Stem cell transplant
Stem cell transplants are mainly used to treat blood cancers, although they can be used to treat other cancers and diseases. Stem cell transplants may also be referred to as bone marrow transplants, or blood and marrow transplants (BMT).
It is an intensive and specialised treatment which is only available in certain hospitals.
Stem cell transplants are not often used to treat chronic leukaemia, and would only be suggested for selected patients who had not responded to other treatments.
What you need to know
What are stem cells?
Stem cells are early (primitive) cells. They divide and mature to make different types of cells that the body needs. Our bodies are continually making new cells from stem cells.
The stem cells that form blood cells are called haematopoietic stem cells. These are mainly located in the bone marrow, but some may be found in blood and other tissues. The umbilical cords from babies also have stem cells.
What is a stem cell transplant?
A stem cell transplant involves killing blood cells using very high doses of chemotherapy, and possibly radiotherapy. These high doses also eliminate stem cells in the body which then need to be replaced with new ones.
The new stem cells are not exposed to the chemotherapy or radiation therapy as they are collected beforehand and kept in storage.
There are 2 main types of stem cell transplants:
- autologous (auto)
- allogeneic (allo).
How are stem cells collected and given?
There are 2 ways that stem cell are collected or harvested:
- bone marrow aspiration – usually done in an operating theatre under a general anaesthetic
- apheresis – the most common way of collecting stem cells.
The stem cells can be frozen and stored under special conditions until needed.
The stem cells are given in a drip, similar to a blood transfusion. They travel in the bloodstream to the bone marrow where they start to divide and make new blood cells.
What to ask or talk about
Side effects of stem cell transplant
Most of the side effects are caused from the high dose chemotherapy or radiation therapy that you are given as part of the stem cell transplant. There are also long term side effects from having a stem cell transplant.
Some of the side effects during the early stages of a stem cell transplant may include:
- low blood cells requiring transfusion
- anaemia from low red blood cells
- bleeding from low platelets
- sore mouth or ulcers from damage to the lining of the mouth – called mucositis
- nausea and vomiting
- loss of appetite
- hair loss
- skin problems- dryness, itching, rash, peeling and blisters
- pain – mouth, skin, bottom
Longer term potential complications from allogeneic stem cell transplants can include:
- graft versus host disease – when the donated stem cells fight against your body (this can become a long term problem)
- blood clots
- lung problems
- heart problems
- liver problems
- loss of fertility.
Preparing for stem cell transplant
Before having a stem cell transplant you will need to sign a consent form. It is important to understand what you are consenting to. This includes what chemotherapy or radiotherapy you are having, and the possible side effects you may experience.
Some other things you should know are:
- the preparation for stem cell collection if you are having an autologous transplant
- when you will start preparation for the transplant
- whether you need a dental check up
- whether you need to change your diet before the transplant
- what tests you have to have
- whether you need to have a central line inserted (most likely)
- how long you will need off work and how much sick leave you have
- whether you are entitled to any Centrelink payments
- how long you are likely to be in hospital
- who will be able to help you when you go home
- who to contact if you have any questions or concerns
- the possible side effects you may get
- whether there are any restrictions for people visiting you.
There is a lot of information to understand and instructions to follow when preparing for a transplant. It can help to write things down, keep a diary, and take someone with you to appointments.