Leukaemia | Stem Cells Australia
Condition
Leukaemia
Leukaemia is a general term that refers to many different types of blood cancers with different causes, different treatments, and different outcomes.
Our blood is made up of different cells, such as red blood cells, white blood cells, and platelets. Although all these blood cells can be found in the blood, they are actually made somewhere else in the body. These blood cells are made in the centre of our bones, in the bone marrow. All these different kinds of blood cells come from one type of cell that is found in the bone marrow called ‘hematopoietic stem cells’ or HSC. Throughout your life, these cells continuously create and replace all the different cells found in your blood. With leukaemia, it’s the white blood cells – the cells that help your immune system fight off illness - that do not function properly.
Acute leukaemias are characterized by the production of large numbers of blood cells that do not function properly and often suppress the production of normal blood cells. Present stem cell treatments for severe leukaemias may include the application of a blood stem cell transplant, which you may know by the name ‘bone marrow transplant’.
Thousands of leukaemia patients worldwide have received successful transplants containing blood stem cells. Although these treatments still carry very serious risks, these risks have greatly decreased over the years as researchers learn more about leukaemia and blood stem cells
How could stem cells help?
Understanding the disease
Researchers now know most of the gene mutations that are most likely to be present in any given type of leukaemia. Studies continue to examine the HSCs and what turns them into cancerous leukaemia cells.
Replacing lost cells
After undergoing chemotherapy, patients are often given a HSC transplant from a matched donor to replace the healthy cells in the bone marrow that were destroyed during chemotherapy. This method continues to be one of the most effective ways of treating many types of acute leukaemia. However, the side effects of the procedure itself make it risky with the potential for early fatality and usually substantial after effects in long-term survivors, particularly in children. Therefore, this type of therapy is only considered when excellent matched donor cells are available and the features of the disease put it into a poor prognosis group.
What are the challenges?
Immediately before a transplant is performed, the blood and immune system of the patient is largely destroyed by chemotherapy. This makes the patient unable to combat infections until the transplanted cells have regenerated the mature cells required to provide this capacity. An ongoing challenge is reducing this vulnerability of patients to infection while transplanted HSCs rebuild the patient’s immune system.
A second major challenge is caused by minor genetic differences that may exist between the transplanted HSCs and the patient, even when donor and patient tissue types seem the same.
Such differences can create unanticipated serious incompatibilities that lead to rejections of the transplanted cells or the transplanted cells attacking the patient’s tissues. This situation is called graft-versus-host disease, and it can be fatal in extreme cases.
Researchers and doctors are investigating ways to improve current transplantation approaches in order to address these limitations. Another challenge is the shortage of donors and several organisations are working to increase the number of volunteers in donor registries.
Where can I find out more about clinical trials?
There are a number of sites that list clinical trials, including the clinicaltrials.gov registry. Please consult with your medical specialist or general practitioner as they are best placed to advise you on whether you would be a good candidate for a trial given your circumstances. Also note that the scientific justification for the intervention and the credentials of those offering the service may have NOT been fully evaluated by this registry. Your findings may include listings that are NOT legitimate clinical trials.
Although HSCs are routinely available for leukaemia across Australia in major hospitals, some ‘stem cell’ clinics may also claim to offer experimental stem cell treatments for leukaemia. There are serious questions about the scientific rationale and the safety of many of these approaches.