Treating Leukemia With Stem Cells

Treating Leukemia With Stem Cells

The purpose of this paper is to introduce, discuss, and analyze literature to create a literature review. Specifically it will investigate past literature on treating leukemia with stem cells and its success.

Allogeneic hematopoietic stem cell (HSC) transplantation can save lives in bone marrow transplants, but it is often not available due to a lack of availability of suitable human matched donors. Umbilical cord blood (UCB) is an alternative, especial in pediatric acute leukemias. Umbilical cord blood is also found to be "an acceptable source of HSCs for adult acute leukemia patients who lack HLA-matched donors" (Tse et al., 2008, p. 465). The authors believe studies into leukemia and UCB will impact the use of stem cell transplants in the future, because UCB is easier to get, less risky for donors, it has a low risk of infection, and is superior in just about every way to regular stem cells.

The study looked at clinical outcomes for a group of adults with leukemia, and found many interesting results. For example, they found "UCB recipients were younger (median, 24.5 vs. 32 years; Po0.001), weighed less (median, 58 vs. 68 kg; Po0.001) and had more advanced disease (52 vs. 33%, Po0.001)" (Tse et al., 2008, p. 469). They also found UCB recipients had better short- and long-term survival rates. They also give recommendations to practitioners about using UCB in adults. They write, "Using double UCB units for adult AML patients can effectively overcome the low cell dose barrier observed in clinical practice" (Tse et al., 2008, p. 470). UCB seems to be an excellent alternative source of stem cells for use in a variety of treatments.

Stem cells are more difficult to obtain, so UCB is a good alternative source for stem cells, and it is especially helpful in bone marrow treatments for children and adult leukemia patients. It is easier to obtain and use, people show better survival rates, and it is generally a superior source of stem cells.

Hematopoietic stem cell (HSC) has been used to treat chronic myelogenous leukemia (CML) for over 15 years and it is still a very standard treatment for CML patients. However, the creation imatinib mesylate, which inhibits the molecular defect that causes CML is an alternative treatment that makes the use of grafting stem cells often unnecessary in CML treatment.

The authors acknowledge the use of stem cells has grown in regard as a successful way to treat leukemia in many patients. They state, "In most patients, imatinib reduces CML to a minimal residual disease state in which options to further deepen remission, such as immunotherapy, are sought; monitoring techniques and interpretation of response advance in parallel to meet demands" (Mauro and Maziarz, 2006, p. 404). The authors maintain stem cell use has helped them learn more effective ways of treating leukemia. They offer imatinib clinical trial information that major cytogenetic response (MCR) was higher with the imatinib control group study that began in 1998. They note, "Complete hematologic response was achieved in 96% of patients. To date in this study, imatinib has induced an MCR in 67% of patients, of which 55% were complete. Of patients with MCR, an estimated 82% have maintained their response for 36 months or more" (Mauro and Maziarz, 2006, p. 406). Follow-up studies show a greater quality of life for imatinib patients, and it is less costly than stem cell treatment, as well.

In summary, ongoing studies indicate that stem cells may be falling out of favor in treating leukemia, because imatinib seems to be a better alternative. Studies show it is more effective than stem cells, patients report a better quality of life after receiving the treatment, and it is less costly. Imatinib also has a greater survival rate, which is extremely important for patients.

The authors did a comparison study of 682 adults with acute leukemia. All these patients received a hematopoietic stem-cell (HSC) transplant from a donor that was unrelated to them. The authors compared them to patients who received UCB instead of HSC. One of the important characteristics of UCB is that it does not have to match the donor, which makes it much more flexible in leukemia and other treatments.

The study covered two groups of people. The authors note, "98 received cord blood and 584 received bone marrow. The transplantations were performed from 1998 through 2002 and reported to Eurocord and the European Blood and Marrow Transplant Group" (Rocha, V., et al., 2004. p. 2276). They traced participants' ages, weights, level of severity of the disease, and other influences to discover what treatment worked best in treating adults with leukemia. They found that rates of mortality and relapse were very similar between the two groups. They discovered that cord-blood transplantation had delayed neutrophil recovery and a lower incidence of acute GVHD" (Rocha, V., et al., 2004. p. 2283). They also found that UCB was a good alternative form of treatment of acute adult leukemia, especially when they did not have a matched bone marrow donor.

In summary, this was an extensive study that looked at two groups of leukemia patients. UCB outcomes were similar to traditional treatments, and the group found that there were similarities between the two groups. UCB is a successful alternative to stem cell transplants in many patients.

Using partially matched donor hematopoietic stem cells (HSC) shows promise in patients who have hematologic cancer and are a relapse high risk. Often, the transplants can promote immune system reconstruction and control other related diseases. The authors studied 43 transplant patients and did follow-up studies on their condition after the transplants. These studies included "morphologic examination of bone marrow, assessment of hematopoietic chimerism with the use of short-tandem-repeat amplification, and HLA typing" (Vago, L., et al., 2009, p. 478). The authors conducted monthly follow-ups on all the patients, and monitored their progress in many ways. There purpose was to try to discover what causes a patient to relapse with the disease.