Stem cell treatments have become increasingly popular due to their high efficacy and success rates, which can reach up to 80%. As an expert in the field, I have witnessed the tremendous impact of this modern type of regenerative medical treatment that utilizes a unique biological component known as stem cells. Every year, around 50,000 transplants are performed, and this number continues to grow by 10-20%. In fact, more than 20,000 people have lived five years or more after undergoing a stem cell transplant. The success of stem cell transplants lies in their ability to not only rescue the bone marrow but also kill cancer cells.
This is achieved through a combination of preparatory chemotherapy and radiation, followed by post-transplant immunosuppression. However, this process can also lead to severe pancytopenia in the first week after infusion, which can result in life-threatening infections. The mechanism of action behind stem cell transplantation against malignancy in leukemia is based on the effect of graft and donor immunity against malignant cells in recipients. Over the past decade, the use of hematopoietic stem cell transplantation has expanded in clinical practice, and ongoing clinical trials continue to evaluate its effectiveness in various medical conditions. Stem cells are able to travel to the bone marrow, where they are engrafted or "removed" and begin producing blood cells.
In some cases, blood remaining in the placenta and umbilical cord (known as cord blood) can also be collected and stored for future use in a stem cell transplant. However, there are instances where the bone marrow function does not fully recover after reconstitution or there is no gain of function at all, which is known as graft failure or rejection. Additionally, researchers are exploring the role of stem cell transplantation in treating autoimmune diseases such as systemic sclerosis and systemic lupus erythematosus, with promising results already seen in cases of relapsing-remitting multiple sclerosis. For certain types of leukemia, lymphoma, and multiple myeloma, a stem cell transplant may be a crucial part of treatment. Cell therapy, which involves transferring human cells to heal or replace damaged tissue or cells, holds great promise for patients with cancer and other diseases.
In hemoglobinopathies, transplanted stem cells are able to produce functional cells after engraftment, replacing diseased cells. Aplastic anemia, an autoimmune disease, causes white blood cells to attack blood stem cells, resulting in low red blood cell, white blood cell, and platelet counts. While a stem cell transplant may offer hope for some patients, the decision to undergo the procedure is not an easy one. The process involves initial mobilization of stem cells, where peripheral blood stem cells are collected due to their low numbers and the need for high levels of progeny cells. This is followed by a preparatory regimen and finally, infusion.
Studies have shown that patients under the age of 65 who receive consolidation treatment with melphalan followed by autologous stem cell transplant and maintenance therapy with lenalidomide have increased overall survival and progression-free survival rates.
