Stem Cell Transplantation

Allogeneic Stem Cell Transplantation

An allogeneic stem cell transplantation is a treatment that uses stem cells from a healthy donor to restore a patient’s bone marrow that is damaged or diseased after receiving high doses of chemotherapy and/or radiation therapy. Allogeneic stem cell transplantation remains the only potential cure for MDS. 

Once patients are ready for an allogeneic stem cell transplant, they receive a “conditioning therapy.” This consists of very high doses of chemotherapy, either with or without radiation, to kill the cancer cells remaining in their bodies. It is also given to suppress their own immune systems, so their bodies do not reject the donor stem cells. After the conditioning therapy, patients receive donor stem cells by IV infusion. A transfusion is a slow injection of blood products put into a patient’s bloodstream through a vein. This procedure can take several hours to complete.

Allogeneic transplantation uses healthy blood-forming cells from an HLA-matched donor. They can be from a family member or an unrelated person, or from a donated umbilical cord. The transplanted blood stem cells travel to the bone marrow where they multiply and grow. The donated stem cells restore the bone marrow’s ability to form new blood cells. Ideally, an allogeneic stem cell transplant will generate a new immune system that helps the patient’s body fight infections and other diseases.

Compared to other treatment options, allogeneic stem cell transplantation is associated with a higher rate of side effects and mortality. However, it may be considered for patients with higher-risk MDS, based on their cytogenetic and molecular test results and other prognostic factors. The decision to perform an allogeneic transplant also depends on other factors, including the patient’s age, physical fitness, comorbidities (other co-existing medical conditions), and social supports (from family members, caregivers, friends), as well as the patient’s understanding of the potential benefits and risks.

Graft Versus Host Disease. A serious risk of allogeneic stem cell transplantation is graft versus host disease(GVHD), which develops if the donor's immune cells attack your normal tissue. GVHD's effects can range from minor to life threatening.

Reduced-Intensity Allogeneic Stem Cell Transplantation

Patients who can't tolerate allogeneic transplantation with high-intensity chemotherapy may be eligible for reduced-intensity stem cell transplantation. With this type of transplant, patients receive lower doses of chemotherapy drugs and/or radiation. 

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