Stem cells are a class of undifferentiated cells that are able to differentiate into specialized cell types. Commonly, stem cells come from two main sources:

  • Embryos formed during the blastocyst phase of embryological development (embryonic stem cells) and
  • Adult tissue (adult stem cells).

Both types are generally characterized by their potency, or potential to differentiate into different cell types (such as skin, muscle, bone, etc.).

Stem cells are either extracted from adult tissue or from a dividing zygote in a culture dish. Once extracted, scientists place the cells in a controlled culture that prohibits them from further specializing or differentiating but usually allows them to divide and replicate. The process of growing large numbers of embryonic stem cells has been easier than growing large numbers of adult stem cells, but progress is being made for both cell types.

Allogenic Transplant

Allogeneic stem cell transplantation involves transferring the stem cells from a healthy person (the donor) to your body after high-intensity chemotherapy or radiation.

Allogeneic stem cell transplantation is used to cure some patients who:

  • Are at high risk of relapse
  • Don’t respond fully to treatment
  • Relapse after prior successful treatment

Allogeneic stem cell transplantation can be a high-risk procedure. The high-conditioning regimens are meant to severely or completely impair your ability to make stem cells and you will likely experience side effects during the days you receive high-dose conditioning radiation or chemotherapy.

The goals of high-conditioning therapy are to treat the remaining cancer cells intensively, thereby making a cancer recurrence less likely inactivate the immune system to reduce the chance of stem cell graft rejection enable donor cells to travel to the marrow (engraftment), produce blood cells and bring about graft versus tumor effect

Autologous Transplant

An autologous transplant (or rescue) is a type of transplant that uses the person’s own stem cells. These cells are collected in advance and returned at a later stage. They are used to replace stem cells that have been damaged by high doses of chemotherapy, used to treat the person’s underlying disease.

Autologous transplants are used to treat a number of different blood cancers – leukaemias lymphomas and myeloma, and certain solid tumours – breast cancer, testicular cancer, osteosarcoma and others. Autologous transplants allow the use of high dose chemotherapy, which provides some people with a better chance of cure or long-term control of their disease.

Most people have a single autologous transplant. Others, particularly those with myeloma or some solid tumours, may have two or more sequential (one after the other) transplants, over a period of a few months.

Umblical Cord Transplant

Umbilical cord blood, like bone marrow and peripheral blood, is a rich source of stem cells for transplantation. There may be advantages for certain patients to have cord blood stem cell transplants instead of transplants with marrow or peripheral blood stem cells (PBSCs).

Stem cell transplants (peripheral blood, marrow or cord blood) may use the patient’s own stem cells (called “autologous transplants”) or use donor stem cells. Donor cells may come from either a related or unrelated matched donor (called an “allogeneic transplant”). Most transplant physicians would not want to use a baby’s own cord blood (“autologous transplant”) to treat his or her leukemia. This is because donor stem cells might better fight the leukemia than the child’s own stem cells.

Cord blood for transplantation is collected from the umbilical cord and placenta after a baby is delivered. Donated cord blood that meets requirements is frozen and stored at a cord blood bank for future use.

Stem Cell Treatment in Orthopaedics

Stem cell therapy is a new and rapidly advancing entity in the field of medicine. The separation of stem cells from the bone marrow and its application in the various defective areas of the body forms the basis of this treatment. Its therapeutic implication in various specialities is growing with improved ways of stem cell harvest and application. In Orthopaedics, it has gained recent importance in the treatment of various disorders like

  • Osteoarthritis
  • Cartilage repair and regeneration
  • Non union of fractures
  • Tendinitis – Tennis elbow, Plantar fasciitis
  • Osteonecrosis(bone death)