Allogeneic stem cell transplantation
In an allogeneic transplant, blood-forming stem cells come from another person — a sibling or an unrelated donor matched by HLA tissue markers. After conditioning treatment, the donor cells rebuild the patient's bone marrow and immune system, and donor immune cells can additionally destroy remaining leukemia cells (the graft-versus-leukemia effect). The price of this effect is the risk of graft-versus-host disease, in which donor cells attack the recipient's healthy tissues. The method is used above all in acute leukemias and myelodysplastic syndromes.
How it works
A suitable donor is found by comparing HLA markers (human leukocyte antigens) — proteins present on most cells of the body; the closer the match, the better the chance that the body accepts the graft, and matched siblings are typically the best donors. The patient first receives conditioning treatment — high-dose chemotherapy with or without total-body irradiation, or lower-dose regimens in so-called reduced-intensity ("mini") transplants — after which the donor's stem cells are given through a vein. Over the following weeks they settle in the marrow and rebuild both blood production and the immune system.
Because the new immune system comes from another person, it can attack remaining leukemia cells (the graft-versus-leukemia effect), but it can also turn against the patient's healthy tissues, causing graft-versus-host disease (GVHD). GVHD may appear within the first months (acute) or later (chronic) and is treated with steroids and other immune-suppressing drugs. Recovery is long: regaining full immune function can take one to two years, and patients remain under close specialist follow-up.
Used in
Acute Myeloid Leukaemia (AML)
C92-C94
consolidation option in high-risk disease and after relapse
Where this therapy is delivered
University Clinical Centre, Gdańsk
Gdańsk · routine care
University Hospital in Kraków
Kraków · routine care