Video summary
Leukemia is a cancer affecting blood cells, originating from the Greek term "white blood," which describes the abnormal accumulation of white blood cells first observed by doctors in the 19th century. Unlike other cancers such as breast or lung cancer, leukemia accounts for only about four percent of all new diagnoses but remains the most frequent type of childhood cancer. The disease stems from a disorder at the stem cell level within the bone marrow; these immature progenitor cells acquire genetic mutations over time due to DNA damage and begin multiplying uncontrollably. This process prevents them from maturing into healthy red blood cells for oxygen transport or immune cells needed to fight infections, effectively starving the body of essential components while filling it with dysfunctional leukemic blasts that can eventually lead to fatal complications if untreated.
Standard chemotherapy is often used as a first line of treatment but faces significant challenges because leukemia develops gradually through multiple genetic mutations, leading to diverse cell populations where some may become resistant to drugs. While patients may achieve remission when healthy stem cells temporarily take over again, residual cancerous cells frequently survive and cause the disease to relapse later on, at which point chemotherapy often loses its effectiveness. To overcome this limitation, doctors utilize a more aggressive approach known as hematopoietic stem cell transplantation, where patients undergo intense conditioning therapy involving high-dose chemotherapy and radiation designed to wipe out both leukemia cells and any resistant ones. Following this harsh treatment, healthy donor stem cells are infused into the patient's bloodstream or directly into their pelvic bone marrow via surgery, allowing them to migrate back to the bone marrow cavity and regenerate a fully functional immune system capable of producing all necessary mature blood cells.
Finding an appropriate donor is critical because the transplanted stem cells also introduce a new immune system that must not reject the recipient's body; this compatibility depends on matching specific genetic markers called HLA types found in cell surface proteins encoded by DNA. Since humans possess hundreds of variations for these five key genetic markers, creating thousands of possible combinations makes finding an exact match difficult outside of family members, with siblings offering a 25 percent chance per person to be a perfect donor while identical twins provide the best immune compatibility but lack the "graft-versus-leukemia" effect where donor cells actively hunt down remaining cancer. Consequently, national and international registries like DKMS play a vital role in connecting patients with unrelated donors from around the world, as only about 20 to 30 percent of leukemia patients find a suitable match within their own families, making voluntary registration by healthy individuals essential for saving lives globally.
The process of becoming a stem cell donor is surprisingly straightforward and safe, requiring only an online application followed by a simple cheek swab or mouth rinse sample collection that takes just minutes to determine HLA type without any pain or risk. If selected as a match, the actual donation procedure typically involves collecting stem cells from the bloodstream over three to five hours using a machine after administering mild mobilizing drugs, with only about 20 percent of cases requiring bone marrow extraction under anesthesia; donors generally experience minor discomfort but recover quickly and report high satisfaction rates if asked whether they would donate again. For patients facing aggressive forms of leukemia where relapse risks are extremely high without intervention, this transplantation method significantly increases survival chances by twenty to thirty percent, offering a genuine hope for cure when other treatments fail, highlighting the profound impact that ordinary citizens can have through simple acts of generosity and scientific collaboration across borders.
