Treatments for blood cancers

There are many different types of haematological cancer and a range of treatment options available.

Please click on the links below for more information provided by Macmillan.

Bone Marrow Transplantation

The Bone Marrow Transplant Department is situated on Ward 89 in the Bexley Wing. It consists of four ‘isolation’ rooms, within a 20 bedded haematology ward.

Why do I need a transplant?

Leukaemia and other blood disorders interfere with the growth of some stem cells and cause the cells to stop developing or to become faulty (or in some cases both). Eventually, the abnormal cells enter the bloodstream or organs in the body, such as the spleen, causing ill-health.

Transplantation may offer the best chance of cure. It aims to replace the body’s abnormal bone marrow cells with normal stem cells. The donor marrow provides a new immune system, which will actively seek out any remaining disease and attack it. This is known as the ‘graft versus disease’ effect and it can help to stop the disease coming back in the future.

These normal stem cells will eventually provide immunity and allow normal cell production.

What is involved in a Bone Marrow Transplant?

Preparative therapy
Transplant donor stem cells (Day zero)
Cells travel to bone marrow and grow (engraftment)

The process involves giving ‘preparative therapy’. This prepares your body for the transplant by killing off the bone marrow and as many of the remaining diseased cells (if any) as possible. It also suppresses the immune system so the transplanted normal stem cells are more likely to be accepted. Preparative therapy was also called conditioning therapy in the past and it may include chemotherapy drugs, radiotherapy and immunosuppressive drugs.

After the preparative therapy has been given, the donor marrow stem cells can be transplanted. The process of transplantation does not involve any surgery, as some people think. The infusion of the donor marrow stem cells is relatively straight-forward procedure but it can be an emotional time and, after all the build-up, can feel like an anti-climax. It is given intravenously (into the veins) as a drip, similar to the way in which a blood transfusion is given.

Types of transplant

There are several different types of transplant donors and different preparative therapies. Your own circumstances and disease will determine which you have. If you need to have a transplant using a donor then it is vital to find a donor who is a good ‘tissue match’. Some of the more common types of donor are described below:

Matched Related Donor (MRD)
There is about a 1 in 4 chance that a brother or sister will be a tissue match and can be a bone marrow stem cell donor.

Matched Unrelated Donor (MUD)
In this case the tissue matched donor is an unrelated healthy volunteer. Volunteers are found with the help of donor registries, for instance, the Anthony Nolan Donor Panel. In this case the donation of stem cells is anonymous.

Cord Blood Stem Cell Donor
Donor cells, taken from the umbilical cord at birth, are frozen and stored by the cord blood stem cell banks. The blood obtained is rich in stem cells and these stem cells are able to function in the same way as bone marrow stem cells from adult donors. The cord blood stem cells can be used as a donor for patients who need a bone marrow stem cell transplant. Adult patients generally need a combination of two matched cords.

Mismatched Stem Cell Donor
This is done using bone marrow that is not a complete match to your own, usually because no other donor is available. This procedure may be less successful due to the side-effects of treatment and complications that can develop. This does not mean however, that they do not offer a valuable form of treatment for some patients. The difference between a bone marrow transplant and a stem cell transplant is the type of cells given back.

Some donors choose to give stem cells (taken from a cannula in their arm after growth injections) or bone marrow (bone marrow – containing stem cells taken in theatre). Sometimes it is possible to know which one is best for you. Your team can advice you on this however if your donor is unrelated they have the option to choose.