Leukaemia Stem Cell Therapy in South Africa

Leukemia is blood cancer that are caused when certain genes undergo a series of rare mutations. In all forms of leukemia, there is an overproduction of white blood cells. They form blasts and the cells cannot perform the normal function which is to protect the body against disease and infection.

Most types of leukemia are thought to undergo several rare mutations for them to develop and the first change is presumed to occur in a cell that remains in the body for a long time. The prime candidate group of cells is called the hematopoietic stem cells (HSCs) which are primitive blood cell precursors.

HSCS make new blood cells inside our bodies for our whole lives and if a genetic change affects a cell, all the cells it produces will inherit the same mutation. However, to develop from HSCs into specialized cells such as the white blood cells, the HSCs have to go through a number of steps.

• Genetic inheritance
• Accidental exposure to radiation
• Treatment with some anti-cancer drugs

Acute leukemia is life threatening and requires immediate treatment which is usually intensive. Treatment options include steroids, chemotherapy and hematopoietic stem cell transplant (HSCT). Sometimes HSCT combines with chemotherapy and followed by a transplant of healthy HSCs.

The cells for the transplant are collected from a healthy donor’s blood or bone marrow. The transplant is effective because the donated cells have immune cells which kill the leukemic cells and HSCs which rescue the production of blood.

In some cases, the patient’s own cells are used for the transplant if enough healthy cells can be collected prior to the treatment being performed.

If a different donor is needed the patient’s tissue must be matched to avoid the transplanted donor cells being rejected and attacked by the patient’s residual immune system.

Before the stem cell transplant, the patient undergoes an intensive treatment to destroy as many leukemia cells as possible. High doses of chemotherapy or radiation therapy are given. In some cases, a mini-allogeneic transplant is given. This involves using lower and less toxic chemotherapy doses before the transplant.

The stem cells are administered intravenously like in a blood transfusion and the procedure takes approximately an hour. The stem cells enter the blood stream and travel to the bone marrow where they begin to make new blood cells in a process called engraftment.

• Infections: In the time it takes to produce new blood cells for the body the patient is very vulnerable to infections. The patient has to be under close observation and restricted from other people. Antibiotics are usually used as a preventative e form of treatment
• Graft-versus-host disease (GvHD): This is a complication that occurs when the patient’s normal tissues are attacked by the donor blood cells. This complication is characterized by symptoms such as blisters, rashes, fever, and diarrhea. GvHD is minimized by matching very closely the donor’s tissue type to the patient’s. Other ways of preventing GvHD include removing lymphocytes from the transplant and using drugs to suppress the immune system.