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Stem cells can develop into many cell types and act as the body’s repair system. They replace or restore damaged tissues, offering new possibilities for treating diseases.
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The journey toward a stem cell transplant begins with a comprehensive and exhaustive evaluation phase. This period is critical for establishing a baseline of the patient’s health, confirming the specific nature of the disease, and identifying the optimal donor strategy. The diagnostic process is multidisciplinary, involving hematologists, oncologists, cardiologists, pulmonologists, and infectious disease specialists. The goal is to stratify risk and ensure that the potential benefits of this intensive regenerative therapy outweigh the inherent dangers of toxicity and complications. At centers like Liv Hospital, this evaluation is streamlined into a cohesive pathway to expedite the time to transplant.
Before a transplant can be scheduled, the precise status of the underlying disease must be confirmed. Stem cell transplants are most successful when the disease is in remission or at a low burden; performing a transplant on a patient with uncontrolled, bulky disease often leads to poor outcomes.
The conditioning regimens used in transplantation involve potent chemotherapy and sometimes radiation, which can place immense stress on vital organs. Therefore, a rigorous audit of organ function is mandatory.
For allogeneic transplants, identifying a compatible donor is the most pivotal step. This process relies on Human Leukocyte Antigen (HLA) typing. HLAs are proteins found on the surface of most cells that help the immune system distinguish between “self” and “non-self.”
Donor Health Screening: Once a donor is identified, they undergo their own medical evaluation to ensure they are healthy enough to donate and do not carry transmissible infections or genetic conditions.
A stem cell transplant is not just a physical challenge; it is a psychological marathon. The evaluation phase includes an assessment of the patient’s mental health, resilience, and social support network.
The high-dose chemotherapy used in conditioning regimens carries a high risk of causing permanent infertility. As part of the pre-transplant evaluation, patients of reproductive age are counseled on fertility preservation options. For men, sperm banking is a standard and adequate precaution. For women, options may include egg or embryo freezing, depending on the urgency of the transplant and the patient’s medical stability. Addressing these quality-of-life issues is a crucial component of the holistic care model in regenerative medicine.
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HLA (Human Leukocyte Antigen) typing is a genetic test used to match patients with donors. These antigens are markers on cells that the immune system uses to recognize which cells belong in the body. A close HLA match is critical to prevent the donor’s immune cells from attacking the patient’s body (graft-versus-host disease) and to prevent the patient’s body from rejecting the new stem cells.
Chemotherapy destroys white blood cells, leaving you unable to fight infections. A minor tooth infection or gum disease that is currently painless could flare up into a severe, life-threatening systemic infection (sepsis) when your immune system is compromised. Clearing dental issues beforehand removes this risk.
Minimal Residual Disease refers to the small number of cancer cells that may remain in the body after treatment, which cannot be seen under a microscope but can be detected by sensitive genetic tests. A negative MRD result means no cancer cells were found, which generally predicts a better outcome for the transplant.
Yes, in an autologous transplant, you act as your own donor. Your stem cells are collected and frozen before you receive high-dose chemotherapy. However, this is only an option for certain diseases (like myeloma or lymphoma) and requires that your bone marrow is relatively free of cancer cells and healthy enough to be harvested.
The timeline varies. If a sibling is a match, the process can move quickly, often within weeks. If an unrelated donor must be found through a registry, it can take several months to identify, contact, and test potential matches. In urgent cases, doctors may opt for a haploidentical (half-match) donor to proceed more rapidly.
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