Quite often, when choosing stem cell therapy, a patient faces the choice of which stem cells he needs: autologous (his own) or allogeneic (donor).
Let’s figure out which cells to give preference to and get the maximum result from therapy.
So, the main basic concepts that we know about autologous (his own) cells:
1. No risk of rejection
Since the cells belong to the patient, their genetic material is completely compatible with the body. This eliminates the risk of immune rejection, which can sometimes occur when using donor cells.
2. No graft-versus-host disease (GVHD)
GVHD is a serious complication during donor cell transplantation, when the donor’s immune system begins to attack the recipient’s tissues. This is impossible when using your own cells.
3. Availability and convenience
Cells can be collected in advance (for example, from blood, bone marrow, or umbilical cord blood) and frozen for later use. This allows the transplant to be performed at a time convenient for the patient.
4. Elimination of problems with finding a donor
There is no need to search for a suitable donor, which can take a significant amount of time and is not always successful.
Despite these advantages, it is worth considering that autologous cells may not always be suitable for the treatment of certain diseases, for example, in the case of genetic, autoimmune or oncological diseases, where the patient’s own cells may already be damaged. The choice of cell type always depends on the clinical situation and the doctor’s recommendations.
What most of you know about allogeneic (donor) cells:
1. The “graft versus tumor” effect (GvL)
Donor cells can attack the remaining malignant cells in the recipient’s body, which is especially important in the treatment of onco hematological diseases such as leukemia or lymphoma.
This immune effect helps prevent relapses.
2. No risk of transferring the patient’s genetic or pathological defects
If the patient has a genetic disorder or their own cells are damaged (for example, in blood cancer), donor cells provide the opportunity to replace damaged bone marrow with healthy ones.
3. Genetic renewal
Donor stem cells can be a source of a fully functioning immune system, which is useful in diseases associated with impaired immune function.
4. Effectiveness in aplastic anemia and other severe bone marrow diseases
In such conditions, the patient’s own cells are often unusable. Donor cells can fully restore hematopoiesis functions.
5. Availability in cell banks
If the patient’s cells are unavailable or unsuitable, donor cells can be found through international biobank registries.
6. Possibility of treating certain hereditary diseases
Donor cells allow the patient’s genetically abnormal cells to be replaced with healthy ones, which is important for treating hereditary diseases such as sickle cell anemia or thalassemia.
7. Ready to use in the absence of pre-stored autologous cells
In situations where the patient has not had the opportunity to pre-store their own cells (e.g. due to an unexpected diagnosis), donor cells are the only solution.
8. Variety of cell sources
Donor cells can be obtained from bone marrow, fat, peripheral blood or umbilical cord blood, embryonic and fetal material, allowing you to choose the most suitable option for a particular case.
9. Possibility of treating rare diseases
Donor cells are often used in rare genetic and autoimmune diseases, such as severe combined immunodeficiency (SCID).
10. Potentially better cell quality
The quality of the cells is much higher quality and viable than the patient’s cells (e.g. in an elderly or chronically ill person).
WHAT WE DON’T KNOW ABOUT AUTOLOGOUS (OUR OWN CELLS)
AGE
The age up to which a person can be a quality stem cell donor depends on the physiological processes of aging and general health. The active limit for donation is between 18 and 35 years. After 40 years, the quality of stem cells begins to decline, and their use becomes less effective. With age, the ability of stem cells to divide and differentiate decreases, which worsens their ability to regenerate tissue. Age-related changes in DNA (for example, the accumulation of mutations and epigenetic changes) make cells less viable. Cells from an older donor may be less effective at engraftment, which increases the likelihood of transferring aging cells to the recipient, which can affect the outcome of therapy.
STEM CELL SIGNALING MEMORY
It is the ability of stem cells to “remember” previous signals they have received throughout their life and change their behavior based on this “memory”.
Signalinging memory is the retention of information by the cell about influences such as:
Inflammatory signals (disease)
Changes in the microenvironment
Stressful conditions (e.g. hypoxia, mechanical pressure)
Memory of harmful signals (e.g. inflammation) can increase the risk of cell aging or mutations, which can cause additional problems. When culturing autologous cells, this signal memory cannot be eliminated, which can negatively affect the results of therapy.
