The treatment of blood diseases and cancers, including allogeneic stem cell transplants, is now highly specialized. The "conditioning regimen" is the chemotherapy treatment for the recipient of the donated stem cells to prepare the body to most effectively receive the donated cells.
You will read about the intensity of the conditioning referred to as "Myeloablative" regimens and "Reduced Intensity" or "Non-myeloablative" regimens. The standard approach for decades was to completely destroy all the cells in the patient's bone marrow (called "myeloablation"). Radiation is included for some patients. Not only does the chemotherapy kill the bad cells, a lot of damage can occur to healthy cells, including bodily organs.
Newer chemotherapy combinations are studied and used to maximize the effectiveness of the transplant while minimizing the risk and harm to the patient. These are called "reduced intensity conditioning" (RIC) regimens, and are usually given to older patients (over 60 years of age).
There are many studies underway to determine optimal treatments for overall survival and minimal Graft vs. Host Disease across patient age, gender, and cytogenetic risks.
Some factors transplant physicians consider when determining each patient's conditioning regimen:
1. Patient's age
2. Underlying cancer & cytogenetic risk factors
3. Other co-morbidities (health issues)
4. Patient's mobility, fitness before transplant
5. Response to treatment
There is still much to be learned. Each option has its potential risks and benefits. Physicians are continually balancing multiple risks throughout a patient's transplant journey.
As a patient, I came to believe that SCT decisions are a combination of science, physician experience, and art. The decisions are well beyond what a patient can contemplate. Ask questions, but don't expect to fully understand all the implications. Trust in your doctors and focus on taking care of your body, mind, and spirit as you embark on the biggest ride of your life. You can do it!
12/16/2015 0 Comments
Reported 3/22/2015 by BMDW, Be the Match, and WMDA
Bone Marrow Donors Worldwide (BMDW) and the World Marrow Donor Association (WMDA) announced that a record 25 million people worldwide are currently listed as potential volunteer marrow donors in hopes of saving the lives of those battling life-threatening blood cancers and diseases. The significant milestone gives greater hope to searching patients, caregivers and healthcare professionals around the world.
The BMDW global database provides a unique service to transplant centers and registries searching for the best match for patients in need of a life-saving blood stem cell or marrow transplant and who do not have a matching sibling. By providing a single registry for listing all available adult volunteer marrow donors and cord blood units, it provides a quick and thorough search service, reporting on whether and where a good match can be found. In 2014, over 225,000 search requests were made for patients in need of a blood stem cell transplant.
BMDW works closely with the WMDA (Worldwide Marrow Donor Association) — an association responsible for establishing consistent, high-quality standards for 97 marrow donor registries in 57 countries. BMDW provides a comprehensive list of potential marrow donors and donated umbilical cord blood units, primarily from WMDA member registries and cord blood banks. The BMDW global database is easily accessible to physicians to search on behalf of their patients in need of a blood stem cell transplant.
Professor Dr. Jon J. van Rood, founder of BMDW, said, “Today we celebrate a remarkable 25 million potential marrow donors on worldwide registries. Thanks to these 25 million potential volunteer donors, 250,000 patients have found their match and received an unrelated marrow transplant. But our work is not done. We need more potential donors to join registries around the world, as an equal number of patients have searched for a donor and could not find one.”
Every year, thousands of people are diagnosed with a blood cancer. A marrow or cord blood transplant is a potentially life-saving treatment for more than 70 different diseases, including leukemia, lymphoma and sickle cell disease. Other diseases include aplastic anemia, myelodysplastic syndrome, inherited immune deficiency disorders and inherited metabolic disorders.
Michael Boo, J.D., president of WMDA and chief strategy officer of the National Marrow Donor Program® (NMDP)/Be The Match®, said, “We are so grateful for the millions of people around the world who have volunteered to be the cure. Every person who has joined a marrow donor registry moves us closer to finding a marrow donor for every patient in need. Our goal as a global community is to continue to grow this inventory of donors and cord blood units by adding more than one million potential volunteer marrow donors and cord blood units from an increasing number of countries each year.”
To find the best matched donor for a patient, the first step is to look into BMDW, the global database, where all potential donors and cord blood units are listed. The database is available for physicians who can quickly look and determine within a few minutes if there is chance for a match for their patients.
BMDW was created in 1989 as a collaborative effort of eight countries and has grown to a community of 53 countries that are working together to achieve a centralized file of all potential volunteer marrow donors worldwide. This resource is crucial for patients in need of a blood stem cell transplant, because in nearly 50 percent of blood stem cell transplants, the donor and the patient come from different countries.
BMDW is operated by Europdonor Foundation, a Dutch nonprofit organization. For more information, visit: www.bmdw.org.
Worldwide, over 50,000 patients per year are looking for a matched donor outside their family.
Nearly 50% of the patients that find a donor find his or her perfectly matched donor in another country. WMDA works towards a global standardization by establishing an accreditation program for registries. The accreditation program ensures that organizations protect the welfare of the donors and high-quality stem cells for patients worldwide. WMDA is an international association. To learn more, visit: www.wmda.info.
About Be The Match®
The U.S.-based Be The Match Registry® is the world’s largest and most diverse donor registry with nearly 12.5 million potential marrow donors and more than 209,000 donated cord blood units. Be The Match connects patients with their donor match for a life-saving marrow or umbilical cord blood transplant. Be The Match provides patients and their families one-on-one support, education, and guidance before, during and after transplant.
Since the organization began operations in 1987, Be The Match has facilitated a total of 68,000 transplants, including nearly 6,300 transplants in 2014 alone, for patients in need of a cure.
Be The Match is operated by the National Marrow Donor Program® (NMDP), a nonprofit organization that matches patients with donors, educates health care professionals and conducts research so more lives can be saved. To learn more about the cure, visit BeTheMatch.org or call 1 (800) MARROW-2.