Types of Stem Cell Transplant: A Complete Guide for Nigerian Patients

Learn about the different types of stem cell transplant — autologous, allogeneic, and more — and what Nigerian patients should know before choosing one.

Types of Stem Cell Transplant: A Complete Guide for Nigerian Patients

Stem cell transplants are an increasingly significant treatment for a number of serious blood diseases, cancers and inherited disorders. It is important for Nigerian patients who might be interested in treatment outside Nigeria to understand the different types of stem cell transplant before discussing with specialists to make the best treatment decision. SCT (stem cell transplant) replacing damaged or unhealthy blood-forming stem cells with healthy stem cells. Doctors may suggest various methods of transplantation depending on the type of disease, the person's age and health whether or not there is a match and whether the person has previously been treated. Transplantation might be an option for patients who have a special type of blood disorder like sickle cell or some kinds of blood cancer or some problems with the bones marrow or immune system. However, all patients are not eligible and treatment is ALWAYS determined by a qualified hematology or transplant team.

What is a stem cell transplant?

A stem cell transplant is a treatment where healthy blood-forming stem cells are put into the blood stream. These cells can migrate to the bone marrow where they can contribute to the formation of new blood cells. The stem cells can be from the patient or donor. This is the reason for the two main types of stem cell transplant, autologous and allogeneic. Stem cell transplantation has been employed in the treatment of leukemia, lymphoma, multiple myeloma, aplastic anemia, some inherited blood diseases and some very special cases of sickle cell disease. In patients, conditioning treatment is often given prior to transplantation. This can include chemotherapy, radiation or an immunotherapy treatment or a combination of them. The goal is to condition the body and bone marrow for the transplanted stem cells.

Main Types of Stem Cell Transplant

The two main types of stem cell transplants are those derived from different sources of stem cells.

Autologous Stem Cell Transplant

An autologous transplant is a transplant in which the patient's own stem cells are used. Stem cells are first taken from a patient's blood and stored in preparation for high dose treatment. The patient is then given conditioning therapy and the stored stem cells are given back via an intravenous infusion. Some patients who have multiple myeloma and some lymphomas are candidates for the treatment of autologous transplantation. Since the patient's own cells are transplanted, there is no immune reaction between the cells of the donor and the patient (graft versus host disease). An autologous transplant may not be an option, however, when the stem cells of the patient are damaged by the disease, or when a donor transplant offers a greater likelihood of controlling the disease.

Allogeneic Stem Cell Transplant

Allogeneic transplant is a transplant with cells taken from a different person. The donor could be a sibling, another relative or an unrelated donor with a tissue match. This is a type of stem cell transplant that is one of the most critical for some blood cancers, some bone marrow failure diseases and inherited blood disorders. The abnormal cells (in the patient) may be recognized by the donor's immune system and attacked. This phenomenon is known as graft-versus-tumour or graft-versus-leukemia activity and may be useful in certain types of cancer. Allogeneic transplantation is more complex, however, in that potential complications may include graft versus host disease, infections and graft failure. Donor matching and monitoring is therefore crucial.

Other types of stem cell transplants are classified in different ways

Sometimes doctors refer to the kinds of stem cell transplant based on the relationship between donor and the person receiving them.

Syngeneic Transplant

  • Syngeneic transplant: stem cells from an identical twin. Some immune-related complications might be less common in identical twins as they tend to share many of the same genetic traits.
  • This type of transplant is rare and happens only when the patient has an identical twin that is good health.

Matched Sibling Transplant

  • Matched sibling donor is an important option for an allogeneic transplant. His/her brothers and/or sisters may also be checked to see if they have a suitable human leukocyte antigen (HLA) match.
  • Identification of a suitable donor may be important in the evaluation for transplant for Nigerian patients who have inherited disorders like the sickle cell disease.

Haploidentical Transplant

  • Haploidentical transplant is performed with a partial match family donor. A parent, child or sibling could be a donor.
  • With the improvement of transplant medicine, haploidentical transplantation is becoming a more and more convenient option for patients without a fully matched sibling donor.

Unrelated Donor Transplant

  • When there is no suitable family donor, medical staff can consider an unrelated donor using a suitable donor register. Genetic matching and access to a registry of donors is required.
  • If the patient has to travel from Nigeria to India or another country to get treatment, the transplant center can lead them in donor selection and compatibility testing.

Sources for stem cells used during transplantation

  • The other way to know the types of stem cell transplant is to know the collection process location from where the stem cells are being collected.

Peripheral blood stem cells

  • Peripheral blood is currently a common source of blood-forming stem cells. Medication is administered to the donor or patient who stimulates the stem cells to migrate from the bone marrow into the blood stream. The cells are then removed by a process called "apheresis.

