Stem Cell Transplantation

Types of transplants

There are two main types of transplants – autologous and allogeneic.

• An autologous transplant uses the patient’s own stem cells, collected in advance and returned to them after they receive high doses of chemotherapy.
• In an allogeneic transplant the stem cells are donated from another person, a genetically matched stem cell donor. While all transplants are serious procedures, allogeneic transplants are more complicated and therefore carry more short and long-term risks than autologous transplants.

The type of transplant you are given depends on a number of factors. These include the type of disease you have, your age, general health, the condition of your marrow and whether you would benefit by receiving donated stem cells, or whether your own stem cells can be used. A stem cell transplant is not necessarily the best option for everyone. The transplant process is demanding both physically and emotionally, and some people may not be fit enough to tolerate it. Also, many people don’t need a transplant and can be successfully treated using a less intensive approach. For others a transplant is the only option which offers a prospect of cure, or long term survival.

Your doctor will spend time discussing with you and your family what he or she feels is the best option for you and your particular situation.

For more information visit the Leukaemia Foundation Stem Cell Transplants website.

• Allogeneic (Donor) Transplants 
  In an allogeneic transplant, stem cells are donated to the person from another person, a genetically matched stem cell donor. This is usually a family member, a brother or sister with the same tissue type. Where no sibling is available, a search is made of Australian and overseas donor registries to find a suitably matched, unrelated stem cell donor.

• Autologous (Self) Transplants
  An autologous transplant (or rescue) is a type of transplant that uses the person’s own stem cells. These cells are collected in advance and returned at a later stage. They are used to replace stem cells that have been damaged by high doses of chemotherapy, used to treat the person’s underlying disease.

• Haploidentical Transplants
  For patients who need a stem cell transplant but do not have a HLA-matched related or unrelated donor, recent medical advances have made possible the use of a partially matched or haploidentical related donor. A haploidentical related donor is usually a 50% match to the recipient and may be the recipient’s parent, sibling or child.

Stem cell collection

If your doctor has referred you for a stem cell collection, the stem cells will be collected directly from the bloodstream. While stem cells normally live in your marrow, a combination of chemotherapy and a growth factor (a drug that stimulates stem cells) called Granulocyte Colony Stimulating Factor (G-CSF) is used to expand the number of stem cells in the marrow and cause them to spill out into the circulating blood.

From here they can be collected from a vein by passing the blood through a special machine called a cell separator, in a process similar to dialysis. This machine separates and collects the stem cells and returns the rest of your blood to you.

he stem cells are then processed, frozen and stored until the scheduled date of your transplant. This procedure is usually carried out in the outpatient department of the hospital.

Stem cell (bone marrow) transplant

A stem cell transplant is a process that involves replacing blood-forming cells called stem cells that have been damaged as a result of high doses of chemotherapy or radiotherapy. High dose therapies are sometimes used because they give some people a better chance of cure or long-term control of their disease. Sometimes stem cells need to be replaced because they are diseased (for example in leukaemia) or defective (for example in aplastic anaemia).

Finding a donor

Tissue typing

For patients who need a bone marrow or blood stem cell transplant, tissue type matching is an important factor for the success of the transplant.

For the transplant to have a chance of succeeding, there needs to be a precise tissue-type match. The most suitable donor for a bone marrow/blood stem cell transplant is a fully matched family member but only around one person in three has such a donor. If a suitable donor is not found in the immediate family, a wider family search and/or unrelated donor search may be needed.

Can my friends and family be tested?

Tissue typing, also known as HLA typing, is done to check how closely the patient’s cells match the potential donor’s cells. HLA stands human leukocyte antigen.

We inherit our tissue typing from our parents. This means that the first step in finding a suitable donor is within the immediate family. If a suitable donor is not found in your family, the next step is to start a search through the Australian Bone Marrow Donor Registry (ABMDR) for an Australian unrelated donor or cord blood unit. The ABMDR can only search for a donor if your treatment team has asked for it.

• ABMDR Searching for a donor
• ABMDR Patient brochure

Cancer research

Cancer care Services has an active research program through our collaboration with a range of world-class research organisations.

Clinical trials

Clinical trials test new treatments to find better ways to prevent, detect or treat disease. Both healthy people and people with a disease or condition can volunteer to be part of a trial.

Cancer Care Services participate in a range of clinical trials at our hospitals. For information about any of the trials below, ask your doctor or nurse.

For information about clinical trials in general visit the Australian Clinical Trials website or search the Australia and New Zealand Clinical Trials Registry.