News and Events
Overview
What is a Stem Cell Transplant?
- A stem cell transplant is used to increase the chance of a cure or remission for various cancers and blood disorders.
- A stem cell transplant may be necessary if your bone marrow stops working and doesn’t produce enough healthy stem cells.
- A transplant may occasionally be required to suppress an overactive immune system
- A stem cell transplant also may be performed if high-dose chemotherapy or radiation therapy is given in the treatment of blood disorders such as leukaemia, lymphoma or multiple myeloma.
- A stem cell transplant may be necessary if your bone marrow stops working and doesn’t produce enough healthy stem cells.
- The treatment requires close nursing and medical care for a number of weeks.
- It is an intensive treatment and there are risks involved in undergoing this therapy.
Centres
Currently active haemopoietic cell transplant centers in South Africa in the state sector include:
Chris Hani Baragwanath
Prof Moosa Patel
011 717 2113
26 Chris Hani Road, Johannesburg
Groote Schuur Hospital
Prof Louw, Drs Verburgh and Antel
021 404 3084
Clinic E5 New Main Building, Hospital Road, Observatory, Cape Town
Currently active haemopoietic cell transplant centres in South Africa in the private sector include:
Alberts Cellular Therapy
Drs Brittain, McDonald, Gerdener, Dr Marshall and Cass
012 993 2555
Medical Suite M34, Netcare Pretoria East Hospital, Cnr Netcare and Garsfontein Avenue, Moreletapark, Pretoria
Constantiaberg Mediclinic
Drs Du Toit and Dr Kotze
021 761 6600
Haematology Department, Constantiaberg Mediclinic, Burnham Road, Plumstead, Cape Town, Western Cape
Definitions
Term | Definition |
Acyclovir/Valacyclovir/Valgancyclovir | A drug used specifically against and for the prevention of herpes, zoster or CMV virus; given IV or orally. |
Allogeneic Transplant | A transplant between 2 different individuals. |
Alopecia | Hair loss |
Amphotericin | A drug used specifically against fungal infections: given IV. |
ANC | Absolute Neutrophil Count represents the total number of white cells that are capable of fighting bacterial infections. |
Anaemia | A condition in which blood has a low number of red blood cells. Signs and symptoms of anaemia may include: fatigue, weakness, pale colour, headaches, dizziness, low blood pressure and elevated heart rate. |
Antibodies | Protein substances in the blood stream that react against bacteria, viruses and other materials harmful to the body. |
Antibiotics | Drugs used to fight infections. |
Antigen | A chemical (sometimes a protein) recognized by the body’s immune system as being foreign. |
Aplastic anaemia | A disease where the bone marrow does not produce an adequate number of red cells, white cells and platelets. |
ATG | Anti-thymocyte globulin is an antibody made in horses or rabbits against T-cells and used to increase the likelihood of engraftment in bone marrow transplant recipients or to treat graft vs. host disease. |
Autologous transplant | A transplant in which the donor and recipient are the same person. |
Bactrim/Purbac | A medication taken IV/orally to prevent gastrointestinal infections as well as a type of lung infection called pneumocystis. |
Betadine | Brown soap that effectively kills germs when applied to the skin. |
Biopsy | The removal of a small piece of tissue from the body for purposes of diagnosis (i.e., bone marrow, skin, liver, lung). |
BMTU | Bone Marrow Transplant Unit. |
Bone marrow | A spongy material found in the centre of the bones that contains stem cells that manufacture blood cells. The 3 major types of blood cells that bone marrow stem cells produce are red blood cells (RBC), white blood cells (WBC) and platelets. Each has an important function. See red blood cell, white blood cell and platelets. |
Bone Marrow Transplant (BMT) | A procedure in which bone marrow stem cells are collected from one individual (the donor) and given to another (the recipient). The stem cells can be collected either directly from the bone marrow or from the blood by a procedure called apheresis. Sometimes the patient serves as his or her own bone marrow stem cell donor. |
Busulfan | A chemotherapy drug that is given prior to bone marrow transplantation. |
Cancer | Diseases that are characterized by the uncontrolled and abnormal growth of cells. Examples: leukaemia, lymphoma, and multiple myeloma. |
FBC | The Full Blood Count includes the level of haemoglobin and number of red and white blood cells and platelets in the blood. |
CD34 | A unique marker that is found on the surface of bone marrow stem cells. Special chemicals called monoclonal antibodies can be used to identify the CD34 positive stem cells in the bone marrow or blood. CD34 positive stem cells can be purified and T cell depleted for transplantation from donors. |
Central line or catheter/CVP | A central line or central venous catheter is a soft flexible tube that is placed under the skin and then directed into a large vessel leading into the heart. The catheter allows fluids, medications, nutrition and blood products to be given without sticking the patient with a needle. Blood can also be drawn through the catheter for laboratory tests. The catheter may have either one or two tubes or lumens. |
Chemotherapy | Drugs primarily used to destroy cancer cells but also used in bone marrow transplant patients without cancer in order to ensure successful engraftment. These drugs have side effects that affect other normal cells in the body. Another name commonly used is “chemo.” |
