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Research shows children do better with stem cell transplants than adults

Tony Truong at Cumming School examines stem cell transplant reactions at the Alberta Children’s Hospital
February 29, 2016
Taiya MacLean was treated for leukemia four years ago at the Alberta Children’s Hospital where she received a stem cell transplantation to restore her immune system. A new research study by Dr. Tony Truong, a member of the Alberta Children's Hospital Research Institute, which included Taiya and more than 200 other children shows they have fewer adverse reactions than adults to the life-saving treatment. Photo Riley Brandt, University of Calgary

Taiya MacLean was treated for leukemia four years ago at the Alberta Children’s Hospital where she received a stem cell transplantation to restore her immune system. A new research study by Dr. Tony Truong, a member of the Alberta Children's Hospital Research Institute, which included Taiya and more than 200 other children shows they have fewer adverse reactions than adults to the life-saving treatment. Photos Riley Brandt, University of Calgary

The MacLean family, from left: Heidi, Taiya, Amanda and Chad lived for six months at and near the Alberta Children's Hospital in 2012 while Taiya received the treatments and transplants for her leukemia.

The MacLean family, from left: Heidi, Taiya, Amanda and Chad lived for six months at and near the Alberta Children's Hospital in 2012 while Taiya received the treatments and transplants for her leukemia.

Dr. Tony Truong shows Taiya the intravenous line used to infuse stem cells into the patient.

Dr. Tony Truong shows Taiya the intravenous line used to infuse stem cells into the patient.

Ten-year-old Taiya MacLean and her family are at the Alberta Children’s Hospital for a friendly visit with her oncologist. The family lives in Okotoks and has made this trip many times.

Taiya was treated for AML leukemia at the hospital four years ago. She is now completely healthy. As a big component of her therapy, she received a stem cell transplant to help restore her immune system which became suppressed as a result of the chemotherapy and radiation she received.

Stem cells are obtained from a donor’s blood or bone marrow and infused into the recipient to restore the immune system.

“Taiya had little to no reaction to the stem cell transplant. I think she got a fever but it was manageable,” says her mom, Amanda MacLean. "It was in the evening so Taiya and I watched a movie while she was getting the stem cells. We had three nurses with us in the room the whole time each with a different job to do. I honestly only remember it to be a very exciting day for us. We had a pinata to celebrate."

Study finds children react favourably to stem cell infusions

Taiya is not alone in receiving stem cell transplants at the Alberta Children’s Hospital. Over a decade, approximately 200 children were treated in the same way. Now, a University of Calgary research team has combed this data — examining the results of the treatment to determine how children react. The research is published in the January edition of the journal Bone Marrow Transplantation.

There are few studies and scant literature globally examining stem cell transplant reactions in a paediatric population.    

“We were pleased to see that most of the children — nine out of 10 — did extremely well with the transplants. No child in our study had any severe or life-threatening reactions,” says study lead Dr. Tony Truong, an assistant professor in the Departments of Oncology and Paediatrics at the Cumming School of Medicine, and a member of the Alberta Children’s Hospital Research Institute.

In the study, only 11 per cent of children suffered moderate adverse reactions with hypoxia (low blood oxygen) and high blood pressure being the most common. These symptoms were easily treated and resolved within a few hours.

All other reactions were considered mild with fever and nausea being the most common. Unlike the adult population in similar studies, children tolerated a higher level of mature white blood cells, a component that tends to accompany the stem cells during these transplants.

Physiology of children is different than adults

“This tells us that the physiology of children is much different than adults when it comes to blood and marrow transplantation," says Truong. "This difference, along with other important disease and treatment factors, allows them to tolerate these procedures much more easily to the benefit of health outcomes.” 

Publications on similar studies in adults show almost twice as many moderate adverse reactions, usually cardio-pulmonary, with a few adults suffering fatal heart attacks. The U.S. National Cancer Institute has established a universal reporting system for adverse reactions to which all researchers adhere in their studies. 

The MacLean family is grateful for the research, the transplant and a healthy recovery for their daughter. “For Taiya, it was life-saving,” says Amanda.

Anyone interested in donating stem cells can contact the Canadian Blood Services OneMatch program, which is how Canadians register to become a donor.

Chronic diseases, infections, and inflammatory states together with pain create the greatest burden on health care in the world. The University of Calgary’s Infections, Inflammation and Chronic Diseases in the Changing Environment research strategy brings together multidisciplinary teams and top scientists to understand and prevent the complex factors that threaten our health and economies.