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[Music]
thank you very much for the kind
introduction
a really great honor for me to be here
tonight and to talk about fighting
leukemia
when i first started with my phd project
i was really optimistic i was working
on the genetic basis of therapy
resistance and leukemia and
with my thoughts i i was so i was i was
thinking
we're gonna be able to cure this deathly
disease if we just gain more and more
information
however when i progressed with my phd
project
i realized things weren't that easy
during that time i came across a news
feed similar to this one by the dkms
which is a journey registry for stem
cell donors
and they were looking for a suitable
donor for a patient with leukemia
and since i was working in the field i
was honestly a little bit ashamed
because i thought i should have
registered earlier
so i thought i'm probably not going to
be able to save the whole world with my
phd project
but maybe there's one patient with
leukemia who benefit from my stem cells
so i signed up and tonight i would like
to give you a basic information about
leukemia and also why stem cell
transplantation
is for some of these patients the only
chance for a cure
leukemia is cancer of our blood cells
every hour there's a new diagnosis here
just alone in germany
summing up to about 14 000 new cases
each year and compared to other cancers
like breast cancer or lung cancer
leukemia right rare making only about
four percent of all
diabetes cancer diagnoses in children
however it's the most frequent
type of cancer leukemia
the bird leukemia originates from the
greek language
meaning white blood the disease was
first described in the 19th century and
by then
the doctors didn't really know what it
was they only observed
that in the blood of leukemia patients
they have this abscess of white cells
compared to the blood of a healthy
individual they even thought it might be
an infection because by that time they
didn't really know much about our blood
cells
so in order to understand leukemia we
first have to get an
overview about how our blood cells are
generated
so this is a very simplified
illustrations of the different blood
cells that are existing in our body
it would fit very important purposes for
our
daily health so for example we have
immune cells that fight
diseases like bacteria or viruses
and you probably all heard about our red
cells that are important for
transportation of oxygen
importantly even though all these cells
look different they have different sizes
different shapes they fulfill different
jobs in our body
they all originate from the same
blood stem cells these blood stem cells
live in our wall now
and they have what we call set of
renewal capacity which means
when they start dividing they will form
a new stem cell
but also a progenitor cell who's already
a little bit more committed to becoming
a mature
stem there in mature blood cell so the
whole maturation process happens in the
bone marrow and once the cells
ready it will cleave the bone and
migrate to the bloodstream
in leukemia the stem cells of the
progenitor cells become abnormal
they start to multiply in the bone
marrow and accumulate there
patients with leukemia don't necessarily
die of the cancer cells itself
but these cells are not any longer able
to reduce the mature cells that we need
for our
health so this slide summarizes what the
doctors back in the 19th century didn't
know that leukemia is a stem cell
disorder leading to an accumulation
of leukemic glass this is the white mass
that we saw in the blood sample
and that the patients that suffer from
leukemia will lack the
mature blood cells so in the next slide
i would like to talk about how leukemia
is treated
just like other cancers the standard
therapy for
leukemia involves chemotherapy however
there's one big challenge
so leukemia is a disease that doesn't
just happen overnight it's a long
progress
you start or it starts with healthy stem
cells
that require gene mutations as indicated
here by these stocks
gene mutations are the cause that are
caused by
damages to our dna for example by toxic
chemicals
or irradiation so over the years
the stem cells will acquire more and
more of these gene mutations
and eventually when the patient is
diagnosed with full-blown leukemia
we have a genetically diverse disease
when the patient is now treated with
chemotherapy
this may lead to resistance of some of
these cells because they have acquired
gene mutations
that make them less sensitive to the
chemotherapy
if a patient overall responds to the
treatment
he's in a state called the recall
remission so the healthy stem cell take
over again
but unfortunately as you can see here in
many times residual leukemia cells are
still present in the patient
and over time these cells start growing
again
and the patient is in the in the patient
and
suffers from a relapse which is the
recurrence of the disease
and unfortunately at this point the
patients literally don't respond to the
chemotherapy any longer
and most patients who suffer from rehabs
will eventually die
so applying chemotherapy to patients is
always a matter of balance
on the one side you want to be as harsh
as possible to kill leukemia cells
however if you are too toxic you will
also affect the healthy remaining stem
