures where the needle was inserted. A sterile bandage will be applied to the site whenthe collection end.
Risk After the surgery might feel tired or weak andhave trouble walking for a few days. The area where the bone marrow was takenout might feel sore for a few days but doctor will ask patient to take a painreliever for the discomfort. Normal cases, likely be able to get back to normalroutine within a couple of days but it may take a couple of weeks before feelfully recovered. Because of newer modern technologies and past experience, afatal risk are minimize.