Types of Stem Cell Transplants
Arnold Wax, MD
There are two basic types of stem cell transplants and several good sources for these cells. You and your doctor will decide together on the best choice for you. The main types are:
Autologous ("Auto") Stem Cell Transplant
This type of transplant uses your own stem cells. Most transplants for multiple myeloma and relapsed non-Hodgkin's or Hodgkin lymphoma are autologous.
Advantages: Less risk of rejection or graft-versus-host disease, in which the new donor cells think your cells are foreign and attack them. Quicker engraftment. Fewer side effects.
Disadvantages: Some cancer cells may remain; cancer-killing effect ends after you have chemotherapy or radiation.
How It Works:
- Your own stem cells are collected, frozen, and stored.
- You have "conditioning treatment" with chemotherapy and possibly radioimmunotherapy to kill the cancer cells and the immature stem cells left in your bone marrow.
- Your previously collected stem cells are thawed and transplanted back into you.
In a tandem (double autologous) transplant, you go through the above process twice instead of once, with a three- to six-month break in between. For multiple myeloma, a tandem transplant has a slightly higher success rate than a single transplant. However, recent clinical trials show that using your own cells once, followed by reduced intensity conditioning treatment and then a transplant from a sibling, offers even longer remissions than tandem.
Allogeneic ("Allo") Stem Cell Transplant
This type of transplant uses a donor's stem cells, either from a relative or a volunteer registered with the National Marrow Donor Program or other registry. It is less common than autologous transplants. It's used for many leukemias, aggressive lymphomas, and failed autologous transplants.
Advantages: The transplanted stem cells are cancer-free. Because the transplant creates a new immune system, the cancer-killing effect continues after the transplant.
Disadvantages: Your body may see the donor stem cells as foreign and reject or react against them. Slower engraftment. More side effects
How It Works:
- The stem cells come from the bone marrow or peripheral stem cells of a matched donor or from umbilical cord blood.
- You receive conditioning treatment with chemotherapy and radiation. This kills the cancer cells and destroys or weakens your own immune system so the donor's immune system can take over.
- You receive the transplant of the donor stem cells.