Autologous Haematopoietic Stem Cell Transplantation (AHSCT)
Autologous Haematopoietic Stem Cell Transplantation (AHSCT) is being investigated as a treatment for severe immune-mediated diseases, particularly MS.
What is AHSCT?
The aim of AHSCT is to ‘reset’ the immune system to stop it from attacking the central nervous system. Haematopoietic stem cells are not the type of stem cells that would be expected to change into or regenerate permanently damaged nerves or other parts of the brain and spinal cord.
The treatment uses high doses of chemotherapy and antibody treatments, and therefore is more intensive and higher risk than most other MS treatments and involves a number of steps:
- Collection or ‘harvesting’ of stem cells from the bone marrow or blood of the person receiving treatment
- Purification and freezing of the harvested stem cells until they are required
- Administration of chemotherapy to wipe out an individual’s white blood cells
- Infusion of the thawed stem cells to help ‘reset’ the immune system
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Autologous HSCT requires the extraction (apheresis) of haematopoietic stem cells (HSC) from the patient and storage of the harvested cells in a freezer. The patient is then treated with high-dose chemotherapy with or without radiotherapy with the intention of eradicating the patient’s malignant cell population at the cost of partial or complete bone marrow ablation (destruction of patient’s bone marrow’s ability to grow new blood cells). The patient’s own stored stem cells are then transfused into his/her bloodstream, where they replace destroyed tissue and resume the patient’s normal blood cell production. Autologous transplants have the advantage of lower risk of infection during the immune-compromised portion of the treatment since the recovery of immune function is rapid. Also, the incidence of patients experiencing rejection (graft-versus-host disease) is very rare due to the donor and recipient being the same individual. These advantages have established autologous HSCT as one of the standard second-line treatments for such diseases as lymphoma.
However, for others cancers such as acute myeloid leukemia, the reduced mortality of the autogenous relative to allogeneic HSCT may be outweighed by an increased likelihood of cancer relapse and related mortality, and therefore the allogeneic treatment may be preferred for those conditions. Researchers have conducted small studies using non-myeloablative hematopoietic stem cell transplantation as a possible treatment for type I (insulin dependent) diabetes in children and adults. Results have been promising; however, as of 2009 it was premature to speculate whether these experiments will lead to effective treatments for diabetes.
Taken from Wikipedia