Complications and risks of stem cell transplantation | Stem Cell Transplantation

Complications and risks of stem cell transplantation

Survival rates after allogeneic or autologous stem cell transplantation have continuously increased in recent years. This is due to increasingly safe transplants and a decrease in transplant-associated mortality. However, the survival rate depends on many factors.

Stage of disease and form of disease, age and constitution, as well as the degree of matching between recipient and donor cells in allogeneic transplantation play an important role. Within the first year after allogeneic stem cell transplantation, the risk of death or relapse is highest. Among the most frequent complications and possible causes of death are graft versus host disease, infections, and organ damage.

While the percentage risk is about 80% in the first year, it decreases to about 50% in the following five years. It is also true for autologous stem cell transplantation that a relapse in the first year after the procedure is associated with a worse prognosis. In 2014, survival rates were published for the first time by the German Registry for Stem Cell Transplantation (DRST).

The term cure is used when the recipient is free of the disease five years after the intervention. A cure was achieved after allogeneic stem cell transplantation in about 50% of patients with acute myeloid leukemia (AML). The 5-year survival rate was, in other words, 50%.

For some other forms of leukemia, the 5-year survival rate after allogeneic stem cell transplantation was about 40%. The 8-year survival rate after autologous stem cell transplantation is about 50%. In the case of multiple myeloma, a cure can be achieved in about half of the cases.

Costs of a stem cell transplantation

The costs of a stem cell transplantation are covered by the recipient’s health insurance company. This also applies to all necessary examinations, hospital stays and the resulting loss of working hours of the respective donor. The accounting of the health insurance company is regulated by the German Bone Marrow Donor Center, in short DKMS.

Costs are also incurred for the preceding initial typing and the inclusion of the donor in a donor file. However, these costs are not paid by the health insurance companies, but are primarily financed by donations. The German bone marrow donor card index is financed by donations on the one hand and by reimbursement of costs by the health insurance companies on the other.

The health insurance companies reimburse the costs of laboratory tests, the collection of stem cells and their procedure and organization. The costs for registration in the donor file amount to 50 Euros. The total costs for a stem cell transplantation in Germany amount to approximately 100,000 Euro.