Saving lives by dona­ting stem cells

Leukemia was first descri­bed as a dise­a­se in 1845 by Rudolf Virchow, a pro­mi­nent phy­si­ci­an at Ber­lin Cha­ri­té Uni­ver­si­ty Hos­pi­tal. “Leukemia” can be free­ly trans­la­ted as “white blood” and refers to the patho­lo­gi­cal mul­ti­pli­ca­ti­on of white blood cells. Today, several dise­a­ses of the blood-forming sys­tem are cove­r­ed by this term. The blood con­sists of cells that move around in a flu­id (blood plas­ma). The­se blood cells are divi­ded into three types: ery­thro­cytes (red blood cells) are respon­si­ble for trans­por­ting oxy­gen, leu­ko­cytes (white blood cells) are respon­si­ble for the body’s immu­ne sys­tem, and plate­lets (throm­bocytes) are respon­si­ble for blood clot­ting. All the­se cells have a limi­ted lifespan in the blood, mea­ning that the body must con­ti­nuous­ly pro­du­ce new cells. The­se cells grow in the bone mar­row from so-cal­led blood stem cells by divi­ding and pas­sing through several sta­ges of matu­ra­ti­on, ent­e­ring the bloo­d­stream as soon as they are func­tio­n­al. This ensu­res a con­stant sup­ply of fresh blood con­tai­ning func­tio­n­al cells.

Patho­lo­gi­cal mul­ti­pli­ca­ti­on of white blood cells

White blood cells and, in par­ti­cu­lar, their imma­tu­re pre­cur­sors, mul­ti­ply signi­fi­cant­ly in the pre­sence of leukemia. The dise­a­sed cells dis­place the healt­hy cells in the bone mar­row. This leads to a defi­ci­en­cy of all three healt­hy blood cell types, which is expres­sed in the fol­lowing way:

  • Red blood cells: Paleness and weak­ness due to wor­se­ning oxy­gen transport
  • White blood cells: Incre­a­sed sus­cep­ti­bi­li­ty to infec­tions due to a lack of immu­ne cells
  • Plate­lets: Brui­sing and blee­ding that is dif­fi­cult to con­trol due to impai­red blood clotting

Depen­ding on the type of leukemia cells, a dis­tinc­tion is made bet­ween mye­lo­id and lym­pho­cy­tic leukemia. Both types of leukemia can be acu­te or chro­nic. Acu­te leukemia deve­lo­ps very quick­ly and can beco­me life-threa­tening wit­hin a few weeks without tre­at­ment. Con­ver­se­ly, chro­nic leukemia deve­lo­ps gra­du­al­ly, with sym­ptoms some­ti­mes only appearing after mon­ths or years.

A dis­tinc­tion is main­ly made bet­ween the fol­lowing types of leukemia:

  • Acu­te mye­lo­id leukemia (AML)
  • Acu­te lym­pho­cy­tic leukemia (ALL)
  • Chro­nic mye­lo­id leukemia (CML)
  • Chro­nic lym­pho­cy­tic leukemia (CLL)

The chan­ces of reco­very vary depen­ding on the type and seve­ri­ty of the leukemia. Sin­ce leukemia is very indi­vi­du­al, the atten­ding doc­tor needs to crea­te a per­so­nal tre­at­ment plan for each pati­ent. Fre­quent­ly, howe­ver, tre­at­ment with che­mo­the­ra­py or radia­ti­on is not suf­fi­ci­ent. Trans­fer­ring (trans­plan­ting) healt­hy stem cells then beco­mes the only hope of survival.

Indi­ca­ti­ons for a stem cell transplant

The trans­plan­ta­ti­on of healt­hy stem cells has also pro­ven suc­cess­ful in a num­ber of other blood dise­a­ses – espe­cial­ly seve­re immu­ne defi­ci­en­ci­es and dise­a­ses requi­ring par­ti­cu­lar­ly aggres­si­ve tre­at­ment, such as mas­si­ve che­mo­the­ra­py or strong irra­dia­ti­on. Examp­les of dise­a­ses include:

  • Acu­te mye­lo­id leukemia (AML)
  • Acu­te lym­pho­cy­tic leukemia (ALL)
  • Chro­nic mye­lo­id leukemia (CML)
  • Chro­nic lym­pho­cy­tic leukemia (CLL)
  • Mye­lo­dys­plastic syn­dro­me (MDS)
  • Non-Hodgkin’s lym­pho­ma (NHL)
  • Hodgkin’s lym­pho­ma (HL)
  • Plasmocytoma/​multiple myeloma
  • Poly­cytha­emia vera
  • Osteo­myelo­fi­bro­sis
  • Seve­re aplastic anemia
  • Sick­le cell anemia
  • Fan­co­ni anemia
  • Par­oxys­mal noc­turnal hemo­glo­bin­uria (PNH)
  • Tha­las­sa­emia major
  • Immun­ode­fi­ci­en­ci­es (con­ge­ni­tal or acqui­red, e.g. SCID)

A more detail­ed list (in Ger­man) can be found in the indi­ca­ti­on cata­log of the Ger­man Working Group for Bone Mar­row and Stem Cell Trans­plan­ta­ti­on (DAG-KBT): <https://​dag​-kbt​.de/​L​e​i​t​l​i​n​i​e​_​z​u​r​_​a​l​l​o​g​e​n​e​n​_​S​C​T​.​h​tml

Ques­ti­ons and answers

The most fre­quent­ly asked ques­ti­ons and ans­wers about typ­ing and stem cell dona­ti­on can be found in our FAQs.

From typ­ing to transplantation

Here you can find infor­ma­ti­on about the pro­cess of a stem cell dona­ti­on from the per­spec­ti­ve of the pati­ent and the donor at a glance.

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