cells that are left
so doctors came up with a different
approach
and this is illustrated here in this
slide in
the setting of a stem cell
transplantation
the patient will receive a really harsh
chemotherapy treatment
and usually this is combined with
radiation the goal of this really harsh
treatment is
as indicated here by this cross to
really get rid of as many
cells in the bone marrow as possible and
after this harsh treatment
the patient receives donor stem cells
from a healthy individual
over time these stem cells will
repopulate the bone marrow
and start to regenerate all the mature
blood cells that we have talked about
before
there's one big problem with this
approach
you've probably heard about immune
reactions when a patient's received
receives a kidney or a lung transplant
in the setting of a stem cell
transplantation we are actually
transplanting the immune system of a
donor into the leukemia patient
so the immune cells will realize they're
in a foreign environment and actually
start to attack the
patient of the body of the patient
so when we choose a donor for a leukemia
patient we have to make sure that this
immune reaction is very little but how
can we predict that
the immune cells were recognized in
foreign cell by
cell surface markers so if the cell
surface markers of the donor and the
recipient
are pretty similar the immune reaction
will be
little and the type and the shape of
these cell surface markers
are encoded in our dna so when we are
choosing a right donor we have to
perform genetic analysis
we are characterizing what is so called
the hla type therefore we look at five
different genetic markers
for each of these markers we have two
versions one that we got from our mother
and the other one that we got from our
father
but unfortunately due to our genetic
priority they are not just two versions
of these genes
in the whole human population we have
hundreds of different
versions of these genetic markers so
just looking at these five genetic
markers
we have ten thousands of possible
combinations that makes us unique
however it
also makes it also hard to find a donor
that is genetically
similar to us or to the communication
so the search for a suitable donor
usually starts off in the family because
family
members are genetically similar a
perfect match would mean that the two
versions for all of the five markers
that we're looking at
are addictable our mother or our father
will never be a perfect match because we
get
50 of the genetic information from each
of them
but then when we look at siblings since
they usually share the same
genetic pool there's a 25
chance where every of our brothers or
sister to be a perfect match
so the more siblings you have the
greater your chances to find a suitable
donor so that's the reason why you
should always be nice to your siblings
right
because eventually they can save your
life when you look at other family
members such as cousins
the chances are very little actually to
find the perfect match
overall only about 20 to 30 percent of
leukemia patients will find a matching
donor within the family
so the majority of them depends on an
unrelated donor
but how can we find that especially when
you think of the genetic variety
it's really like searching for an
elimination
so national and international registries
have been set up to facilitate
the research to find a suitable donor
and that's what i will be talking about
in the next couple of slides
the dkms is one of the german registry
for
stem cell owners and it was founded in
the 90s and
so far they have collected or they have
registered about
nine million still about ten percent of
leukemia patients won't find the
matching donor
so if you're willing to um to make your
health say
a leukemia patient i would like to show
you now how you can sign up
at the pkms first of all
it's very easy and for free all you have
to do is you go online you
check it you qualify and you provide
your contact information
a couple of days later you will receive
a buckle swap basically looks like a
q-tip
and you rub that in the inside of your
mouth that collects enough cells
and you will send them back to the
laboratory they will perform genetic
analyses
and determine your hla type this
information is stored unanimously
in a global patient search so you could
not only save someone here germany but
basically all over the world
in case you are a match for someone in
their database which actually only
happens in five percent of the cases
the dkms will get back in touch with you
and check if you're still willing and
also physically able to become a donor
and then there are basically two ways of
how the stem cells are collected
in the majority of the cases a so-called
purple stem cell collection is performed
the stem cells that are living in our
triggered by a chemical to
move outside into the purple bloodstream
and then
from there on as shown here in this
picture it is a machine
who can basically filter out the stem
cells from your blood
this whole procedure takes about three
to five hours and you see this guy
smiling it doesn't really hurt and
you can know hama afterwards um
in about 20 of the cases
[Music]
some people think you have to get the
boner from the spine but it's actually
the pelvic bone just close to your hips
it's done under full anesthesia and the
