SIMPLIFICATION, NOT
DEMYSTIFICATION NOR TRIVIALIZATION OF STEM CELL
TRANSPLANTATION
Guillermo J. Ruiz-Argüelles, Centro de Hematología
y Medicina Interna de Puebla Clínica Ruiz de Puebla,
Puebla, Mexico
Correspondence: Guillermo J. Ruiz-Argüelles MD, FACP, Centro
de Hematología y Medicina Interna de Puebla Clínica
Ruiz de Puebla 8B Sur 3710 72530 Puebla, PUE, Mexico. Email:
gruiz1@prodigy.net.mx
The
e-letter by Drs. Borbolla, González-Avante and Siller
suggest that my
observations on stem cell minitransplants may lead into the
trivialization (considering without seriousness or dignity) of the
bone marrow transplantation procedures. They may be aware of the
fact that these therapeutic procedures have been chosen by the
physicians of over 2300 patients allografted in 14 countries (USA,
Italy, Germany, England, Japan, Israel, México, Poland,
Spain, Ireland, Canada, India, Australia and France) using
non-myeloablative preparative regimens and reported in abstracts
submitted to the annual meetings of the American Society of
Hematology between 1996 and 2000.1 On the other hand,
they also suggest that stem cell transplants need to be
demystified; since mystic means "hidden from or obscure to human
knowledge or comprehension; pertaining to what is obscure or
incomprehensible; mysterious; dark; obscure", it may well be
possible that some individuals, but not most hematologists, need
demystification of the stem cell transplantation procedures.
Accordingly, I fully share their concerns in the last paragraph of
their letter, since those persons requiring demystification of
these procedures need sufficient knowledge prior to getting
involved in the conduction of these therapeutic procedures.
Finally, Drs. Borbolla, González-Avante and Siller are
certainly to be recognized for their efforts to organize an
oupatient program to conduct bone marrow transplantation on an
outpatients basis as I clearly stated in the manuscript
".....provided that certain requirements are fulfilled", and also
for their efforts to simplify the cryopreservation techniques of
stem cells; they must be aware of the fact that stem cell
cryopreservation can be completely avoided when performing
autologous transplants, if certain preparative regimens are
selected.2
I do believe that reducing expenses and simplifying, not
trivializing nor demystifying, effective therapeutic procedures is
particularly important in circumstances with limited economic
resources; worldwide, over 50% of individuals with hematological
diseases live in these circumstances.
