Stem Cell Transplant

A stem cell transplant is a procedure that is coupled with high doses of chemotherapy. It may be used to treat certain types of blood cancer, such as some forms of leukemia, lymphoma, and multiple myeloma.¹

Stem cell transplants restore the immature cells (stem cells) that are depleted from the high doses of chemotherapy. Stem cells develop into different types of blood cells, including red blood cells, white blood cells, and platelets.¹

In some types of blood cancer, a stem cell transplant may provide the best chance of a cure for the disease. However, stem cell transplants are not an option in all types of blood cancer or in all people. Stem cell transplants can be very taxing on a person's body. They may not be an option for people with other health conditions or older adults.

Types of stem cell transplants

There are 2 types of stem cell transplants:¹

• Autologous, in which the stem cells are retrieved from the person before receiving chemotherapy
• Allogeneic, in which the stem cells are donated by another person

In allogeneic stem cell transplants, the donor's blood cells must match the recipient's blood cells as closely as possible. This is to reduce the risk of possible side effects and the possibility of the transplant not being successful. Doctors test the proteins, called human leukocyte-associated (HLA) antigens, found on the surface of the blood cells through a blood test.²

How does a stem cell transplant work for blood cancer?

Chemotherapy attacks fast-growing cells. This includes cancer cells but also healthy cells that grow quickly, such as blood cells. The high doses of chemotherapy used with a stem cell transplant are effective on blood cancer cells. However, it can also damage healthy blood cells. By replacing the stem cells with a transplant, the body can rebound as the infused stem cells become new, healthy blood cells.

Stem cell transplants also help treat certain blood cancers, such as some forms of leukemia, in a different way. The donor's stem cells can also directly fight the blood cancer cells. This is called a "graft-versus-tumor" effect. Graft refers to the donor's cells.³

What to expect

Before a stem cell transplant, you will be evaluated with a series of tests. This may include:⁴

• Blood tests
• A complete health history and physical exam
• Heart function tests
• Lung function tests

In general, younger people tend to do better with stem cell transplants than older adults. However, each person should talk to their doctor about their potential treatment options and the possible risks and benefits of each.⁴

In an autologous transplant, the stem cells are gathered from the person using a machine. The machine filters the stem cells out from the rest of the blood. The other blood components are returned to the person with cancer. In an allogeneic stem cell transplant, the stem cells are collected from a donor who has a similar HLA profile to the person with cancer. The donor may or may not be someone related to the person.⁴

After the stem cells are collected, you will receive conditioning treatment. This is high-dose chemotherapy and/or radiation therapy. This treatment is aimed to kill any remaining cancer cells. It will also suppress your immune system to lessen the risk of a rejection of the donor's cells. High doses of chemotherapy and/or full-body radiation can cause serious and painful side effects. It may take many months to fully recover. Some long-term side effects may be permanent, such as infertility.⁴

You will receive the stem cells a few days after the conditioning treatment. The stem cells are delivered similar to a blood transfusion.⁴

After the stem cell transplant, you will be in the recovery stage. In this stage, you will be regularly monitored to see if the stem cells begin to multiply and create new blood cells. During this time, blood cell counts are still very low. This puts you at increased risk of infection and bleeding. You may receive antibiotics or other drugs to treat or prevent infections. You may also need blood transfusions to replace the depleted blood cells.⁴

What are the possible side effects?

High doses of chemotherapy during the conditioning treatment can cause side effects such as:^1,4

• Nausea
• Vomiting
• Hair loss
• Mouth sores
• Breathing problems
• Increased risks of infection and bleeding

The infusion of stem cells may cause side effects such as:^1,4

• Fever
• Chills
• Shortness of breath or coughing
• Hives
• Low blood pressure
• Chest pain
• Weakness

For people who have an allogeneic stem cell transplant, there is a possible side effect called graft-versus-host disease (GVHD). This is when the donor's cells attack certain organs in the transplant recipient's body. GVHD can range from mild to life-threatening and can happen either acutely (soon after the transplant) or at a later time.⁵

These are not all the possible side effects of stem cell transplants. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with a stem cell transplant.

Other things to know

Talk to your doctor if you have any questions about stem cell transplants.

Before receiving a stem cell transplant, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.