Lisa Ray has done a great thing for cancer patients the world over. The actress who was diagnosed with Multiple Myeloma, a rare form of cancer in 2009 let doctors try treating her with Hematopoietic stem cell transplantation. She has now publicised this treatment and given sufferers hope.
Multiple Myeloma is a cancer of the white blood cells known as plasma cells which destroys bones. There is currently no known cure and treatment is focussed on containment. Lisa battled with chemotherapy medications, steroids and treatment like Inj. Velcade and Revlimid before agreeing to experiment with stem cell transplant. This January, she underwent the treatment and is pronounced to be cancer free at the moment.
Hematopoietic stem cell transplantation is the transplantation of blood stem cells and is most often performed on people with diseases of the blood, bone marrow, and certain other cancers as well as for some non- cancer conditions.
Stem cells can be derived from bone marrow, peripheral blood or the umbilical cord. Peripheral blood stem cells are now the most common source and are collected from the blood through a process known as apheresis. Blood from the donor is withdrawn through a needle in one arm and passed through a machine that removes blood stem cells. Collecting peripheral blood stem cells provides a bigger graft and it does not require that the donor be subjected to general anaesthesia. You get results in a shorter time compared to engraftment, and it may provide for a lower long term relapse rate.
Umbilical cord blood is obtained when a mother donates her infantâ. Cord blood has a higher concentration of stem cells than is normally found in adult blood. Stem cells could also be removed from a large bone of the donor, typically the pelvis.
Many recipients of HSCTs are multiple myeloma or leukemia patients who would not benefit from prolonged treatment with — or are already resistant to — chemotherapy.
When stem cells are derived from the patient and transplanted back into the same patient, it is termed autologous HSCT. When the stem cells of a donor are transplanted into the patient, it is called allogeneic HSCT.
Autologous HSCT requires the extraction of haematopoietic stem cells (HSC) from the patient and storage of the harvested cells in a freezer. The patient is then treated with high-dose chemotherapy with the intention of eradicating the patient’s malignant cell population at the cost of partial or complete bone marrow destruction.
The patient’s own stored stem cells are then returned to his/her body, where they replace destroyed tissue and resume the patient’s normal blood cell production. Autologous transplants have the advantage of lower risk of infection and the incidence of patients experiencing rejection is very rare due to the donor and recipient being the same individual.
Allogeneic HSCT donors must have a tissue type that matches the recipient. By transplanting healthy stem cells to the recipient’s immune system, allogeneic HCSTs appear to improve chances for cure or long-term remission once transplant-related complications are resolved.
HSCT though is not a miracle cure. It has side effects. Allogeneic HSCT is associated with a 10 per cent treatment-related mortality, which limits its use to conditions that are life-threatening. Major complications are severe liver injury, mucositis, infections and graft-versus-host disease.

The writer is director and chief surgical oncologist Indo-American Cancer Institute & Research Centre.