29 August 2023
Inside the bustling Royal Adelaide Hospital is a sterile oasis.
Dedicated to protecting vulnerable patients, the clean room keeps blood cells free from disease and infection.
How? Rather than pushing filtered air into the room, the room pushes out as much filtered air as possible, keeping a continuous flow of clean air throughout.
Leanne Purins, Laboratory Manager says, "The room and special cabinet help keep the environment as sterile as possible while the scientists within, sample and process the cells".
Anyone entering the space must sanitise their hands, wear a hair net and shoe cover, and don a lab gown, two pairs of gloves and oversleeves.
They also spray disinfectant solutions to sanitise the workspace.
What’s the clean room for?
The clean room is for processing cells for Autologous and Allogeneic blood stem cell transplants.
Autologous transplant means the blood stem cells are taken from and returned to the same patient.
Allogeneic transplant means the stem cells have come from a different person (a donor) rather than the patient themselves
Many of the patients we treat this way have Myeloma or Lymphoma and will often have chemotherapy that can weaken their immune system.
Before this treatment begins, blood stem cells are taken from their blood by a special process called apheresis so that after treatment they can be reinfused, and their immune system can recover.
Leanne says, "After the cells are harvested by apheresis a bag of cells is delivered to the lab for processing."
When it arrives, it’s then taken to the clean room and processed to concentrate the cells and a special freeze mix is added. This allows the cells to then be placed in storage at very low temperature in a liquid nitrogen tank.
We also take samples during processing to ensure there are enough stem cells for the infusion later.
The result? Cells are stored and are ready to be infused into the patient when they are ready after their chemotherapy.
This treatment is an integral part of helping a patient's immune system recovery after intensive chemotherapy
In more serious leukemia, such as acute myeloid leukemia, a patient may be offered a transplant of donor cells. This is high risk treatment which is not suitable for all patients and a lot of factors need to be considered by the doctor and the patient.
For patients who have this treatment a search for a safe and compatible donor will be done. Sometimes this will be a relative and sometimes the best donor will be anonymous and will be found through the Australian or global bone marrow donor registry
The cells are then transported to the Cellular Therapies team for processing and testing before being released for infusion into the patient
"With any donor program, there is always a risk of rejection and other serious complications, however if the transplant is successful, it's amazing, you'll have blood cells which will have a different genetic origin than the rest of the cells in your body because they'll come from the donor. They will go back into the bone marrow and start the normal process of making blood cells again. Some patients may end up with a completely different blood type."
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