Bone Marrow Transplants and Stem Cell Transplants for Cancer Treatment
Collecting Bone Marrow or Stem Cells for Cancer Treatment
How would a doctor collect stem cells from you or a donor? That depends on whether you’re getting a peripheral blood stem cell transplant or a bone marrow transplant for cancer treatment.
Peripheral blood stem cells. In this approach, the stem cells circulating in the donor’s blood are harvested and stored. This technique has become more common than bone marrow transplants for cancer treatment. Peripheral blood stem cell transplants are as effective for some, but not all cancers, but the process of donating is simpler.
For a few days, the donor -- whether it’s you or another person -- will take special drugs called growth factors that temporarily increase the number of stem cells in the blood. Side effects of this drug include bone pain. Then, a health care professional will insert a catheter into a vein to filter the donor’s blood through a special machine. This device extracts the stem cells and circulates the blood back to the body.
The process usually takes two to four hours. The donor might need to repeat the process for a few days before enough stem cells have been collected. The stem cells are then frozen until the transplant. The risks are very low. Side effects during the procedure include faintness and cramps in the hands.
Bone marrow stem cells. Because harvesting bone marrow is more involved, it’s done in an operating room. The donor will be under either general anesthesia (and asleep) or regional anesthesia (which eliminates feeling from the waist down.) A doctor will then insert a needle into a bone -- usually in the hip -- and withdraw some of the bone marrow, which is then stored and frozen.
The process takes one to two hours and the risks are very low. The most serious danger comes from the anesthesia itself. The area where the needle is inserted might be sore or bruised for a few days. Donors might also feel tired for several days or weeks afterward.
Chemotherapy and Radiation Therapy
Before you get the stem cell transplant, you’ll get the actual cancer treatment. To destroy the abnormal stem cells, blood cells, and cancer cells your doctor will give you high doses of chemotherapy, radiation therapy, or both. In the process, the treatment will kill healthy cells in your bone marrow, essentially making it empty. Your blood counts (number of red blood cells, white blood cells, and platelets) will drop quickly. Since chemotherapy and radiation can cause nausea and vomiting, you might need anti-nausea drugs. Mouth sores are also a common problem that may need to be treated with pain medication.
Without bone marrow, your body is vulnerable. You won't have enough white blood cells to protect you from infection. So during this time, you might be isolated in a hospital room or required to stay at home until the new bone marrow starts growing. You might also need transfusions and medication to keep you healthy.