Blood stem cells are special cells in the bone marrow that make red blood cells, white blood cells, platelets, and more stem cells. A stem cell transplant is also known as a bone marrow transplant. It replaces damaged stem cells with healthy ones.
A stem cell transplant may be needed to:
Having the transplant is a serious decision that you, your family, and your treatment team will make. The procedure is expensive and risky. It's a long and often painful process for you and for those close to you. Success depends on the type and stage of the disease, your age and general health, and the support you'll get from others. A transplant doesn't work for everyone who gets one. But when it works, it can increase the chances of remission of the disease.
The stem cell transplant procedure has several stages. Parts of the treatment may be done in a hospital, and others may be done in an outpatient centre. The length of time of your treatment depends on how you respond and any problems you may have from the treatment. Your doctor can tell you more about this.
You will first have tests to make sure that your health is good enough for the chemo and radiation that are part of the procedure. This may take a few days.
After the tests, you and your doctor will look at your test results, the support you can expect from caregivers, and the physical and emotional challenges you will face. Based on these things, you might go ahead with the transplant. Or you might choose some other treatment instead.
There are two types of stem cell transplants:
You'll have chemo and radiation to kill all the cancer cells or the bone marrow in your body. It can take 1 to 2 weeks. You may have side effects, such as mouth sores, nausea, hair loss, and poor appetite. The side effects may last several months. But your doctor can give you medicine to help ease them.
After the cancer cells are killed, the healthy stem cells are put into your bloodstream. This usually takes 1 to 5 hours. The stem cells travel to your bone marrow. They will start to make new stem cells in 1 to 4 weeks. These cells will then take over the job of making new blood cells.
You may spend up to 4 weeks or longer in the hospital after the transplant. The length of time depends on your disease, your overall health, and any problems you have during the transplant.
The chemo and radiation destroy your white blood cells. Without them, your body can't fight infection. Your doctor may give you antibiotics. Your caregivers, family, and other visitors may have to wear masks, gowns, and gloves and follow other rules while you're in the hospital. These steps will help protect you from getting an infection while your body is making new white blood cells.
Your immune system will need time to get back to normal. It can take several years.
You'll need constant care for a while after you are home. For the next 6 to 12 months, you'll see your doctor and have your blood tested often. You may get blood transfusions until you can make enough blood cells of your own. If the stem cells came from a donor, your doctor will check for signs that your body is rejecting the cells. Your doctor will want to see you if you have any sign of an infection.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
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Current as of: March 28, 2018
Caroline S. Rhoads, MD - Internal Medicine
& Kathleen Romito, MD - Family Medicine & Brian Leber, MDCM, FRCPC - Hematology
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