Chimerism | The state in which donor cells have durably engrafted in the recipient. Full donor chimerism implies that 100% of bone marrow and blood cells are of donor origin, while mixed or partial chimerism means that recipient cells are also present. |
Clotrimazole | Anti-fungal agent. See Mycostatin. |
Conditioning regimen | Term used for those chemotherapy drugs and sometimes radiation that collectively prepare the body for transplant. The conditioning regimen usually takes 6-8 days to complete. |
Culture | A laboratory procedure in which samples of blood, urine or other body fluid are used to determine the presence of an infection. |
Donor | The family member (parent, brother or sister) or unrelated volunteer who donates his/her bone marrow stem cells. Sometimes the patient serves as his or her own donor. On the day of transplant, the donor either undergoes a procedure called apheresis to collect bone marrow stem cells from the blood or (far less commonly these days) goes to the operating room and under general anaesthesia has multiple bone marrow aspirations (bone marrow harvest) to remove a portion of bone marrow. |
ECG | Electrocardiogram – a machine that records electrical measurements of the heart’s impulses. |
Engraftment | The successful growth of donor bone marrow stem cells in the recipient. |
Erythrocytes | Red blood cells. |
Fludarabine | An immunosuppressive chemotherapy drug that is given prior to transplant in order to prevent rejection of the donor cells by the recipient’s immune system. |
Gastrointestinal (GI) | Pertains to the digestive tract which includes the mouth, throat, oesophagus, stomach, small and large intestine and rectum. |
G-CSF | Granulocyte Colony Stimulating Factor. A drug that is found naturally in the body and that stimulates the production of granulocytes (neutrophils) by the bone marrow. G-CSF is also used to increase the number of stem cells circulating in the blood. |
Graft vs. Host Disease (GVHD) | A reaction between the transplanted T lymphocytes of the donor (graft) and the tissues/organs of the patient (host). The T- cells of the donor graft can attack the recipient’s tissues. The skin, GI tract, liver and other organs can be affected. |
Granulocyte | A type of white blood cell that helps fight infections. |
Haploidentical | When the donor and recipient share half of their HLA antigens (a “50% match”). Usually all parents are haploidentical with their children since children inherit half of their HLA antigens from their mother and half from their father. |
Haematocrit | A measure of red blood cell volume. A normal haematocrit (Hct) is between 36-48. A low Hct (for example <20) may result in the need for a red blood cell transfusion. |
Haematology | The branch of medicine that studies and treats diseases of the blood and blood forming organs. A haematologist is a physician that specializes in this area of practice. |
Haematopoietic | Referring to the tissue that produces the components in the blood including red cells, white cells and platelets, that is, bone marrow. Another term for a bone marrow transplant (BMT) is “haematopoietic stem cell transplant (HSCT)” |
Haemoglobin | The molecule inside red blood cells that carries oxygen and a measure of red blood cell volume. |
Haemoglobinopathy | A disorder of the bone marrow cells that produce erythrocytes (red blood cells). Two haemoglobinopathies for which a bone marrow transplant is occasionally performed are thalassemia major and sickle cell disease. |
Haemorrhage | Refers to a large amount of blood loss over a short period of time. |
HEPA filter | A High Efficiency Particulate Aerosol filter found in each of the transplant rooms which prevents harmful germs from entering the room via the air system. |
Histocompatibility | The degree of tissue similarity between the donor and recipient that will determine how easily the donor cells will be accepted and/or the likelihood and severity of GVHD. |
Histocompatibility (HLA) typing | Blood tests of the tissue typing system. The HLA and MLC determine the likeness between potential donor – recipient pairs. |
HLA | Human Leukocyte Antigen. See histocompatibility typing. |
Hyperalimentation | Intravenous administration of nutrients needed by the body. It is also called total parenteral nutrition (TPN). The nutrients in the form of fluid are given through the central line. |
Immune system | The body’s system of defences against disease. The immune system is primarily composed of white blood cells and antibodies. |
Immunology | A branch of medicine which studies the body’s natural defence mechanisms against disease. An immunologist is a physician that specializes in this area of practice. |
Immunosuppressed | The state where the body has a reduced ability to adequately fight infections. |
Infection | Invasion of any part of the body by germs. Bacteria, viruses, and fungi are the major germs that infect transplant recipients. |
Informed consent | The process whereby a patient/parent/legal guardian is given information about a specific surgery or treatment (i.e., bone marrow transplant). All potential risks and benefits must be understood prior to the signing of a consent form. It is a legal document that gives the physician permission to perform the procedure. |
Intravenous (IV) | The administration of fluids/medications directly into a vein. |
Isolation | Procedures (for example, handwashing, donning of gowns/scrubs, gloves and masks) in the transplant rooms that minimize the exposure of transplant patients to infection. |
