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Department for Internal Medicine III
Haematology and Internal Oncology

[Translate to englisch:] Stammzelltransplantation am UKR

Internal Medicine III

Stem cell transplantation

Stem cell transplantation procedures using the patient's own (autologous) or foreign (allogeneic) blood stem cells are used for high-risk patients with lymphoma and leukaemia as well as for some other causes of bone marrow failure, e.g:

  • Myelodysplastic syndrome (MDS) = collective term for a group of acquired bone marrow stem cell disorders
  • Severe aplastic anaemia = disorder of bone marrow function associated with a reduction in the number of bone marrow cells and reduced formation of all blood cells.
  • Congenital haematopoietic disorders

Treatment

New cell therapies using genetically modified lymphocytes (called CAR-T cells) are expanding treatment options. These therapies are the clinical and scientific focus of our clinic. A specialised team of doctors, nurses, psychologists and physiotherapists is available for the preparation, implementation and follow-up of these therapies to ensure optimal patient care at all stages of treatment.

  • Autologous stem cell transplantation (SCT)

    The dosage and timing of chemotherapy are critical to the success of tumour treatment. Side effects of cytostatics (chemotherapy drugs) on haematopoiesis in the bone marrow limit the dosage of such drugs. In autologous SCT (stem cell transplantation using the patient's own cells), stem cells are collected from the patient's blood (after administration of growth factors) and frozen several weeks before the planned therapy (leukapheresis). After high-dose chemotherapy, the patient's own cells are reinfused.

    This procedure allows the dosage of chemotherapy drugs to be significantly increased, as haematopoiesis is completely restored by the transplanted stem cells after 8-14 days. The main beneficiaries of this treatment are

    • Patients with relapse of high grade lymphoma or Hodgkin's disease,
    • Patients with multiple myeloma and/or amyloidosis
    • Patients with germ cell tumours.

  • Allogeneic stem cell transplantation (SCT)

    Allogeneic stem cell transplantation (SCT) offers a chance of cure to many patients with high-risk diseases, including

    • acute leukaemia,
    • myelodysplastic syndrome (MDS),
    • lymphoma recurrence
    • Some non-malignant causes of haematopoietic failure.
    • These include severe aplastic anaemia, disorders of bone marrow function associated with a reduction in the number of bone marrow cells and reduced formation of all blood cells, and haemoglobinopathies in which the structure, function or formation of the blood pigment haemoglobin is disturbed.

    After pre-treatment of the patient, SCT involves the transfer of blood stem cells from healthy family or unrelated donors, which then engraft in the bone marrow and take over haematopoiesis. Immunological mechanisms are also involved in the success of the therapy: donor lymphocytes recognise the patient's blood cells as "foreign" and destroy them, so that leukaemia and lymphoma cells are also eliminated by this immune reaction.

    Allogeneic stem cell therapy at UKR

    Allogeneic SCT is a focal point of the clinical and scientific work of our clinic and the University of Regensburg. Under the direction of Professor Dr Matthias Edinger, an interdisciplinary team looks after the treatment and well-being of the patients.

    • With more than 80 allogeneic stem cell transplants a year, it is one of the largest and most experienced centres in Germany.
    • Within Europe, it ranks in the top 5% for patient survival one year after transplantation (EBMT Benchmark Analysis 2020 and 2021).

    The transplant centre is JACIE-accredited (Joint Accreditation Committee-ISCT & EBMT), demonstrating its medical and organisational quality.

  • Patient information

    Stem cell transplants can be used to treat haematopoietic disorders and blood diseases. A distinction is made between autologous (own cells) and allogeneic (foreign cells) stem cell therapy.

    Risk assessment: the first step is for the medical team to justify the therapy and determine the indication. In addition to the desired responses, each therapy carries certain risks, so an individual risk assessment is carried out for each patient.

    Search for a donor: The first thing is to find a donor within the family, as certain blood characteristics are inherited. The search is then extended to the donor file.

    Therapy preparation and inpatient phase:

    • Conditioning: a few days before the transplant, high-dose chemotherapy or combined chemotherapy and radiotherapy is given to kill the patient's cancer cells, blood stem cells and immune cells.
    • The patient is closely monitored for complications.
    • Hygiene plays a very important role in the care and support of patients receiving a stem cell transplant, as the immune system is suppressed in preparation for the donation, increasing susceptibility to infections and germs.
    • Patients and their families receive a comprehensive range of support services, including psychological care, physiotherapy, pastoral care, bridging care, etc.
    • Aftercare: incl. immunosuppression (desired suppression of the immune response), protection against infections, vaccinations, day clinic
    • Hygiene after stem cell therapy
    • Offers and information on nutrition and exercise
    • The social services team will discuss the period after your hospital stay with you and your family.
    • Psycho-oncology & paediatric counselling
    • Patient house of the Leukaemia Aid Eastern Bavaria

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