Mini transplants

These are similar to allogeneic transplants (from a donor) except that standard-dose chemotherapy is given instead of high-dose. This treatment may be given to people who cannot have high-dose chemotherapy, possibly due to their age or because they are not fit enough. A course of standard-dose chemotherapy is given, usually over five days, before the patient is given the donor’s stem cells or bone marrow. A drug which works on the immune system to reduce the risks of graft-versus-host disease is also given. It is hoped that this will trigger an immune reaction which will encourage the donor’s cells to take over in the patient’s bone marrow.

This is a new and still experimental treatment, which is being carried out in clinical trials. It is sometimes called a mini-allo or a non-myeloablative transplant.

Tandem transplants

In a tandem transplant, high-dose chemotherapy with stem cell support is followed within 3–6 months by another high-dose chemotherapy treatment with more stem cell support. It is thought that this may make the treatment more effective in controlling the illness. However, tandem transplants are still in the early stages of research.

Cord blood

It is now possible to take stem cells from the umbilical cord of a newly born baby. These stem cells may be used if the baby’s cells are a match for a brother or sister who needs a transplant. A major drawback is that usually not enough stem cells are collected. This treatment is also experimental and further research is going on to look at using stem cells from cord blood.