Does stem cell donation harm the donor?
Stem cell donation is generally considered to be a safe procedure. The majority (more than 98.5%) of donors, who donate bone marrow, fcell completely recovered within a few weeks. A small percentage (1.34%) of donors experiences a serious complication due to anesthesia or damage to bone. nerve or muscle in their hip region. The risk of side effects of anesthesia during marrow donation is Similar to that during other surgical procedures. Serious side effects of anesthesia are rare. Common side effects of general anesthesia include sore throat (caused by the breathing tube) or mid nausea and vomiting. Common side effects of regional anesthesia are a decrease in blood pressure and a headache after the procedure. For donors who give stem cells from the peripheral blood, less than 1% experiences a serious side effect from the donation process. We take all the necessary precautions to ensure the safety and well-being of the donor.
The transplantation process
Patient is assessed for the need of stem cell transplantation
Availability of an HLA-matched donor is checked for allogeneic transplantation
Patient and donor fitness is ascertained with respect to organ function and tests for infectious diseases
The patient is admitted for the 'conditioning regimen' which prepares his bone marrow space for transplantation
Donor stem cells are harvested either form the bone marrow or the peripheral blood
Stem cells are infused in to the patient intravenously
The patient is managed for preventing and treating complications, if they occur.
After the patients are stable they are discharged and are folowed up In the day-care and the out-patient department.
Our dedicated interdisciplinary team includes medical oncologists. Hematologists, pathologists. Nurses, nutritionists, physiotherapies, counselors and social workers.
Consultations on complicated cases
State-of-the-art unit dedicated to allogeneic, syngeneic and autologous stem cell transplantation
HEPA-filtered transplantation rooms designed to provide optimum protection from infection in an environment that is comfortable for patients and family members
Allogeneic/syngeneic/autologous stem cell transplantation services
Stem cell collection facility for both peripheral blood and bone marrow harvest.
A dedicated day care facility for chemotherapy and post-transplantation care
At Gleneagles BGS Global Hospital, our state-of-the-art Stem Cell Transplant (SCTT) unit is dedicated solely to the care of patients with leukemia’s and those undergoing stem cell transplants.
What is a stem cell transplant?
• A stem cell transplant is the infusion, or injection, of healthy stem cells into a patient.
• The aim of the procedure is to replace damaged or diseased stem cells in the bone marrow.
Types of stem cells transplants
when the source of the stem cells is the patient's own bone marrow then it is called as an autologous stem cell transplant.
When another donor provides the stem cells then the procedure is called as an allogeneic Stem cells transplant.
In a syngeneic transplant the donor of stem cells is an identical twin sibling.
Where can we get the stem cells for transplantation?
Stem cells can be obtained from the bone marrow in which case the procedure is called a Bone Marrow Transplant
(BMT). Where as in several diseases it is better to take stem cells from the blood, in such cases we call it a peripheral blood stem cell transplant (PBSCT). The umbilical cord blood from newborn babies is also a good source of stem cells and when these are used the procedure is called as a cord blood transplant (CBT).
What are the common diseases for which stem cell transplantation is done?
Diseases affecting the bone marrow: Certain diseases such as aplastic anemia, thalassemia and blood cancers (leukemia’s and multiple myeloma) can be cured with a stem cell transplant. Some patients, who have an inborn defect in their immune system, are prone to have serious, life-threatening infection. Some of these can also be cured with timely stem cell transplantation.
Diseases requiring high doses of chemotherapy: There are some diseases which can be cured with very high doses of chemotherapy. But such high doses of chemotherapy cause serious side effects on the patient's bone marrow. We can collect the stem cells of such patients and then give them such chemotherapy. Later when these autologous (patient's own) stem cells are given back then they help the patient tolerate the side effects which the chemotherapy will have on the bone marrow and thus help the marrow to recover. Such autologous stem cells transplantation can be done in patients with relapsed lymphomas (cancers of lymph nodes) and some in some children with cancers like neuroblastoma.
Certain benign disease, which is not cancerous, such as systemic erythematosus (SLE), in which the immune system does not work properly, can also be helped by an autologous stem cell transplant.
How is stem cell transplantation done?
Assessment of Patient and Donor: We first assess patients to confirm that they will benefit from stem cell transplantation. Several tests are also done to ensure that the patient is fit to undergo the treatment. If an allogeneic transplantation is being planned then we test the patient's brothers, sisters and if required, parents to find an HLA-matched donor within the family. If there is no HLA-matched donor in the family then we assess if the patient will benefit from receiving stem cells from an unrelated donor. An international donor search is then initiated and if such a donor is found then a matched unrelated transplant (MUD) is done. We also ensure that the donor is fit to donate stem cells.
Process of Stem Cell Transplantation: The patient is then admitted for the 'conditioning regimen’ which prepares his bone marrow space for transplantation. The donor stem cells are harvested either from the bone marrow or the peripheral blood. These stem cells are then infused in to the patient's veins, just like a blood transfusion is given. The patient does not have to undergo any surgery. The patient is then monitored for complications such as infections and these are treated, if they occur. Once the patients are stable and the new bone marrow starts producing blood cells (usually within 2-3 weeks) they are discharged and are followed up in the day-care and the out-patient department usually for 2-4 months to detect any new complications.
What are the usual complications of stem cell transplantation?
Infections: In the first few weeks after transplantation, patients are at a risk of Infections. To decrease the risk of infections patients are kept isolated in rooms where the air is filtered to prevent fungal infections (HEPA filter). They are given food with a low bacterial load. We monitor patients for infection and attempt to treat these promptly and effectively.
GHVD: In allogeniec stem cell transplantation patients are given medicines such as Methotrexatre and Cyclosporine to prevent the donor cells from attacking the patent's organs, this condition is called as graft versus host disease (GVHD). Some patients will nevertheless develop GVHD and in most of these we are able to control it. Some patients may develop GVHD which persists after the first 100 days since transplantation and then they are said to have chronic graft versus host disease (cGVHD).
Rejection: Occasionally the donor stem cells may be rejected by the patient's body and then we try to support them with transfusions and antibiotics. Some of these patients might benefit from second stem cell transplantation.