Bone marrow source of stem cell transplantation is the most common, but not the most convenient. The donor of bone marrow stem cells must be in anesthesia because a large needle will be put into the donor’s hip until it reached the marrow in the pelvis. The thick liquid marrow is then pulled into the syringe and is repeated until sufficient marrow is collected.
Then, the collected marrow is filtered and freeze until it is time to use. The melted and softened marrow is given into the recipient’s vein, thus, the stem cells will find their way to bone marrow and start dividing (VA et al., 2016). Blood tests can be performed to identify the new blood cells, usually in four weeks of transplant.
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In peripheral blood stem cells, stem cells are collected from donor’s blood. The donor is given growth factors before collecting stem cells from blood system. The growth factors caused the stem cells from bone marrow enter the bloodstream and enhance the growth. A catheter is connected into two parts which are to the donors’ large vein and to a tube carrying blood containing stem cells into a machine during harvesting as shown in Figure 1. The machine filters stem cells from other components of blood, thus, the other components are flowing back into donor’s body and this process took for 4 to 6 hours and repeated until sufficient stem cells are collected.
After the chemotherapy, the stem cells are infused into a patient’s vein and new cells can be identified much sooner than bone marrow transplant which is within 10 to 20 days. An umbilical cord blood stem cell is beneficial for patients who do not have matched donor among their family members and blood banks. This is because of patient’s high differential and cannot adjust into the most immune system. The newborn babies have numerous stem cells as the blood in the placenta and the umbilical cord kept for future use in stem cell transplants. It is collected from the thrown out blood after a baby is born. However, only a small number of stem cells usually found, but, these stem cells are able to make more cells than bone marrow stem cells.
Other than that, oogonial stem cells are collected from the ovary of reproductive-age females that having the potential of giving. A team of scientists used a fluorescent-activated cell sorting technique to attach antibodies to a protein; Ddx4 resides at an outer surface of stem cells. This method-of-labeling able to separate healthy stem cells from damaged cells.
This breakthrough allows scientists to detect hormones and drugs that affect these cells in eggs production, thus, this leads to slow aging of women and prolong the efficient of the reproductive (Broxmeyer, 2016).The suitable stem cells source is based on patient’s condition. The most commonly used currently is peripheral-blood-stem-cell-transplantation because the harvesting process is controllable as doctors able to manage, even though it is time-consuming. The disadvantage is the risk of developing chronic graft-versus-host disease is higher in peripheral blood stem cell transplant compared to in bone marrow stem cell transplants. When a good match is hard to find for bone marrow or peripheral blood cell transplants, umbilical cord blood transplants is believed to be the suitable option. Although it is best if cord blood is well matched, it does not need to be closely matched as in the extent of bone marrow and peripheral blood cases as suggested by studies.
As for patients with rare tissue type, cord blood is considered an advantage. Moreover, blood-cord-transplants reduce the severity of chronic graft-versus-host disease, but they take longer to engraft causing high-risk of infections to the patient (Socie and Ritz, 2014). In donation of bone marrow, it usually does not pose any problems for donor and its most serious risk is by the use of anesthesia during transplantation. The area may cause patient feeling stiff for a few days. However, the time required for a donor to recover is different (Agerskov et al., 2015).
In autologous transplants, the stem cells are obtained from the patient’s own body before infected and can be collected when a patient is temporarily cured when the recurrence of the disease is doubted (Giske et al., 2015). However, in allogeneic transplants, stem cells are obtained from a donor, who had well in HLA-matching, usually among family members, but this transplant can also be achieved between the unrelated donor and patient (Ikegawa et al., 2018). Syngeneic transplants are when patient getting stem cells of his identical twin, but, since identical twins are uncommon in births, thus, the syngeneic transplantation type is rare.
Identical twins have the same set of HLA because they have the same genes. Thus, less chance for the transplant gets rejected.Preservation of peripheral and bone marrow stem cells are done by filtration and froze until time for use. However, preservation of umbilical cord blood stem cells is done by removing plasma and red blood cells from cord blood, then, the stem cells stored at very low temperatures of liquid nitrogen vapor phase. Most experts of transplantation imply that umbilical cord blood stem cells remain viable continuously.
