Half-matched Stem Cell Transplants: Twice the Hope, Half the Wait, Full Recovery

January 18, 2021
A haploidentical stem cell transplant (colloquially called “half-matched transplant”) is a highly effective treatment option available at the Horizon Regional Cancer Center. “The bone marrow transplant is a treatment option for cancer of the blood. In some cases, it is the only hope of being completely cured of cancer, but the chances of finding a complete-match bone marrow  donor are very slim. However, a 50% match is now all that is required for treatment with high success rate. ” said Assoc. Prof. Col. Dr. Wichean Mongkonsritragoon, a haematology and oncology specialist.
“Apart from chemotherapy and pharmacotherapy, a bone marrow transplant is the only other option left for a full and complete recovery by the patient with blood disorders. The treatment is effective against common cancers of the blood, such as lymphoma and acute lymphoblastic leukaemia, not to mention aplastic anaemia, thalassemia, and certain kinds of autoimmune diseases.” Dr. Wichean gives a brief overview of the treatment options.
“Informing the patient of the true extent of their condition is often complicated by their personal belief systems, ideas, and religions, which also affect the viability of the treatment options available. For example, patients who are Jehova’s Witnesses will not accept blood transfusions. We have to find a way treat them to the best of our ability, while at the same time sincerely respecting their needs. It would be wrong for us to callously treat the physical while disrespecting the mental or spiritual element of our patients.” These days, bone marrow transplants can be done with stem cells from many sources, such as bone marrow, blood, or placenta.


A 50% match with a 100% chance

“The difficulty of a bone marrow transplant lies in finding stem cells that are a 100% match to the human leukocyte antigens of the patient. This is not easy to find, because even siblings have only a 1 in 4 chance of being a full match. For unrelated people to be a 100% match, the chances are incredibly slim, and it often takes a very long time to find a match, if one can be found at all. This factor has been a limitation for this treatment option until now. Today, a 50% stem cell match is sufficient for treatment with a chance of full recovery.


Professional teams for patient confidence

“The patient is always foremost in our consideration of the treatment plan. The window of time in which diagnosis and treatment is feasible will be different for each patient. We have to take many factors into account, such as allowing the patient some time with their family, which is crucial for morale. Yet, the treatment duration should also be as tight and continuous as possible.” Dr. Wichean goes on to detail the specialist teams that also include nurses, pharmacists, and other medical professionals. “Our physicians across all specialties are constantly drawing on each other’s expertise for the good of the patient. From the laboratory tests to diagnostic imaging, be it the x-ray, CT, MRI, PET SCAN, we can do it all. We even have nutritionists to ensure that the patient is on the very best diet for their condition and treatment plan. Bone marrow patients require an extremely specialised diet to minimize the chances of infection and inflammation. Even the bread has to be baked without yeast to make sure it is safe for immune-compromised patients, for example.


Knowledge is healing power

“We try our best to treat the patients as if they were our own relatives,” Dr. Wichean outlines his guiding principle in treating patients. “There was a case of an Arabic man with aplastic anaemia and a low blood cell count. Eventually, he ended up having to get a bone marrow transplant. He had more than ten siblings, yet none of them could provide the bone marrow to match his, which necessitated a haploidentical stem cell transplant. We had to mobilize the entire team to care for this patient properly, it was such a delicate situation. We got through the most critical stage when his white blood cell count was low, when he couldn’t eat, and had chronic diarrhea. Ultimately though, we were successful and he was able to go home. A couple of years later, he came to visit us. He wanted us to know that he was living a happy, healthy life, and that he was about to get married.”
“I want to tell all cancer patients to not lose hope, because these days cancer treatment has really advanced in leaps and bounds, especially for cancer of the blood. There are so many medications and treatment modalities that can be used. So don’t surrender hope when there are such good chances of a full recovery with the right treatment.” Dr. Wichean said in closing.
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