What is a stem cell transplant?
Most stem cells
are in your
bone marrow. You also have some in your blood that
circulate from your bone marrow. Bone marrow stem cells turn into
red blood cells,
white blood cells, or
platelets to help your body stay healthy. If your bone
marrow is attacked by a disease such as multiple myeloma, it can no longer make normal
blood cells. In a stem cell transplant, healthy stem cells are placed in your
body through an
IV to help your bone marrow start to work right.
When the stem cells come from your own blood or bone marrow, it
is called an autologous transplant.
When is a stem cell transplant needed?
transplants are used to:
Other uses for stem cells are being studied, such as the
sickle cell disease, and
How do you know if you are a good candidate for a stem cell transplant?
Your doctor will consider your overall health and
your age. People who are good candidates usually are younger than 70, do not
have other diseases such as heart disease or diabetes, and have a normal kidney
and liver. Your doctor will also consider how much your disease has grown and
how aggressive your cancer is. People with aggressive cancer that has spread to
many areas of the body are not usually thought to be good candidates. Your
doctor may also consider whether you have cancer that has come back, such as
relapsed non-Hodgkin's lymphoma.
How are stem cells collected?
Autologous stem cell transplants are done using peripheral blood stem cell transplantation (PBSCT). With PBSCT, the stem cells are taken from blood. The growth factor G-CSF may be used to
stimulate the growth of new stem cells so they spill over into the blood. G-CSF is a protein that is
produced naturally in the body. The blood is removed from a vein and passed
through a machine that separates the stem cells. The machine then returns the
remaining blood through a needle in the person's arm or through a
central venous catheter. This way of collecting stem
cells is called
In adults, most autologous
transplants use stem cells from blood. In a child, the decision whether to use
cells from the bone marrow or the blood depends on the size of the
Why are chemotherapy and radiation therapy used before a transplant?
Before you have chemotherapy and radiation, you have
blood taken and stored (banked) for later. Then you have chemotherapy and
radiation to destroy the diseased cells in your bone marrow and the rest of
your body. This gets rid of the cancer cells in your bone marrow. Later, when
you get your stored blood cells back, those new stem cells will be able to take
over the job of making new blood cells.
How are stem cells transplanted?
A central venous
catheter is inserted in your chest. The stem cells travel from the blood bag
through the catheter into your blood, and to your bone marrow, where they will
begin to produce new cells in 1 to 3 weeks. During this time:
- You may be in isolation and given antibiotics to prevent or to
treat infection. Destroying your bone marrow cells with chemotherapy leaves
your body unable to fight infection.
- Your blood will be tested
often to check the levels of red blood cells, white blood cells, and platelets
in your body.
- You may need to receive several
transfusions of blood cells and platelets until your
body begins to produce its own.
- You may need more antibiotics or
other medicines if you get an infection.
What To Expect After Treatment
Some people are able to receive
part or even all of their treatment in an outpatient clinic. Even if you need
to be in a hospital, you will not usually have to stay longer than 3
Severe, often life-threatening infection can develop after
a stem cell transplant. You will need to take antibiotics for several months to
Your immune system may take 1 to 2 years or
longer to recover after a transplant.
Bone marrow aspiration or biopsy is used to check your
bone marrow. You will need to have many immunizations updated. Check with your
doctor to find out which immunizations you will need.
Why It Is Done
Autologous stem cell transplant is
- After high doses of chemotherapy for killing cancer cells. The
chemotherapy also destroys your bone marrow. The stem cell transplant gives you
back your normal bone marrow.
- To treat diseases that damage the
bone marrow, such as multiple
- Experimentally (and rarely) to treat solid tumors, such as
breast cancer or
testicular cancer. It is also used to treat tumors
that develop from cells producing eggs or sperm (germ cell tumors), such as
dysgerminomas and teratomas.
- Experimentally for gene therapy and
the treatment of other diseases, such as diabetes.
How Well It Works
The success of a transplant depends
on the type and stage of the disease and your age and general health.
The original disease may come back after the transplant. If relapse
occurs after autologous transplant, chemotherapy or other treatments may be
Early complications usually occur within 5 to 10
days and include:
- Nausea and
- Mouth sores.
- Bleeding because of severe reduction in red blood cells,
white blood cells, and platelets.
- Infection, such as
Other possible complications include:
- Kidney, lung, and heart
- Recurrence of your cancer.
- Other types
of cancer later in life.
What To Think About
Transplants from your own marrow
Using your own
stem cells in a transplant is safer than using someone else's, because your
body will not reject your own stem cells. But stem cells from your own marrow or
blood may still contain some cancer cells. So the stem cells may be treated to get rid of any cancer cells before being put back into your body.
Not every hospital is able
to perform transplants. You may have to travel to a hospital that has special
equipment and specially trained doctors and nurses.
Complete the special treatment information form (PDF)(What is a PDF document?) to help you understand this treatment.
Primary Medical Reviewer
||Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer
||Douglas A. Stewart, MD - Medical Oncology
Current as of
||March 12, 2014