Stem Cell Transplantation at Virginia Oncology Associates

Virginia Oncology Associates autologous stem cell transplant program is only one of three in the state of Virginia and 135 nationally. Sanctioned through the Foundation for the Accreditation of Cellular Therapy (FACT), the program adheres to the most stringent clinical standards. FACT accreditation is the gold standard insurance companies often demand. It is the benchmark for quality care.

A stem cell transplant, sometimes called a bone marrow transplant, is a procedure that restores blood-forming stem cells in the bone marrow. This is necessary when a patient has had their bone marrow damaged by cancer or by cancer treatment. Blood-forming stem cells are important because they grow into different types of blood cells. The main types of blood cells are white blood cells, red blood cells, and platelets. You need all three types of blood cells to be healthy.

Stem cell transplants are used most commonly for patients with blood cancers such as leukemia, multiple myeloma, and some lymphomas. In cancers such as these, high doses of chemo (sometimes in combination with radiation), are administered with the intent of killing the stem cells. This stops the process of making new blood cells and the cells required for your immune system. Once the treatment is complete, the patient will receive a transplant of stem cells from a donor. The cells are administered through the blood and then move to the marrow where they can begin their work of regenerating the necessary blood and immune cells.

Over time, the stem cells that have settled in the bone marrow begin to grow and make blood cells that are healthy. This process is called engraftment.

The blood-forming stem cells that are used in transplants can come from the bone marrow, bloodstream, or umbilical cord.

There are two main types of transplants, which are named based of who gives the stem cells:

If you have an identical twin, you may receive a less common type of transplant, called a syngeneic transplant. In this transplant, the stem cells are taken from your twin as long as you both have identical genetic makeup and tissue type.

The goal of an autologous stem cell transplant is to restore the bodys ability to make normal blood cells after receiving high-dose chemotherapy or radiation treatment. In this procedure, your own stem cells are harvested (removed) from your bone marrow or your blood before you get treatment that would destroy them. Once your stem cells are removed, they are frozen (cryopreservation). After you receive your chemo treatment, the stems cells are thawed and given back to you.

One big advantage of this type of transplant is that youre getting your own cells back. This means you arent at risk for graft versus host disease -- a medical complication where new stem cells (called the graft) attack your body. However, there can still be graft failure, which means the cells dont make blood cells as they should because they havent reached the bone marrow. Additionally, this type of transplant doesnt offer the benefits of graft versus tumor (GVL) effect, which is when healthy donor cells attack cancer cells.

There are also some adverse side effects to autologous stem cell transplantation, which are mostly a result of the high-intensity conditioning therapy. These effects may include:

Autologous stem cell transplants are mainly used to treat certain leukemias, Hodgkins disease, lymphomas, and multiple myeloma. In some cases, it is used for testicular cancer, neuroblastoma, and certain childhood cancers.

VOA uses autologous stem cell transplants.

People have different sets of proteins, called human leukocyte-associated (HLA) antigens, on the surface of their cells. The set of proteins, called the HLA type, is identified by a special blood test.

When a donor will be the source of stem cells for a cancer patient, the oncologist will aim to match the patients own stem cells as closely as possible. This can help minimize side effects.

In most cases, the success of allogeneic transplantation depends in part on how well the HLA antigens of the donors stem cells match those of the recipients stem cells. The higher the number of matching HLA antigens, the lesser the chance the patient will reject the stem cells.

Instead of working against cancer directly, stem cell transplants help you recover your bodys own ability to produce stem cells after chemotherapy and/or radiation treatment.

With that said, stem cell transplants may work against cancer directly in patients with multiple myeloma and some types of leukemia. For example, a stem cell transplant where stem cells come from another person can also help treat certain types of cancer in a way other than just replacing stem cells. Cells that are donated can often find and kill cancer cells better than the immune cells of the person who had the cancer ever could. This is called the graft-versus-tumor (GvT) or graft-versus-leukemia (GVL) effect, which simply means that certain kinds of transplants actually help fight the cancer cells, rather than just providing normal blood cells.

Although some patients could benefit from stem cell transplants, they are typically only used when all other first-line treatments have failed.

Even though stem cell transplants have been successful for many people, it is important to weigh the risks and benefits before making a decision. Your cancer care team should talk with you about the risks and potential benefits. They may also discuss other methods of treatment available, including clinical trials. Various factors, including your age, stage of the cancer, donor type, and overall health are all part of the decision-making process.

As with all other types of medical treatment, the final decision is yours regarding whether or not to move forward with a stem cell transplant.

Through stem cell therapy research, cancer stem cells (CSCs) are leading to an encouraging outlook on the future treatment of patients who have been diagnosed with germ cell tumors as well.

Germ cell tumors are growths that form from reproductive cells. They arise in the ovaries (in girls) and the testes (in boys). They can also sometimes occur in other areas of the body, such as the lower back (common in infancy), the abdomen, the chest, and within the brain.

Germ cell tumors may be cancerous or noncancerous. In most cases, cancerous germ cell tumors occur as testicular cancer or ovarian cancer.

If a stem cell transplant has been recommended for you, be sure to take time to have your questions answered. If you would like a second opinion on a recommended cancer treatment plan, please contact the VOA office closest to you.

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Stem Cell Transplantation at Virginia Oncology Associates