Stem Cell Transplantation in Cancer
21.03.2024
STEM CELL TRANSPLANTATION IN SOLID CANCER TREATMENT
Stem cell transplantation is the process of transferring healthy stem cells to an individual to heal diseased tissues in cancer patients. It is often used to treat diseases such as blood or bone marrow cancers. During the procedure, damaged or diseased stem cells in the patient's body are destroyed with high doses of chemotherapy or radiotherapy. Then, healthy stem cells are transplanted into the patient. These stem cells are usually collected from a donor or the patient himself (autologous transplant). The transplanted stem cells begin to produce new and healthy blood cells, helping to improve the patient's immune system and blood structure. This treatment is considered a promising method, especially for blood cancers and some genetic diseases.
Image 1: In stem cell transplantation, the person's own stem cells (autologous) or the donor's stem cells (allogeneic) can be used.
IN WHICH CANCERS IS IT APPLIED?
Stem cell transplantation plays an important role in the treatment of various types of cancer, especially blood cancers. It is most commonly used in blood cancers such as leukemia (Acute Lymphoblastic Leukemia, Acute Myeloid Leukemia, Chronic Lymphocytic Leukemia and Chronic Myeloid Leukemia), lymphoma (Hodgkin and Non-Hodgkin Lymphoma), myelodysplastic syndromes and multiple myeloma. It is also used to rebuild bone marrow following high doses of chemotherapy or radiotherapy. Stem cell transplantation is not limited to blood cancers, but can also be applied to some other diseases such as some solid tumors (for example, testicular cancer, some brain tumors and sarcomas) and genetic blood disorders (for example, thalassemia and sickle cell anemia). Because each patient's situation is unique, the suitability and feasibility of stem cell transplantation is evaluated on an individual basis, taking into account the patient's general health, the type and stage of cancer, and responses to previous treatments.
Stem cell transplantation can be used in the treatment of some solid cancers, but application conditions and success rates may vary depending on the type of cancer, the patient's general health condition and other factors.
Some types of solid cancer for which stem cell transplantation is applied:
Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL): Stem cell transplantation may be used in some high-risk or recurrent cases of Hodgkin and Non-Hodgkin lymphoma.
Neuroblastoma: Stem cell transplantation can be used in the treatment of neuroblastoma in children, especially in high-risk cases or in advanced stages of the disease.
Wilms Tumor: Stem cell transplantation can be used in the treatment of Wilms tumor in children, especially in high-risk cases.
Testicular Cancer: Stem cell transplantation may be considered in testicular cancer cases, especially in high-risk and recurrent cases.
Breast Cancer: Stem cell transplantation is not usually the first treatment option for breast cancer, but in some cases it can be used in advanced or high-risk cases. It is not used much today.
Stem cell transplantation is a procedure generally considered a last resort for solid cancer treatment and may carry risks. Every patient is different, and treatment decisions should be made based on the patient's specific situation by a multidisciplinary cancer treatment team.
Image 2: In stem cell transplantation, healthy stem cells in the bone marrow of the person or donor are collected.20
HOW TO DO?
In cancer treatment, stem cell transplantation can be used in the treatment of hematological (blood cancers) and solid (solid tumors) cancers. Stem cell transplantation is a treatment method that involves introducing healthy stem cells into the bone marrow or circulatory system of a sick person.
Below is an item-by-item explanation of how stem cell transplantation is performed in cancer treatment.
1-Stem Cell Selection:
Autologous Transplantation: The patient is treated with stem cells taken from his own body. These stem cells are usually collected from the bone marrow of the sick person.
Allogeneic Transplantation: Stem cells from a donor suitable for the patient are used. The donor may be a relative of the patient or another person with a suitable tissue match.
2-Stem Cell Collection:
Autologous Transplantation: Stem cells suitable for the patient are collected from the bone marrow or peripheral blood circulation. Collecting stem cells from the peripheral bloodstream is often done through a procedure called apheresis.
