Tuesday, April 12, 2022
The Basics of a Stem Cell Transplant
You might have heard other terms for this procedure, like "bone marrow transplant" or "peripheral stem cell transplant." Sometimes, it's a "cord blood and marrow transplantation."
The term is based on where the stem cells originate from, but they all mean the same thing: like in the case of a type of hematopoietic cell transplantation used to treat deadly blood cancers.
Essentially, donated cells are given to someone in need, and those donor cells are transplanted into the new host.
While there are significant benefits that come with stem cell transplantation, there are also some long-term side effects that you should be aware of.
Where Each Stem Cell Comes From
Most people who have a stem cell transplant procedure experience minimal side effects. What you can expect depends on the type of transplant you're having and the source of the stem cell.
There are three typical cells used in these procedures: bone marrow, bloodstream, and umbilical cord. Here's a quick summary of each kind.
Bone Marrow Transplants
Bone marrow can come from you or from a donor. It is full of hematopoietic stem cells because its job is to make the blood cells your body uses. Frequently, the pelvis is used as the preferred stem cell harvesting point for transplant patients because it has the largest marrow and stem cell pool.
To remove the marrow, a donor or patient is put under general anesthesia. Once collected and filtered, the marrow is given to the patient through their veins in a process called a bone marrow transplant. The cells head to the new marrow, making new blood cells that can fight any host disease cells that may already be there.
Peripheral Blood Transplants
When a patient is at a higher risk and can't have a bone marrow transplant, peripheral blood transplants may work. Stem cells aren't usually in the blood in large doses, but clinical oncology experts have found a workaround.
Stem cell donors are given shots of growth factors, or hormone-like substances that boost the growth of these cells. At the same time, the cells leave the bone marrow and move into the blood. Each stem cell is then removed from the donor via a catheter.
The blood is carried to a machine that separates the stem cells from the other red blood cells, and the unused blood is returned to the donor. The cells are filtered and frozen until they're ready to be used. At that time, they're transfused into the vein, where they travel to the marrow and begin to make new blood cells.
Umbilical Cord Blood Transplants
High doses of these cells are found in newborn baby blood. While this sounds scandalous, the truth is that there is a lot of unused blood left in the umbilical cord and placenta. Storing this blood to be used in a stem cell transplant later has been an option for parents for over a decade.
But those who don't opt to do this end up with the placenta and cord thrown away. Today, we're able to collect the blood without involving the baby at all when the parents approve. The cells are removed and frozen, then used for actual proposed treatment to save lives.
Placental Stem Cells
The placenta is a crucial part of pregnancy, as it provides nutrients and oxygen to the fetus while also removing waste. And while its usefulness during pregnancy is vital, the placenta may have more to offer.
All of these cells develop from a type of cell found in the bone marrow, called a "hematopoietic stem cell." The body is able to direct hematopoietic stem cells to develop into the blood components needed at any given moment.
Doctors have found that placental stem cells are capable of regenerating tissue and repairing cells in a way that adult stem cells can't. The main difference between these cells is the ability to differentiate into different types of tissue. Adult stem cells typically only differentiate into one type, which makes them less effective for medical treatments compared to placental stem cells, which can be used for an assortment of treatments.
Fetal Stem Cells
Fetal or embryonic stem cells are stem cells that are harvested from a 6-week-old aborted fetus.
Fetal stem cells have the ability to differentiate into any cell type. But they also carry risks. There are reports that patients developed tumors after spinal treatments with fetal stem cells. We strongly caution anyone who is considering using this type of cell therapy.
Possible Transplant Complications: GvHD
One of the first concerns a primary physician and surgeon consider is the fact that the patient's immune system could attack the donor cells. The term for this is "graft-versus-host disease," or GvHD.
GvHD occurs when the transplant backfires, and the host's body sees the new tissues as foreign. At that point, the white blood cells do their job and launch an attack on the new invaders. Instead of helping, the treatment regimen creates a variety of other problems that could be mild or substantial, depending on where the immune system attacks and the patient's health status.
The overwhelming majority of complications of GvHD usually occur with allogeneic stem cell transplants (donor cells), not with an autologous stem cell transplant (host cells). So, to avoid the increased risk of attack, doctors try to use the patient's stem cells when possible. If an additional risk occurs because of the marrow removal, a donor is matched as closely as possible to the host.
Acute vs. Chronic Graft Versus Host Disease
Classic acute GvHD happens within 100 days after the transplant. It primarily affects the skin, liver, and gastrointestinal tract.
After 100 days, the condition moves into the category of "classic chronic GvHD." At that stage, the same organs are affected, but then it can also impact the nervous system, lungs, eyes, and genitourinary tract.
These symptoms can overlap or be inconsistent. Risk factors often include the type of cancer cells, age-related health conditions, and whether conventional chemotherapy and radiation therapy were also used.
Common Long-Term Side Effects
In addition to the difference between an autologous transplant and the allogeneic stem cell transplant GvHD complications, some people can have other long-term side effects. However, this is the case with any treatment regimen for cancer patients, especially high-dose chemotherapy treatment.