doctors will take it
to collect about five percent of your
total bone now so
after a couple of weeks your body has
recovered the stem cells that you have
announced
um the dkms actually did a survey asked
past donors if they would do it again
and actually
95 of them said if they had a chance to
donate again more patient they would do
it
so that just shows that the procedure
itself really is not
as um as hard as someone might think
so and finally we have the stem cells
here this is a
infusion or this is a bone marrow sample
and this is really transfused
to the patient by the blood veins and
then the stem cells
just know to go back into the bone
marrow and from there
they start to repopulate all the blood
cells
the whole process takes about 10 days
and then
the patient usually is feeling wet
again overall the stem cell
transplantation increases the survival
chance of a patient by 20 to 30 which
may not seem much
but for leukemia patients who have a
really high risk disease and great
chances to have a relapse and eventually
die of their disease
this is really the only chance they get
to survive
so to wrap it up i hope i was able to
give you an overview about our blood
cells and how they are important for our
well-being
such as they help us to fight bacteria
and virus
and they transport the oxygen throughout
the whole body
um leukemia is the cancer of our blood
stem cells
and for some leukemia patients the only
chance to survive this death of disease
is safe stem cell transportation
i would like to point out again that
there
to become a is cell owner is very easy
it probably takes longer to order pizza
online
and the procedure itself is not very
harsh so
i hope i was able to encourage you to go
online and there's even an english
version of this website so you have no
excuse if he goes from germany
and register and yeah actually so
statistically speaking
we have about seven to eight people in
this audience who might be
a match for a leukemia patient i think
there's a thrilling
idea that someone here is being could be
saving someone
so yeah thank you very much for your
attention and then i have to take your
give you the questions after each talk
to ask your questions which is also
great thing about this event so
speakers don't run away they stay here
they answer your questions and they also
stay
for the break so if you have any more
you can still talk to them
afterwards so is there anyone who wants
to ask
anything we have volunteers running
around with a microphone so i think
there are people in the back having
questions so
the microphone will come to you you have
to
grow um
[Music]
i didn't hear your question i'm sorry um
[Music]
the question was if you have an
identical twin
how big is the chance so if it's really
an identical twin so it
looks the same like you you have the
same genes because
you started from the very same end you
know that split you're in the process
so an identical twin would be from
looking at immunoreaction a perfect
donor because
you could just transplant any organ and
the immune cells would never recognize
their
important person because the genes are
the same
but there's one problem what i didn't
talk about is
the immune system of the donor will
actually also help to fight the residual
leukemia cells that are in the patient
so when you transplant the bone marrow
from an identical twin
this effect is lost and
[Music]
and the chances actually for a relapse
are higher because the residual leukemia
cells
don't get killed by the donor cells that
makes sense
thank you would you like to
[Music]
because i'm aware that first you have to
take certain drugs which
increase the amount of stem cells in
your bone marrow
so what about the side effects because
it might you know decrease the
amplification of those cells might
or increase the risk of mutations and
other side effects perhaps
so he weaks of this right treatment and
then
so the question saw the side effects of
the purple
stem cell collection right so you're
right
we're giving chemicals that will trigger
your stem cells too
from the bone marrow to the bloodstream
and this has only been done for like
a couple of 10 years so the long-term
side effects are still unclear but i
think
so far there's no data showing that
there's really a long-term
negative effect um donors usually feel
some pain
that's probably because the cells are
leaving like their environment
but um i'm not aware that there's really
a really bad side effect for the nation
my question is do we know why is rare
but very common
yeah so i repeat the question why
leukemia is
more commonly injured i think that just
has to do with the genetic basis of the
disease
so it's a long usually it's a long
process
to gather leukemia and that's why
or cancer general if you think of
also skin cancer or other cancers they
just happen over
over years and then there are some other
cancers
and for example also leukemia and
children that are already starting
at a very early age sometimes we can
even trace back leukemia cells
already at the blood of the newborn baby
then leukemia itself happens a couple of
years later
so it might just be by chance um that
actually these diseases happen and other
cancers just take longer in their
development
thank you very much for your answer
thank you for your questions
you