Allogeneic Transplantation: It is necessary to collect stem cells from the donor. This collection can also be performed from the peripheral bloodstream or bone marrow.
3-Chemotherapy or Radiotherapy: Before a stem cell transplant, the patient may need to receive aggressive treatments such as chemotherapy or radiotherapy to control the cancer. These treatments help destroy or control cancer cells.
4-Stem Cell Transplantation: The collected healthy stem cells are given intravenously to the patient or recipient. Stem cell transplants attempt to control cancer by weakening or rebuilding the patient's immune system. It helps the formation of new and healthy cells and the destruction of cancer cells.
5-Rehabilitation and Follow-up: After stem cell transplantation, the patient is subjected to an intensive monitoring and rehabilitation process. Protection against infections and close monitoring for other complications are provided until the immune system is rebuilt.
6-Long Term Follow-up: After stem cell transplantation, the patient's health condition is monitored in the long term and additional treatments can be applied if necessary.
Stem cell transplantation is a complex procedure and requires a customized approach for each patient. It is managed by a cancer treatment team who plans and implements the treatment. Therefore, the treatment process and details may vary depending on the patient's specific condition and cancer type.
Image 3: In stem cell transplantation, stem cells in the body die due to high doses of chemotherapy, and then the collected stem cells are given to the body to ensure blood production again.
WHAT ARE THE CHANCES OF SUCCESS?
The chances of success of stem cell transplantation in solid cancers may vary depending on a number of factors.
Factors affecting the chances of success may include:
Cancer Type and Stage: The type and stage of cancer significantly affects the chances of success. Stem cell transplantation is generally more successful in solid cancers that have not received very intensive treatment.
Patient Age and General Health Status: General health status and age may affect the success of stem cell transplantation. Younger healthy patients generally have better results.
Stem Cell Source: Autologous transplants (using own stem cells) generally have lower complication rates and are better tolerated. Allogeneic (using donor stem cells) transplants can be successful if there is appropriate tissue compatibility, but they carry the risk of immune reactions.
Suitable Donor Availability: Availability of suitable donors is an important factor affecting success in allogeneic transplants. Finding a well-matched donor may increase the chances of success.
Previous Treatments: Chemotherapy or radiotherapy before stem cell transplantation may affect the patient's general condition and the sensitivity of cancer cells. Some types of cancer respond well to these treatments, while others may respond less well.
Complications and Infections: Infections and other complications after stem cell transplantation can affect success. Therefore, it is important to provide careful monitoring and support after transplantation.
Immune System Regeneration: Stem cell transplant attempts to control cancer by weakening or rebuilding the patient's immune system. This process varies depending on the rate at which new healthy cells form in the patient's body.
Each patient is different, and the chances of success of stem cell transplant treatment should be evaluated taking into account the type of cancer, treatment history, and other personal factors. Therefore, it is important to work with a cancer treatment team that specializes in cancer treatment and the stem cell transplant option. A more specific estimate of the chances of success can be given depending on the patient's particular situation and cancer.
Resources
Philip T. Lavinia, et al. (2019). "Hematopoietic cell transplantation for aggressive non-Hodgkin lymphoma: long-term follow-up of the first randomized trial of autologous versus allogeneic transplantation." Biology of Blood and Marrow Transplantation, 25(11), 2243-2250.
Yu, A. L., et al. (2010). "Anti-GD2 antibody with GM-CSF, interleukin-2, and isotretinoin for neuroblastoma." New England Journal of Medicine, 363(14), 1324-1334.
Dome, J. S., et al. (2006). "Treatment of anaplastic histology Wilms' tumor: results from the fifth National Wilms' Tumor Study." Journal of Clinical Oncology, 24(15), 2352-2358.
Einhorn, L. H. (2002). "Curing metastatic testicular cancer." Proceedings of the National Academy of Sciences, 99(7), 4592-4595.
Andre, F., et al. (2015). "Allogeneic hematopoietic stem cell transplantation for metastatic breast cancer." Bone Marrow Transplantation, 50(7), 935-942.