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Allogeneic stem cell transplant

In October 2015 the Austin began an allogeneic stem cell transplant service, in collaboration with the Victoria Comprehensive Cancer Centre's bone marrow transplant service. 

An allogeneic transplant is the implanting of stem cells from a genetically well matched donor. This can be a blood relative, often a sibling, or an unrelated donor from various national and international registries.

Allogeneic stem cell transplants are used to treat a number of blood cancers, most commonly for acute leukaemia and for a related condition called myelodysplasia. They are also occasionally used to treat lymphoma, myeloma and some chronic leukaemias.

The processes of an allogeneic stem cell transplant

The first step

The first step in an allogeneic stem cell transplant is determining if the transplant is needed and the risks justified. This is often a complex decision which is dependent on your age and general health and whether this type of transplant is the best treatment for you. Your decision about this transplant will come only after multiple detailed discussions with your transplant specialist to ensure this is the best decision for you. 

The second step

The second step is to start a search for a donor. It is only after identifying an available and suitable donor that the final decision about the transplant is made by you and your specialist. 

The third step

This involves two processes which occur at the same time. Your donor receives the same G-CSF injections that a person receiving an autologous stem cell transplant receives. After 3-4 days, when the stem cell concentration in the blood is suitable, their stem cells are collected by the apheresis process. 

At the same time the person receiving the donation is given chemotherapy, occasionally in combination with radiotherapy. The chemotherapy doses can vary between moderate to high dose treatment.  There are two reasons we give you this treatment. Firstly, it reduces the number of cancer cells in your body, and secondly, it suppresses your immune system. This ensures your body’s defences do not attack and reject the donor cells after they are transplanted.

The fourth step

This involves the infusion of the freshly collected donated cells into your bloodstream.  These stem cells end up in the bone marrow and start producing new blood cells. Most patients are discharged within a week of their blood counts recovering. They can then recover from their treatment at home.

 

Issues after transplant

An allogeneic stem cell transplant is a complex procedure and can result in some issues. Your treatment team will work with you to prevent, minimise or treat these potential issues.

Because everyone’s body is different, no two people’s immune systems are completely matched. This means that, even though the donor and patient have been found compatible, the new donor immune cells may react against the patient’s body.

This can cause liver, skin, gut and other organ problems which require taking drugs to suppress the immune system.

There is a chance that the disease may return.

In an attempt to minimise this there are various strategies used to try and maximise the potential beneficial effects of the donor’s immune system against the leukaemia – this is called a ‘graft versus leukaemia effect’.

In patients who are cured, the long term side-effects of the chemotherapy and immune suppression treatment as well as any graft versus host disease.

There is substantial focus on survivorship and addressing the overall aspects of a your psychological and physical wellbeing.

Contact

Allograft Co-ordinator

Peter Shuttleworth

+61 3 9496 5236

peter.shuttleworth@austin.org.au

1800 134 864 - country patient toll free (extension 5236)

131 450 - free telephone interpreter service (TIS)

Out of hours

Page the Haematology Registrar via Austin Health switchboard

+ 61 3 9496 5000

 

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