An autologous stem cell transplant replaces bone marrow that isn't working as it should with a patient's own healthy blood stem cells and is also called an autologous bone marrow transplant. The transplant is often used to cure cancers of the blood, such as Hodgkin lymphoma, non-Hodgkin lymphoma, and myeloma. The goal of the transplant is to allow the body to make normal blood cells again after high-dose chemotherapy or radiation.
Why It's Done
With an autologous stem cell transplant, the patient's own stem cells used for making blood are removed from them, put in storage, and then injected back into the body after receiving a treatment designed to kill cancer. This is accomplished by removing healthy blood-making stem cells before administering high levels of chemotherapy for destroying cancerous cells. Higher levels of treatment have a higher potential for eradicating cancer cells but may destroy the blood-making stem cells found in bone marrow as well. The healthy cells are now introduced back into the blood, from where they travel to the bone marrow and begin producing new blood cells.
The Process
Autologous stem cell transplant procedure involves several steps, including medications that increase the amount of stem cells in your blood. You will receive medications that cause your stem cells to increase in number and depart from your bone marrow and travel into your blood, where they can be easily harvested.
To gather stem cells, a needle is inserted into a vein in your arm to draw out your blood. The stem cells are separated by a machine, and the rest of the blood is returned to your body. Your stem cells are combined with a preservative, frozen, and stored for later use. In the conditioning regimen, you'll receive high-dose chemotherapy or radiation therapy — or both treatments — to kill your cancer cells. After your autologous stem cell transplant, you'll be watched closely for side effects and for how your body is responding to the transplant.
Side-effects
Following an autologous stem cell transplant, patients may experience a range of side effects and recovery that lasts months. The most difficult aspect is waiting for the reinfused stem cells to engraft, for the blood counts to normalize to safe levels, and for side effects to resolve. Full recovery of the immune system can take 3 to 12 months, leaving the patient vulnerable to infection for this period.
Short-term side effects occur during or right after the transplant process. Many frequent effects like feeling sick throwing up, tiredness plus temporary hair loss come from the chemotherapy or radiation given before the transplant. Other possible effects of the preparation include low red blood cells bleeding difficulties, loose stools, reduced hunger, mouth sores plus changes in the sense of taste. During the transplant some patients feel an odd taste in the mouth, chills, a red face, nausea, head pain as well as variations in blood pressure with breathing changes.
Long-term side effects may arise months or even years after the transplant. They can include issues with glands that change hormone production in the thyroid, pancreas or sex organs. Eye problems like cataracts or ocular graft-versus-host disease might also occur. Some patients may face central nervous system difficulties that bring poor concentration, memory loss as well as trouble learning new tasks. Other possible long-term complications involve kidney, lung or heart problems plus the possibility of developing a second cancer.
Life After Transplant and Recovery
The time it takes to recover from an autologous stem cell transplant may vary from patient to patient and may take several months. Patients may feel sick and tired during this period. Patients may have complications like infection, fever, bleeding, anemia, organ damage, and nutritional problems. Most commonly, it is recommended that the patient wait at least three to six months prior to returning to school or work in an effort to allow their immune systems to heal. Counseling, rehabilitation programs, support groups, and psychological counseling can help to improve the quality of life during the healing process.