Applications of stem cell transplantation in recent years have risen greatly in both, the scientific community and among religious groups and different ethnicities. Human stem cells have the ability to transform into many cell types, thus, the stem cells are being studied extensively to treat cancers, chronic infections and diseases. Stem cell transplantation has improved a lot, treating many diseases like cardiovascular diseases, multiple sclerosis, lymphoma and leukemia (Stein, 2011). In donor matching, autologous stem cell transplants do not require matching tests as the stem cells collected are from the patients’ own body before getting the diseased. On the other hand, allogeneic stem cells must come from a donor with tissue type that closely matched with a recipient or then, the immune system of the recipient will detect the stem cells as foreign bodies and thus, destroy the transplanted stem cells (Kisch et al., 2018).
Other issues may arise when the new cells transplanted may identify recipients’ cells as foreign cells thus fight against the new host. Thus, it is very important to find the closest match as possible. In HLA-matching, the most important factor is the human-leukocyte-antigen (HLA) system. Each person has a different amount of HLA antigens pairs and they are genetically inherited. The HLA match is very important to the success of the transplant. HLA has six major antigens and the perfect match is when all the major six HLA antigens are matched between both, donor and recipient. Stem cell transplantations that having perfects matches have the lower possibility of getting complications like graft-versus-host disease, graft-rejection, weakened the immune and serious infections.
After the treatment, vaccinations for Haemophilus influenza and Streptococcus pneumonia are highly recommended for all recipients of stem cell transplants. The inactivated vaccine should also be used on family members against polio and isolation is necessary for a person that has the close contact at the first year after transplant with the patient. Besides, live vaccines like smallpox vaccine are contraindicated in recipients of hematopoietic stem cell transplantation as it results in developing inadvertent inoculations at other areas, for examples are face, nose, mouth, and rectum. Moreover, anthrax vaccine is highly recommended for high-risk patient that undergoing high-dose of chemotherapy (Kisch et al., 2015).In my opinion, stem-cells-transplantation is an advanced way of treating certain cancers. With sufficient amount of research in stem cells near future, this may be the most effective technique to treat cancers.
I believe this is considered as our effort as a human to prolong lifespan and improve quality of life. It would not seem like scientists are ‘playing god’ because not all transplantation will succeed, not all have good HLA-matching and not all succeed transplantation having less or no side effects. In my mind, pregnant women who have to do abortion because of the embryo will cause harm to the mother, that embryo could be the one that suitable for a stem cell research study and transplantation. Besides, the number of stem cells required to be collected in peripheral blood and cord blood stem cell transplantations is kind of difficult. The collecting procedures more convenient for both donor and doctors as it can be done in outpatient settings and do not need anesthesia, but, the stem cells collected are lower than stem cells obtained from marrow. Thus, multiple donations needed to be done many days until sufficient stem cells collected for a patient. Other than that, the magnification-of-hematopoietic-stem-cells-number is difficult because they are likely divided unevenly.
Thus, result in increased the risk of vulnerable developing genetic. Moreover, early side effects such as nausea and vomiting experienced by the recipient can lead to other complications, for instances, interstitial pneumonitis and mucositis (Knight et al., 2016). Plus, the side effects can also result in the development of graft-versus-host disease and bacterial infections.
In conclusion, the stem cell transplantation should be widely used as an alternative to treating a patient but under a serious condition and really needed to be treated. The stem cell transplants are sometimes difficult but it is cost-benefit which physician needs to do, although many issues about ethics in research of stem cell. Stem cell transplantation is a kind of medicine for cancer and very high doses of chemo, along with radiation therapy in order to destroy cancer and this treatment kills stem cells in bone marrow. The syngeneic transplants won’t help destroy any remaining cancer cells because the new immune system is so much like yours.
The choice to do the transplantation was subjective. This debate is how people value in various aspects in another and the critics can lead to big improvements on both sides. Every effort counts to destroy all cancer cells before doing the transplantation prevent the reoccurrence of the cancer cells.