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From high risk to high reward

Photo of a stethoscope next to a paper heart
March 27, 2023

How outcomes are improving for blood stem cell recipients

Blood stem cell transplants have revolutionised the treatment of blood cancers and other diseases, offering hope to those who were once without options. Over the years, advancements in technology and research have significantly improved the safety and effectiveness of transplant procedures, providing a life-saving opportunity for the 135,000 Australians currently living with blood cancer or a related blood disorder.

The first successful blood stem cell transplant was performed in the 1950s on a patient with a rare genetic disorder, but the procedure was far from easy. At the time, the only way to obtain blood stem cells for a transplant was through a surgical procedure wherein bone marrow is donated. This is a safe, straightforward procedure, but it does require a general anaesthetic. The need for an operating theatre, theatre staff and an anaesthetist means that this method of collecting blood stem cells is relatively inefficient and labour-intensive.

From bone marrow to apheresis

The invention of apheresis (cell separator) machines in the 1970s led to the development of peripheral blood stem cell (PBSC) donation, which allows for the collection of stem cells from the bloodstream rather than from the hipbone. This makes the donation process much easier and more convenient, and as a side benefit the technique is able to collect a much higher dose of the necessary blood stem cells than a bone marrow donation. The development of better HLA typing methods and more effective immunosuppressive drugs have also made transplants more successful.

These improvements have led to a significant increase in the number of successful transplants, and survival rates after blood stem cell transplants have also improved greatly over time. The exact statistics on the survival rate of patients who receive these transplants can vary depending on a number of factors, like the patient’s age, underlying medical condition, and the type of transplant they receive.

A chance for a cure

For certain types of blood cancers, such as leukaemia, lymphoma, and multiple myeloma, blood stem cell transplantation can offer a chance for a cure in what would otherwise be a fatal disease. In the 1950s and 1960s, when bone marrow transplantation was first being developed, the success rate was low – often less than 20%. However, with improvements in transplantation techniques and supportive care, survival rates have steadily increased and are now in the range of 40– 70% or higher, depending on the type of cancer and the patient’s individual circumstances.

Of course, it’s important to keep in mind that survival rates can vary widely depending on the individual patient’s circumstances. It’s always best to consult a medical professional for specific and up-to-date information about transplant outcomes.

Overcoming complications

One of the biggest challenges in blood stem cell transplantation has always been the risk of transplant-related complications, such as graft-versus-host disease (GVHD), which occurs when the transplanted cells attack the recipient’s own “host” cells. New research is providing hope in this area as well, with the development of new treatments that can help to prevent or manage GVHD. For example, some researchers are investigating the use of immunotherapy to create “tolerance” in the recipient’s immune system, which would allow them to accept the transplanted cells without any problems.

As medical science advances, more and more people are receiving life-saving blood stem cell transplants. This is a testament to the power of modern medicine and the dedication of healthcare professionals. However, there are still countless individuals waiting for a donor match, and many will never find one. By being a member of the Australian Bone Marrow Donor Registry, you’re helping to bridge this gap and provide hope to those in need. It’s a small commitment, but one that could potentially change someone’s life forever.


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