IV pump | The machine that delivers fluids and medications intravenously. |
Jugular | Refers to the veins in the neck in which catheters may be placed for apheresis procedures or administration of chemotherapy. |
Apheresis | A procedure that is used to collect bone marrow stem cells from the blood (see PBSC). Typically, the donor of the PBSC is treated prior to the procedure with several days of GCSF injections to mobilize the bone marrow stem cells into the circulating blood. The blood is then passed through a machine that collects that part of the blood containing the stem cells. The remaining blood is returned to the donor. |
Leukaemia | A cancer of the bone marrow that is characterized by the abnormal growth of white blood cells. |
Leukocyte | A type of white blood cell. |
LFT’s | Liver function tests are measurements from blood samples that reveal how well the liver is working. |
Lymphocytes | A type of white blood cell that is especially important in fighting viral and bacterial infections as well as in rejecting transplants and causing GVHD. |
Lymphoma | Cancer of the lymph nodes. |
Metastatic | Refers to cancers in which there has been spreading to distant parts of the body from the original or primary site of the tumour. |
Myeloablation | The process of conditioning or preparing a patient for a bone marrow transplant in which the bone marrow stem cells are destroyed or ablated. Generally, the conditioning regimen contains very high doses of chemotherapy and often total body irradiation. |
Neutrophil | A type of white blood cell that plays a major role in fighting bacterial and fungal infections. |
Non-myeloablative | The conditioning regimen prior to transplant in which limited amounts of chemotherapy are administered in order to prevent rejection of the donor bone marrow stem cells without destroying the recipient’s bone marrow. |
Nystatin | A medication specifically used to fight a fungal or yeast infection. |
Oncology | The study and treatment of cancer. An oncologist is a physician who specializes in this area of practice. |
PBSC (peripheral blood stem cells) | Peripheral Blood Stem Cells. These are bone marrow stem cells that are circulating in the blood and can be collected by apheresis. To increase the number of PBSC donors receive GCSF for several days prior to the apheresis. |
Phenytoin | A drug used to help prevent seizures. Patients are put on this while they are receiving Busulfan, a chemotherapy that can cause seizures. |
ICU | Intensive Care Unit. |
Platelets | A type of blood cell that is necessary to stop bleeding and allow injured areas to form clots. A normal platelet count is 150,000-300,000 cells per microlitre. A platelet transfusion may be needed with platelet counts <20,000 or to help stop bleeding. |
Radiation Therapist | A physician who specializes in the use of radiation in the treatment of diseases. |
Radiation Therapy | Treatment using high energy radiation. (See total body irradiation). |
Red Blood Cells (RBC) | Cells found in the blood responsible for carrying oxygen to tissues in the body. |
Stem cells | The youngest bone marrow cell from which other bone marrow cells are formed. |
Syngeneic Transplant | A transplant between identical twins. |
Total Body Irradiation (TBI) | Treatment using radiation to kill cancer cells and/or prepare the body for transplant by destroying diseased cells and suppressing the recipient’s immune system’s ability to reject the donor cells. |
Transfusion | A procedure that supplies the body with a specific types of blood cells (red blood cells or platelets) that are low in number. |
Umbilical cord blood | The blood that is collected from the placenta after the umbilical cord is separated from a new born baby. This blood contains large numbers of bone marrow stem cells and can be used as a source of donor cells from a sibling or unrelated donor for a bone marrow transplant. |
Vascath | A temporary central venous catheter that is used for apheresis procedures. It is usually inserted into a large vein in the neck or the groin and removed once the procedure is over. |
Veno-occlusive disease (VOD) | An old term for sinusoidal obstruction syndrome (SOS). A severe complication following a bone marrow transplant in which there is progressive liver failure. VOD may be mild and resolve without any treatment or may be severe and often fatal. |
Venous | Referring to veins in the body that carry blood from all the organs and tissues back to the heart. Central lines and apheresis catheters are venous catheters, i.e., they are placed in large veins. |
White blood cells (WBC) | Cells found in the blood and tissues that aid in fighting infections and making antibodies for the immune system’s attack against disease. There are several types of white blood cells including neutrophils and lymphocytes. The normal WBC is 5,000-10,000 per microlitre of blood. |
Yeast | A germ that can infect recipients of bone marrow transplants. One kind of yeast or fungus is Candida. Fluconazole is an antibiotic that is given during the transplant period to reduce the risk of fungal infections. Yeast or fungal infections are very dangerous and when yeast is cultured, or a yeast infection is suspected a very powerful antibiotic, amphotericin is usually administered. |
Zoster | A viral infection that may occur post bone marrow transplant in a patient who has previously had chicken pox. Zoster or shingles is the reactivation of the chicken pox virus (varicella). |