Bone Marrow

  • Stem cells can also be directly removed from the bone marrow, typically from the pelvis, under anaesthetic.
  • In some transplant scenarios, the bone marrow can be chosen depending on the disease, donor and the transplant team experience.

Umbilical Cord Blood

  • Alternatively, stem cells could be collected from donated umbilical cord blood. In certain transplantation scenarios, especially when a suitable adult donor is not available, cord blood can be used.
  • There are potential benefits and drawbacks with each source and the team is working out which is best suited.

Stem Cell Transplant and Sickle Cell Disease

Sickle cell disease is a blood disease passed down through the family that can lead to anemia, painful attacks, organ and other serious illness. Medical and surgical treatment that may be done includes medications, transfusion, infection prevention, pain management and other supportive treatments. Selected patients may be able to receive a long-term disease modifying treatment by replacing the patient's blood-forming system with healthy donor stem cells through stem cell transplantation. Doctors will examine a number of factors when thinking about treatment for sickle cell disease, including patients' age, disease severity, organ function, previous complications, availability of donors, and general health. For certain patients with sickle cell disease, an allogeneic hematopoietic stem cell transplant is the accepted transplant method. It is not suitable for every patient and the benefits against the risk of conditioning, infection, graft versus host disease, infertility and other complications must be considered. A proven transplant center in India can assess medical records and decide if transplantation is a viable option for families from Nigeria considering treatment for sickle cell disease in India.

Blood cancers are treated with stem cell transplant

For some blood cancers such as leukemia, lymphoma and multiple myeloma, stem cell transplantation can form part of treatment. The type of transplant will depend on the type of cancer and treatment plan. Selected cases of multiple myeloma and lymphoma are candidates for autologous transplantation and in some cases of leukemia and other high-risk blood disorders, there may be no alternative but to opt for allogeneic transplantation. Chemotherapy or other cancer treatment might be the initial option to get disease control prior to transplantation.

Which Transplant Type is the Right One?

A detailed assessment of the medical condition is required to decide on the type of stem cell transplant. Some factors to take into account are:

  • The underlying disease and the stage of the disease.
  • The age of the patient and his or her overall health condition.
  • Other treatment that has been given in the past such as chemotherapy.
  • A healthy heart, lungs, kidneys and liver.
  • Infection history
  • Having an appropriate donor.
  • HLA compatibility
  • Response to treatments given in previous years
  • Potential transplant-related complications
  • Appropriate post-transplant monitoring is available.

Before recommending a procedure, a transplant specialist might order blood tests, imaging, a bone marrow evaluation, HLA testing and other tests.

What to Expect from an Indian Hospital for Nigerian Patients?

Patients who come from Nigeria for transplantation generally have to be well planned for as the process of stem cell transplantation requires extended medical management.

Treatment can include:

  • Medical record review and virtual consultation.
  • Assessment of the disease and transplant suitability.
  • Assessment of donors and HLA typing (if applicable) prior to the transplant.
  • Conditioning treatment
  • Stem cell infusion
  • Testing for infection and other problems
  • Early recovery and discharge, where medically appropriate.
  • Ongoing monitoring once repatriated back to Nigeria
  • Overall time is widely different depending on the disease, transplant type, complications and recovery of the patient.
  • Arrangements like the accommodation, an airport transfer, an interpreter, hospital organisation and follow-up planning can also be a consideration for international patients.

Why you should think about taking the stem cell transplant in India?

Specialized hematology and bone marrow transplant centers have sprung up in India dealing with international patients. Patients in Nigeria might consider traveling to India due to the availability of specialized facilities, experienced specialists, coordinated support services for international patients and diagnostic services.

But cost should not be the only factor to consider when picking a transplant center. The medical staff should be experienced in the patient's particular disease be able to perform transplants have good infection-control measures, test donors, have intensive-care facilities and be able to provide follow-up care.

Conclusion

Patients who are considering advanced treatment for blood disorders and some cancers should know about the different types of stem cell transplants. There are two primary methods: autologous and allogeneic; and the type of donor and the source of stem cells are other forms of classification. In some selected patients, particularly those with complications of the disease, transplantation may be an alternative especially when an appropriate donor is available for patients with sickle cell disease. Transplantation may be complex and may have risks so patients need to have a special evaluation by an experienced hematology and transplant team. GetWellGo can facilitate your journey by organizing medical consultations, hospital selection, treatment planning, travel assistance and international patient support for Nigerian patients considering sickle cell disease treatment or stem cell transplantation in India. 

Types of stem cell transplant​ GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our Nigerian clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

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  • 24 hour availability.
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  • Expert hematologist with a strong track record of success
  • Assistance during and after the course of treatment.
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  • Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
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