Stem Cell Transplantation

Generally, stem cell transplantation can be performed using bone marrow, peripheral blood stem cells or umbilical cord blood. Since the first successful transfer of hematopoietic stem cells in the late 1960s, this treatment method has been continuously advanced and is now an integral and indispensable part of therapy for children and young adults.

The area of stem cell transplantation has benefitted from many advances in recent years. Nevertheless, this therapeutic procedure is still associated with risks, so the decision whether stem cell transplantation is necessary and justified for a patient must generally be made on a case-by-case basis.

At our center, children and adolescents with malignant and non malignant diseases are treated using stem cell transplantation.

Malignant diseases

Stem cell transplantation in the following diseases:

Diseases of the blood

  • Acute lymphoblastic leukemia (ALL)
  • Acute myeloid leukemia (AML)
  • Chronic myelogenous leukemia (CML)
  • Juvenile myelomonocytic leukemia (JMML)
  • Myelodysplastic syndrome (MDS)

    Lymphomas

    • Hodgkin’s disease
    • Non-Hodgkin’s lymphoma

      Solid tumors

      • Soft tissue sarcoma
      • Ewing’s sarcoma
      • Neuroblastoma
      • Hepatoblastoma
      • PNET
      • Synovial sarcoma
      • Nephroblastoma
      • Germ cell tumors

        Brain tumors

        Non-malignant diseases

        Stem cell transplantation in the following diseases:

        Disturbances of hematopoiesis

        Congenital and acquired anemia

        • Severe aplastic anemia (SAA)
        • Thalassemia
        • Sickle cell anemia
        • Diamond-Blackfan anemia
        • Others

        Congenital and acquired thrombocytopenia

        • Amegakaryocytic thrombocytopenia
        • Evans’ syndrome

        Disturbances of myelopoiesis / macrophages

        • Familial hemophagocytic lymphohistiocytosis (FHL)
        • Histiocytoses
        • Others

        Immune system disorders

        • Severe Combined Immunodeficiency (SCID)
        • Wiskott-Aldrich syndrome
        • Septic granulomatosis
        • Kostmann disease
        • Griscelli syndrome
        • Others

        Metabolic disorders/autoimmune diseases

        Including

        • Farber’s disease
        • Mucopolysaccharidosis
        • Osteopetrosis
        • Lupus erythematodes
        • Rheumatoid arthritis
        • Metachromatic leukodystrophy
        • Adenoleukodystrophy
        • Others

         

        We offer all modern transplantation procedures at this center:

        Autologous stem cell transplantation

        Transplantation of stem cells from the patient

        This procedure is not really transplantation in the literal sense of the word. The stem cells are not transfused from a donor to a recipient, but are harvested from the same patient at an earlier time and then stored. The purpose of this procedure is to permit highly intensive chemotherapy while supporting hematopoiesis and the immune system. Stem cells may be removed from the iliac crest in the form of bone marrow or taken from the circulating (peripheral) blood using a procedure known as leukapheresis.

        Peripheral stem cell harvesting is the predominant procedure at this center. It can be carried out in children starting at a minimum body weight of approximately 5 kg.

        Allogeneic stem cell transplantation

        Transplantation of stem cells from a donor

        In allogeneic stem cell transplantation, a patient receives stem cells from a healthy volunteer donor. To ensure the success of an allogeneic transplantation, donor and recipient must share certain tissue characteristics. These characteristics are part of the human HLA system (human leukocyte antigen system). The HLA genes are very important to the human immune system. They help the immune system to differentiate between self and non-self tissue. This monitoring system is the basis of a functional immune system. It also prevents the introduction of foreign genes into body cells, e.g., via viruses. The system essentially operates by recognizing foreign tissue components and destroying them using targeted defensive measures.

        Therefore, these HLA markers must match in donor and recipient. If recipient and donor have the same HLA markers, the transplant is considered HLA-identical.

        In general, potential donors include healthy siblings and HLA-identical unrelated donors. If an HLA-identical donor could not be found in the global donor banks, a haploidentical transplant can be performed at our center. This involves using one of the patient’s parents as a donor.

        Haploidentical stem cell transplantation

        Stem cell Transplantation from a haplo-identical donor (usually relatives)

        Despite all efforts, we are still unable to identify an HLA-identical donor in time for every patient. For this particular circumstance, we have developed a transplantation procedure in which parents can act as stem cell donors for their children.

        Half of each child's HLA genes come from the father and half from the mother. Parents' HLA markers thus match half of their children’s. Therefore, they are half (“haplo”) identical.

        The major advances of the past 10 years now permit modification of the stem cell graft by removing the undesirable cells using antibodies. Parents can now act as stem cell donors for their children even though they actually "do not match."

        The development of this procedure renders stem cell transplantation an option for every patient.

         

        Immune and cell therapy procedures