Transplants for Cancer Treatment

The field of organ or tissue transplant as a cancer treatment is dominated by hematopoietic stem cell transplants (HSCTs), which include bone marrow transplants and peripheral blood cell transplants1 for a number of cancers, predominantly those affecting the blood. Transplants in the treatment of other cancers is a fairly narrow field and it includes some liver and lung cancers.

What it's effective for and why

HSCTs are effective in the treatment of numerous subtypes of leukemia, non-Hodgkin's lymphoma and Hodgkin's lymphoma, as well as some instances of neuroblastoma and multiple myeloma. HSCTs have become an effective second- or third-line therapy option for leukemia and lymphoma patients because of the procedure's ability to generate the growth of healthy blood cells in the body.

Liver transplants are only performed on cancer patients when the cancer has been positively identified as being a primary hepatoma (a cancer that begins in the liver); liver transplants are not a consideration for cancer patients whose disease has metastasized to the liver from another region of the body2. Like liver transplants, primary cancers of the lung like mesothelioma3 or bronchioloalveolar lung cancer4 are only rarely treated with a lung transplant.

Tranplant complications and risks: Overview

The largest hurdle to achieving a successful organ transplant is preventing rejection by the host, a task that requires severe immunosuppression and puts the patient at great risk of a variety of infections. This holds true for solid organ transplants, but the opposite is true for hematopoietic stem cell transplants. In some of these types of transplants, the patient is receiving donor stem cells, some of which will develop into white blood cells. In graft-versus-host-disease (GVHD), these white blood cells reject the recipient by perceiving healthy cells in the recipient's body as being antigens and attacking them. As in other transplants, a patient receiving an HSCT will receive medication to suppress their immune systems, leaving them vulnerable to infection, but they will also receive medication to prevent GVHD.

References

  1. American Cancer Society: Stem cell transplants
  2. Jackson/Siegelbaum Gastroenterology: Liver transplant
  3. Lung Transplant for Mesothelioma Patients
  4. OncoLink: Recurrence of Bronchioloalveolar Carcinoma in Transplanted Lungs

 

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