How Are Stem Cell Transplants Done – Stem cell transplants help restore blood-forming stem cells in people who have been damaged by certain treatments.
Stem cell transplants are procedures that restore blood-forming stem cells to people whose own have been damaged by high doses of chemotherapy or radiation therapy used to treat a disease.
How Are Stem Cell Transplants Done
Blood-forming stem cells are important because they develop into different types of blood cells. The main types of blood cells are:
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In a stem cell transplant, you get healthy blood-forming stem cells injected into a vein. After entering the bloodstream, the stem cells travel to the bone marrow, where they replace the cells damaged by the treatment. Blood-forming stem cells used in organ transplants can come from bone marrow, blood circulation or umbilical cord. An organ transplant can be:
To reduce possible side effects and improve the functionality of an allogeneic transplant, the donor’s blood-forming stem cells must match your own in some way. For more information on comparing hematopoietic stem cells, see Hematopoietic Cell Transplants.
Stem cell transplants usually do not work against each other. Instead, they help restore your body’s ability to produce stem cells after treatment with very high doses of radiation, chemotherapy, or both.
However, in multiple myeloma and some leukemias, stem cell transplants can work against each other. This is due to the so-called graft-versus-tumor effect, which can occur after allogeneic transplantation. Antitumor surgery occurs when white blood cells from your donor (graft) attack any cells left in your body (tumor) after high-dose chemotherapy. This effect improves the effectiveness of the treatment.
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Stem cell transplants are often used to help people with leukemia and lymphoma. They can also be used to treat neuroblastoma and multiple myeloma.
Other types of stem cell transplants are studied in clinical trials, which are studies involving people. If you want to find a trial that suits you, see Search for clinical trials.
The high doses of treatment you receive before the stem cell transplant can cause complications, such as bleeding and the risk of infection. Talk to your doctor or nurse about other possible side effects and their severity. For more information about side effects and how to manage them, see the side effects section.
If you have an allogeneic transplant, you can develop a serious problem called graft versus host disease. Graft-versus-host disease can occur when the donor’s (graft’s) white blood cells recognize your body’s (host’s) cells as foreign and attack them. This problem can cause damage to the skin, liver, intestines and many other organs. It can happen a few weeks after the transplant or much later. Graft versus host disease can be treated with steroids or other drugs that suppress your immune system.
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The closer the donor’s blood-forming stem cells are to your own, the less likely you are to have reverse-host disease. Your doctor may also try to prevent it by giving you medicines that suppress your immune system.
Stem cell transplants are complex procedures that are very expensive. