Stem Cell Transplantation

The goal of stem cell transplantation is to cure the patient’s cancer by destroying the cancer cells in the bone marrow with high doses of chemotherapy and then replacing them with new, healthy blood-forming stem cells. The healthy blood stem cells will grow and multiply forming new bone marrow and blood cells. There are two main types of stem cell transplantation. They are

  • Allogeneic—patients receive stem cells from a matched or a partially mismatched related donor or an unrelated donor.
  • Autologous—patients receive their own stem cells.

Stem cell transplantation is not used as the first or primary treatment for children with ALL. It may be used as a treatment for high-risk ALL patients, or for patients who do not respond to other treatments.

Allogeneic Stem Cell Transplantation

Allogeneic stem cell transplantation involves transferring stem cells from a healthy person (the donor) to the patient. This is the most common type of stem cell transplantation used to treat ALL.

In preparation for the transplant, patients are given strong doses of chemotherapy, with or without radiation therapy, to kill the remaining leukemic cells in their bodies. This also kills cells in the bone marrow including healthy blood-forming cells.

After, patients receive infusions of the donor stem cells. The donated stem cells restore the bone marrow’s ability to form new blood cells. This creates a new immune system for the patient that helps the body fight infections and other diseases.

Donor stem cells come from an HLA-matched

  • Family member (often a sibling)
  • Unrelated donor
  • Umbilical cord blood unit

Graft-Versus-Host Disease

A serious risk of allogeneic stem cell transplantation is graft versus host disease (GVHD), which develops if the donor's immune cells attack the patient’s normal tissue. GVHD's effects can range from minor to life threatening.

Autologous Stem Cell Transplantation

Autologous transplantation is not commonly used to treat patients with ALL, but it may be a treatment option for ALL patients participating in a clinical trial.

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