Types of Stem Cell Transplant
Stem cells are unspecialized cells capable of dividing and differentiating into cells that can perform numerous functions in different parts of the body. Because of their ability to transform into various other types of cells, they can be employed in treating and understanding disease processes.
There are three main types of stem cell transplant and are classified based on who donates the stem cells, namely
- Autologous transplant: This is a type of stem cell transplantation, in which the patient stands as his or her donor. Such as using own bone marrow or blood. Because a patient receives his or her own stem cells, the risk of complications from transplant rejection is reduced, making it an ideal match for transplantation.
- Allogenic transplant: This is a type of stem cell transplant in which the patient receives a stem cell from a donor, who is either closely related such as a brother or sister, or a closely matched unrelated person who is identified through a registry of possible stem cell donors.
- Syngeneic transplants: This is a special type of allogeneic stem cell transplant that can only be used if a patient is a twin or triplet (identical sibling). One advantage of syngeneic stem cell transplant is that there are no graft-versus-host complications due to the similar genetic makeup.
What is the Process for Stem Cell Transplant?
Conditioning
This phase involves treating the stem cells before transplantation, to high dose chemotherapy to kill any cancerous cells. The chemotherapy therapy may be. The aim of conditioning is to destroy the patient’s stem cells along with any cancerous cells, suppress the patient’s immune system to prevent any transplant rejection and to provide space in the patient’s bone marrow for the transplant. Most patients usually combine radiation with high-dose chemotherapy. Without radiation is also used. This phase is also known as the bone marrow preparation or myeloablation phase and typically require seven to fourteen days.
Complications of conditioning include induction of premature menopause and sterility in both men and women.
Central line or Port Placement
This phase involves setting up the central venous access device into the patient’s chest via the subclavian vein close to the neck. The device used can either be a central venous catheter also known as the central line or a port, sometimes called a portacath.
Stem cell Infusion
Stem cell infusion takes place after the conditioning phase is over, usually a day or two after. The donor stem cells are delivered directly into the recipient’s vein through a central venous catheter or central line. Stem cell infusion usually takes between one and four hours and is typically not painful. Throughout the infusion phase, the patients are closely monitored for possible complications or adverse reactions such as elevated body temperature, chills, drop in blood pressure, difficulty breathing, coughing, chest pain, reduced urine output, fatigue or hives. To prevent any of this complication, patients may be placed on nutritional support, medications or blood cell replacement.
Recovery
The recovery phase begins after the stem cell infusion. This phase involves the new stem cells engrafting or migrating into the patient’s bone marrow, and producing new blood cells. This period can take between twelve to thirty days. During the recovery phase, the risk of infections is very high due to the patient’s low white blood cell count. To prevent this complication, patients are given prophylactic antibiotics. Until the stem cells have been able to regenerate, the risk of infection still remains high.
What Diseases Can Stem Cells Cure?
There is a wide range of diseases that stem cells can cure. Since the early 90’s, skin stem cells have been used to culture skin grafts for patients with third-degree or severe burns on the very large surface area of the body. This is usually reserved for patients with life-threatening burns.
Below are lists of diseases for which stem cell therapy appear to be beneficial, but still under clinical trials or not yet adopted as standard therapy. These lists include Alzheimer’s disease, cardiomyopathy, cerebral palsy, Diabetes type 1, Ewing Sarcoma, HIV, Huntington’s Disease, Testicular cancer, Rhabdomyosarcoma, Liver cirrhosis, Scleroderma, Parkinson’s disease, Multiple Sclerosis, Spinal cord injury, and Hypoplastic Left Heart Syndrome.
How Much Does Stem Cell Treatment Cost?
Stem cell therapy is a very expensive procedure. Stem cell therapy treatments are often considered as a last resort of a viable treatment option because patients are worried about the costs. As stem cell treatment gains more popularity thanks to mainstream media, more people are considering are considering stem cell treatment as a first line of treatment, not minding the uncertainty of the effect on their condition and the opportunity cost of choosing a more familiar option like medication and surgery
The average cost of stem cell therapy is influenced by several factors. In general, the cost of stem cell therapy largely depends on the type of procedure or treatment used for. Another determining is the country or location, as prices tend to vary across different countries. Additional cost can also be influenced by clinic policies, initial consultations, laboratory tests, follow-up appointments, and additional injections
Stem cells costs in different countries vary but can range from $5,000 to as much as $100,000. For example, stem cells clinics in the United States can cost between $5,000 to $16,000 per treatment while private clinics in India can cost between $7,000 to $18,000, excluding travel and hotel expenses.
The cost of stem cell therapy for an orthopedic condition such as arthritis, cartilage defects, tennis elbow, rotator cuff tendonitis, and knee osteoarthritis are inexpensive and average between $5,000 and $8,000.
Many health insurances do not cover stem cell therapy, but some plans may give partial coverage for certain types of diseases such as blood cancer, which may include stem cell therapy. Stem cell therapy that is unapproved by the FDA or still in experimental phase such as for orthopedic conditions are not covered by insurances and are typically borne by the patient.
References
Adiwinata Pawitan, J. (2012). Prospect of Induced Pluripotent Stem Cell Genetic Repair to Cure Genetic Diseases. Stem Cells International, 2012, 1-7. doi: 10.1155/2012/498197
Baker, M. (2009). Cancer stem cells resemble healthy stem cells, resist chemotherapy. Nature Reports Stem Cells. doi: 10.1038/stemcells.2009.110
Papaccio, F., Paino, F., Regad, T., Papaccio, G., Desiderio, V., & Tirino, V. (2017). Concise Review: Cancer Cells, Cancer Stem Cells, and Mesenchymal Stem Cells: Influence in Cancer Development. STEM CELLS Translational Medicine, 6(12), 2115-2125. doi: 10.1002/sctm.17-0138
Vinall, M., & Melton, D. (2015). Stem Cells Can Treat and Cure Diabetes. MD Conference Express, 14(49), 4-5. doi: 10.1177/155989771449001
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