Allogeneic Stem Cell Transplantation is the treatment of choice in many advanced hematological malignancies. Despite its numeorus risks, the procedure offers many patients with treatment resistant leukemias the only chance of a cure.

METHOD

Patient's HLA type is matched with donor's HLA type who wants to donate the stem cells. Upon matching, the donor is asked to undergo Leukapheresis (through Apheresis -a machine that separates the donor's white blood cells and returns the other blood component bact to his/her system, i.e. only a desired population of CD34+ cells is obtained from the donor, the remaining cells go back to the donor's body).  The cells obtained are further purified and stored under optimal conditions to be used by the recipient.

Recipient (person suffering from the disease) undergoes extensive chemotherapy for some days while being admitted for the procedure of HSCT. There are two methods called as Myeloablative conditioning and Non-myeloablative conditioning for clearing the diseased bone marrow cells. We prefer the mini non-myeloablative treatment, as the current trend world-over favors it. Here, reduced intensity of preparative regimens(chemotherapy) are used in order to decrease the risk of regimen- related toxicity and mortality that occur as a consequence of myeloablative conditioning.

Studies have shown that allogeneic stem cell transplants lead to prolonged disease-free survival in a relatively small percentage of patients. In addition, the relapse rate is lower than that seen with autologous transplants (approximately 30%-50%). However, allogeneic transplants are associated with a greater risk of complications than autologous transplants, including infections and graft vs host disease.

Allogeneic HSCT is potentially curative for a number of different hematological malignancies, including acute and chronic leukemias, myelodysplastic syndromes, myeloproliferative disorders, Hodgkins and non-Hodgkins Lymphoma and multiple myeloma.The decision to proceed for Allogeneic SCT is guided by the potential benefits and risks of such therapy. It also depends upon the availability of a suitable donor, presence of cytogenetic abnormalities (in host), response to prior therapy, age of the host, performance status and disease status. Diseases such as CML are however curable only by allotransplantation and show excellent post transplant benefits as well as long term disease-free survival.

This involves collecting patient's own stem cells, and storing them before initiating chemotherapy. These stem cells are re-infused back after completion of chemotherapy in order to generate lost bone marrow and other lineage cells.

In this protocol ther are no graft versus host reactions and there is no need for taking immunosuppresants as seen in Allogenic stem cells transplant.

Download the PDF Brochure on Autologous Stem Cell Transplant in Multiple Myeloma