How do donor hematopoietic stem cells function after being transfused into the patient's body? What conditions does hematopoietic stem cell matching refer to? What screening needs to be undertaken? How to join the China Bone Marrow Bank and become a hematopoietic stem cell donation volunteer?
In this issue, Wang Xiaogang, deputy chief physician of the Department of Hematology of Zhejiang Provincial People's Hospital, and Huang Huiyuan, a staff member of the Zhejiang Provincial Hematopoietic Stem Cell Donor Database, are invited to see how the seeds of life take root and sprout and replay the light of life!
Question 1: What is hematopoietic stem cell transplantation?
Leukemia is difficult to cure by chemoradiotherapy alone, and the emergence of hematopoietic stem cell transplantation has greatly improved the cure rate of leukemia patients.
Hematopoietic stem cell transplantation requires patients to receive a high dose of radiotherapy or chemotherapy to remove the existing hematopoietic cells and immune cells in the body, and then transfuse the donor's normal hematopoietic stem cells to rebuild normal hematopoietic and immune function.
In the early stages of high-dose radiotherapy and chemotherapy, most of the tumor cells and abnormal clonal cells have been eliminated from the patient's body, but a small number of leukemia cells remain, which will be eliminated by the patient's re-established normal immune system after the stem cell transplant.
Question 2: How to match hematopoietic stem cell transplantation?
Human beings have a very complex immune system, which also makes the matching of hematopoietic stem cell transplantation very complicated, whether it can be matched depends on the histocompatibility between people, and both the donor and the patient need to undergo human leukocyte antigen (HLA) genetic testing.
The genes of human beings are diverse, and they are even more ever-changing after permutations and combinations, and there are basically no two people in this world whose genes are the same.
In clinical practice, genes from 5 sites, A, B, C, DR, and DQ are generally screened for matching, and those with the same 10 sites are "fully compatible", and those with more than 5 identical sites are "haploidentical".
Question 3: What should leukemia patients do if they can't wait for matching?
Director Wang said that taking acute leukemia as an example, acute leukemia can be divided into low-risk type, intermediate-risk type, and high-risk type.
Although science and technology are developing rapidly and new drugs are constantly being developed, the position of hematopoietic stem cell transplantation in the treatment of leukemia cannot be replaced, and patients often need to undergo allogeneic hematopoietic stem cell transplantation to achieve the curative effect.
At the same time, Director Wang said that the larger the stock of the Chinese bone marrow bank, the more beneficial it is to the treatment of leukemia.
Question 4: What is the success rate of hematopoietic stem cell transplantation?
In the short term, the probability of successful transplantation in patients with leukemia from hematopoietic stem cell transplantation to testing can reach about 90%.
In the long term, the probability of a patient's recurrence after 5 years of successful transplantation can reach about 60%.
Finally, Director Wang emphasized that the traditional bone marrow transplant draws bone marrow blood, and local anesthesia or spinal anesthesia is required during the donation process, which will cause some damage to the donor's body, but hematopoietic stem cell transplantation draws peripheral blood, not bone marrow blood, which will not cause too much damage to the donor's health.
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