NOT ENOUGH POTENTIAL TO RESET THE IMMUNE SYSTEM
Autologous stem cells may be ineffective in autoimmune diseases due to the following reasons:
Autoimmune diseases are associated with malfunctioning of the immune system, in which it attacks the body’s own tissues. This defect may be embedded in the genetic or epigenetic profile of the patient’s stem cells.
Autologous cells, being “carriers” of this dysfunction, can continue to maintain the pathological condition after transplantation.
The patient’s own stem cells are not effective enough to “reprogram” the immune system so that it stops attacking the body’s tissues.
Even after transplantation, they can be attacked by the same autoaggressive immune cells that caused the disease.
If the autoimmune process is active at the time of transplantation, the stem cells may be damaged or involved in this process, which reduces their effectiveness.
Donor stem cells can have an immunomodulatory effect by eliminating the patient’s autoaggressive lymphocytes. Autologous cells do not have this effect, since they are not foreign to the body and do not enter into an immune conflict with it.
The disease is in remission, and the goal of transplantation is to restore damaged tissue.
There is no possibility or desire to use donor cells due to the risk of complications (for example, graft-versus-host disease).
WHAT WE DON’T KNOW ABOUT ALLOGENIC (DONOR CELLS)
SAFETY
Donor cells themselves do not carry direct carcinogenicity (the ability to cause cancer). Many scientific statistics have proven that the main risk of developing oncology is not associated with donor cells, but with the general condition of the patient (for example, a weakened immune system after transplantation or previous diseases). Donor stem cells from bone marrow or peripheral blood have been used for more than 50 years to treat onco hematological and other diseases (for example, leukemia, lymphoma, aplastic anemia). A high percentage of survival and improved quality of life has been proven in comparison with patients who have not received a transplant for oncological diseases.
IS DONOR THERAPY SUITABLE FOR ME
The use of de-plateletization or T-cell depletion approaches (removal of T-lymphocytes from the transplant) significantly reduces the aggressiveness of the patient’s immune system to donor stem cell therapy. High HLA (major histocompatibility complex) compatibility tests minimize the risk of complications such as graft-versus-host disease (GVHD).
All donor cultures undergo strict medical and infectious screening (for hepatitis, HIV, genetic disorders). Each certified laboratory provides a certificate of quality, purity and regenerative power for all types of cultured stem cells.
WHERE IS THE REGENERATION POWER OF RESTORATION HIGHER
Evidence that donor stem cells can be more powerful than the patient’s own in the context of tissue and organ regeneration is mainly based on clinical studies that show how these cells can compensate for damage or defects in the patient. Here are a few ways in which statistics and studies provide insight into the benefits of donor cells in different contexts:
1. In one study published in the journal Bone Marrow Transplantation (2014), patient survival after bone marrow transplant using donor cells was around 60-70% over 5 years.
In comparison, in the case of autologous transplant (the patient’s own cells), survival may be lower, especially if the patient has damaged stem cells (for example, due to aging or diseases such as cancer). This is also supported by statistics, where hematopoietic regeneration in the case of autoimmune diseases or aging may be less effective.
2. Studies have shown that donor cells (eg, mesenchymal stem cells) can stimulate cardiac tissue regeneration more effectively than the patient’s own cells. This is because the donor cells may be healthy and not have suffered the same damage as the patient’s tissue.
One study in the Journal of the American College of Cardiology (2016) found that using donor stem cells in cardiology can improve heart function by 15-30% compared to traditional treatments, while using the patient’s own cells gave amore modest results.
3. One study published in Stem Cells Translational Medicine (2019) showed that donor stem cells can regenerate damaged cartilage up to 40-50% more effectively than the patient’s own cells, especially if the patient suffers from chronic diseases such as osteoarthritis.
4. In studies using donor stem cells to treat skin burns (e.g. third-degree burns), data show that donor cells can regenerate damaged skin tissue significantly faster and with fewer complications by an average of 40-45% than the patient’s own cells, especially in patients with severe chronic diseases.
Donor stem cells may be more effective in some aspects of tissue regeneration, especially if the patient suffers from chronic diseases, aging, or genetic defects. However, the exact data on how much more powerful they are depends on the specific context (e.g. type of disease, patient age, cell condition). In general, donor stem cells can provide higher regeneration due to their health, youth and lack of genetic defects, making them a more powerful tool in therapy compared to the patient’s own cells, especially in complex cases.