Side effects depend on the type of transplant you had, your overall health, and many other factors, such as your gender.
Side Effects From Autologous Stem Cell Transplants
Called an AUTO transplant for short, the autologous stem cell transplant procedure can have short- and long-term effects, even though the host and donor are the same.
In this procedure, your stem cells are the replacement cells, but they're used in conjunction with chemotherapy. Because of this, common side effects tend to be similar to those you'd get with chemotherapy-only regimens, and they're typically stronger when you receive total body radiation.
This may be the best cancer treatment for you, even with the side effects. One thing to be concerned of is the risk of infections.
Infections and Your Transplant
When you receive chemotherapy, your body's immune system weakens. And if you had a bone marrow transplant, too, then the infection-fighting part is extra weak because the marrow is part of it. At this time, your body can't defend itself from the simplest of germs.
After your procedure, it's a common practice in clinical oncology to start you on a course of antibiotics, depending on how much additional risk you have. Within two weeks or so, your body's natural neutrophils will begin to recover, and they'll start protecting you from germs again.
To reduce the risk of infection, your doctor will talk to you about chemotherapy-only preparative regimens.
Immediate Side Effects of AUTO Transplants
The high-dose chemotherapy involved in an autologous stem cell transplantation can cause immediate side effects such as nausea and vomiting, fatigue, and mouth sores. You may also notice difficulty with blood clotting or anemia as your platelets and blood cells recover.
Long-term Side Effects of AUTO Transplants
Not all side effects are noticed quickly. You may have problems a few months or years later.
- Hormonal and infertility issues, such as difficulty getting pregnant, both sperm and not-sperm related
- Changes in your sex life due to decreased libido or early-onset menopause
- Secondary cancers
- Thyroid problems
- Damage to the bone or lungs
Hormone replacement therapy is a possible treatment when your cancer regimen produces anovulation or sperm count issues. Talk to your doctor if you experience sexual side effects. Prepubertal and adolescent females may not be candidates.
Cataract progression can be slowed with early correction and artificial lenses.
Added Concerns of Infection
Cancers like lymphoma treated with an ALLO transplant put patients at risk of infection. Chemo hinders your immune system, making it more likely that you'll get sick.
The highest risk of infection is during the first few weeks. After that, you're not out of the woods. Infection risk management is part of your long-term therapy routine.
Immediate and Long-Term Side Effects
The side effects you'll likely notice with an allogeneic stem cell transplant are similar to the autologous stem cell transplant. Both are performed with high doses of chemo. You may experience chemo side effects such as nausea and vomiting, fatigue, and mouth sores. Clotting and anemia issues are also common.
With both ALLO and AUTO transplants, you can have delayed side effects due to chemo and high-dose radiation. Infertility may happen, especially in women with delayed ovulation or earlier onset menopause.
There are ways to recover ovulation with hormone therapy. Men who are concerned about infertility can have sperm counts performed before and after their transplant to watch for problems.
The side effect of cataracts is a progressive one, and lamp eye evaluations can measure deterioration. With early signs, it's possible to delay the progression.
Your doctor will watch for signs of new cancers, so it's important to be honest about any "out of the ordinary" symptoms you notice. Secondary cancer can be treated easier when it's caught early
Having high-dose chemotherapy and total body radiation increases the potential of serious long-term side effects, like secondary cancer and a damaged immune system.
How do pluripotent stem cells avert the above concerns?
Embryonic Pluripotent Stem Cells
Embryonic stem cells are derived from a blastocyst, which is an early stage embryo of about 100-200 cells. These cells are not yet predetermined or specialized in any way, so there's no organs or blood cell at this point, just the "inner mass" from which embryonic stem cells can be obtained. Unlike adult stems cells, pluripotent ESC can express DNA to create all the various types of body cell types.
We specialize in pluripotent stem cells, which are a type of "universal cell" that can divide and become any one of 220+ different human cells. Pluripotent stem cell therapy uses these cells to assist the body with healing damaged or diseased tissue by replacing unhealthy tissue with healthy ones. They are most effective at repairing organs and boosting the nervous system, balancing immune function, regulating hormone levels.
Stemaid pluripotent stem cells originally come from an embryo donation of inner cell mass, and grow in laboratory. Application of these cells via IV or injections is a type of allogeneic transplant. Application of autologous ESC is an autologous transplant, but unique in that it is embryonic and not adult.
Stemaid Treatment Programs
Stemaid provides a unique type of treatment using the most potent stem cells available - pluripotent stem cells. We do not provide adult or umbilical, which are less-effective types of stem cell. Stemaid Institute can provide you with an allogeneic transplant utilizing cultured donor stem cells which come fresh from the laboratory, never frozen like other companies' products. These young healthy stem cells are up to six times more potent than either adult or umbilical in their ability to help your body heal itself; while our autologous cells are up to ten times more effective.
Learn more about how our stem cell transplant process avoids many of these short- and long-term effects and issues by contacting us and speaking with our medical team of experts. We are here to help with more natural and effective alternatives that offer something other than traditional drug-based treatment options for an improved quality of life.