HSCT began in 1960’s for a few victims of an accident who were irradiation with near lethal radiation. They were saved with a transplant of bone marrow. Then, bone marrow transplantation was done for leukaemia (blood cancer) in Seattle, USA. Our blood grows from early stem (baby) cells in the bone marrow. These cells are called haemopoietic stem cells. These cells can be obtained by directly removing the bone marrow by sucking out the bone marrow by needles. This is the traditional way it was first performed. Nowadays, majority of haemopoietic stem cells are removed by first stimulating the stem cells to leave the marrow into the blood circulation by simple injections. Then the stem cells are collected via the blood from a vein by a apheresis machine. These stem cells can then be used for a transplant.

HSCT can be used to treat and cure leukaemias (blood cancers), lymphomas (lymphatic cancer), thalassaemias (inherited severe anaemia), certain cancers including germ cell tumors and renal cell carcinoma, and certain severe autoimmune diseases. Cure can be achieved in up to 80-90% of some leukaemias.

The stem cells that are used can be from various sources. Depending on the disease or condition being treated, a certain source may be better. The sources are 1) own stem cells (autologous), 2) a twin (syngeneic), 3) a sibling (allogeneic), and 4) an unrelated donor (allogeneic, unrelated). Also, haemopoietic stem cells from cord blood can be used be it autologous, syngeneic or allogeneic.

Gleneagles Medical Centre, Penang had embarked on its haematopoietic stem cell transplantation programme in year 2003, with the first stem cell collection done. The team is lead by Dr Leong Kin Wah, who was involved in the pioneer team that performed the first adult transplantation in Malaysia in 1995. Dr Leong has also received training and experience overseas in Ireland and Australia. Together with our partner in stem cell technology and storage facilities, Stem Life Sdn Bhd, new milestones have been achieved.

Transplantation is not without its risks. The procedure requires the patient to be relatively fit. There are possible dangers including infections, rejection and a condition called graft vs host disease in which the transplanted stem cells react in the donor’s body causing illness. However, these can usually be treated and controlled. Thus, patients are counseled regarding the chance of success, what the procedure is about and the possible dangers.

The procedure is divided into 3 main parts. First, the stem cells are collected from the donor. The donor is given an injection twice a day to make the stem cells leave the bone marrow and appear in the blood. Then the stem cells are collected using an apheresis machine. The stem cells are then cryopreserved in extremely freezing temperatures. They can be stored for years. The second part is called conditioning. The patient is given medications which include cytotoxic chemotherapy to remove cancer cells and to facilitate the infusion of the new stem cells. The third part is the infusion (actual transplantation) of the new stem cells into the patient via the vein. The stem cells will go to the bone marrow spaces and grow over the next 2-4 weeks, before being functional.

A successful transplant will mean a new lease of life for patients with these life threatening illnesses. Many patient lives have been saved by transplantation.