Frequently Asked Questions (FAQ)
Autologous Stem Cell Transplant / Bone Marrow Transplant
Q. What are stem cells?
A. Stem cells are immature cells that grow and divide into mature red blood cells, white blood cells or platelets. Stem cells can be collected from the peripheral blood and/or from the bone marrow. The peripheral blood is the preferred source.
Q. What do blood cells do?
A. Normal cells are composed of white blood cells, red blood cells and platelets. White blood cells protect against infection, red blood cells transfer oxygen to and from tissues in the body and platelets are essential for blood clotting.
Q. What is a stem cell transplant?
A. Autologous stem cell transplant is:
- the removal of the peripheral stem cells
- the storage of the cells
- the transfusion of the cells back into the same person from whom the cells were removed
Q. Why is the stem cell transplantation performed?
A. In general, stem cell transplantation is performed to allow the patient to recover from the complications of very high doses of chemotherapy and radiation used to treat cancer.
Q. What are the complications from these high dose treatments?
A. Primarily low blood counts, which may lead to anemia, bleeding and infection. Transfusion of blood and blood components, such as platelets, are usually successful in treating anemia and bleeding. Infection, even with the most appropriate antibiotics, can be difficult to treat. Given these complications, it is very important to shorten the period of low blood counts, which follows high-dose chemotherapy. There is also the risk to other organs including the liver, lungs or kidneys (Stem cell transplantation helps patients recover from these complications.)
Q. Does the stem cell transplant protect patients from these complications?
A. Not entirely. Until the transplanted blood stem cells start producing new blood cells in about 10 to 14 days, patients have low blood counts and are at risk for these complications.
Q. Why are high doses of chemotherapy used?
A. It is believed that higher doses of chemotherapy kill more tumor cells than standard doses. Increasing the chemotherapy dosage may prolong the time that a tumor is kept under control or destroy the tumor.
Q. What patients are considered for intensive therapy and stem cell transplantation?
A. Patients are considered if they fulfill the following requirements:
- they have acceptable function of other organ systems
- there is no evidence of active infection
Q. what cancers can be successfully treated with high-dose rate chemotherapy and stem cell therapy?
A. Multiple myeloma, non-Hodgkin's lymphoma, leukemia, Hodgkin's disease and testicular cancer are all treated regularly at Thompson. Other cancers may be treated in clinical trials.
Q. How are the stem cells obtained?
A. The cells are collected in a procedure involving the separation and collection of a particular type of white blood cells, called leukopheresis, from the peripheral blood. The cells are then frozen in liquid nitrogen.
Q. Does it hurt?
A. Yes. The discomfort is similar to that which patients feel in standard chemotherapy.
Q. What is done with the stem cells after the collection?
A. The cells are sent to the Thompson Cancer Survival Center Stem Cell Processing Laboratory. The cells are mixed with DMSO (an agent that protects the cells during the freezing process) and then are carefully frozen. After being frozen, the cells are stored in a liquid nitrogen freezer until after the patient's high-dose chemotherapy.
Q. How is the actual transplant performed?
A. Much like a standard blood transfusion. After the patient has completed high-dose chemotherapy, the frozen blood cells are transfused intravenously.
Q. What are the side effects of transplantation?
A. Some patients experience mild nausea and/or vomiting. Other side effects may include cough, shortness of breath, flushing and stomach cramps.
Q. When does the stem cell transplantation begin to work?
A. It usually takes 10 to 14 days for the cells to fully mature and start producing more white blood cells, red blood cells and platelets.
Q. What are the complications (other than low blood counts) expected from high-dose chemotherapy?
A. These depend on exactly the type of chemotherapy used. Before therapy, all the complications are explained by a member of the transplant team.
Q. How effective is high-dose chemotherapy?
A. That depends on the exact type of tumor and past treatment history. In general, the risks and the possible benefits of high-dose chemotherapy are greater than standard chemotherapy. In many situations better control of tumors can be achieved with this form of treatment as opposed to standard.
