Not exact matches
If your twins are fraternal, it is also good to know that most current cord blood treatments require the use of a well
matched donor's stem
cells, like a sibling's.
That's particularly good news for people of certain ethnic minorities who often have trouble finding
matched stem
cell transplant
donors.
New findings presented today indicate that with proper considerations, haploidentical (half -
matched) transplants or transplants using cord blood
cells can be viable, effective alternatives when a fully
matched donor is not available.
To help the new organ withstand the assault from the recipient's natural defenses, doctors developed tissue type
matching, a technique to determine if the chemistry of the
donor's immune system, defined by antigens on the surface of
cells, was similar to that of the recipient's.
Historically, clinicians evaluating a patient for transplant have sought to identify
donor cells that are perfectly
matched to the patient's
cell type, which is considered to be the optimal approach to help ensure successful outcomes and to minimize risk of graft - versus - host disease (GVHD), a serious and potentially life - threatening complication that occurs when the donated immune
cells attack the patient's
cells as foreign tissue.
In Western society the population is growing older, the incidence of chronic disabilities which could be treated by stem
cell therapy is steadily rising, and the availability of
donor organs is not
matching the need.
The American Red Cross and the researchers themselves were quick to say the study is not definitive enough to change the current practice of
matching red blood
cell donors to recipients.
Researchers have long used a different monkey species to research stem
cell transplants, but that species» biological characteristics means it can't be reliably used to find good
donor matches to mimic human stem transplants.
Organ transplantation is a challenge, requiring immunosuppressive drugs and careful
matching of
donor and recipient for human leukocyte antigen markers, receptors on immune
cells that recognize foreign proteins.
This approach also does not rely on the identification of a
matched donor, thus avoiding the risk of rejection of
donor cells.
Even more remarkable was that each stem
cell line genetically
matched one of 11 skin
cell donors.
In these therapies, the patient's own blood - producing bone marrow
cells are treated with radiation and chemotherapy, and the blood of a twin or closely
matched donor is instilled.
As demonstrated by the breadth of clinical trial involvement shown above, CCIR members are testing the utility of immune checkpoint blockade in lymphoma (shown by Dr. Allison to be effective against melanoma), genetic engineering in
cell therapy (e.g., CD19, CXCR2, TGF - β DNR), and TLR agonists or IL - 2 in vaccine formulations as well as some novel combination therapies, such as the infusion of tumor - reactive lymphocytes from HLA -
matched donors who were vaccinated with a lymphoma idiotype.
It comes as a surprise to many patients in need of a stem
cell transplant that approximately 70 % of patients do not have a
matching donor in their family.
Ultimate use of newborn stem
cells will be determined by the treating physician who will consider if they are applicable for the condition and should come from the patient or a suitable
donor (siblings of the same biological parents have a 25 % chance of being a perfect
match and a 50 % chance of being a partial
match; biological parents will always be a partial
match).
Then bone marrow stem
cells from an immunologically
matched donor (or from the patient's own body) are given back to the patient.
Patients transplanted with
cells from a parent or an unrelated
donor do not do as well as those receiving fully
matched transplants.
Patients receive one of two types of stem
cell - based transplants: autologous, in which a patient donates and receives back his / her own stem
cells; or allogeneic, in which bone marrow - derived stem
cells come from a related or unrelated
donor whose human leukocyte antigens (HLA) are genetically
matched with those of a patient.
The ability to safely use half -
matching donors (parents, most siblings, and all children of the patient) makes bone marrow transplant an effective option for the majority of sickle
cell patients.
By typing for HL - A antigens,
donors and recipients of white blood
cells, platelets, and organs can be «
matched» insuring good performance and survival of transfused and transplanted
cells.
What are appropriate sources of stem
cells for HCT in patients without an HLA -
matched, related
donor?
The best treatments include blood transfusions or bone marrow transplants from a
matched donor, but this is limited due to the eventual immune response which is mounted against the donated
cells.
Using a combination of half -
match stem
cells from a related
donor and cord blood stem
cells, haplo - cord transplant opens the option of transplantation to nearly all patients for whom the procedure was previously not available.
For that to be done successfully, a bone marrow
donor match has to be found, and then chemotherapy given, before a person with the disease is ready to have
donor bone marrow
cells transplanted.
Matching of MHC alleles between the
donor and recipient is important for the success of stem
cell and tissue transplants.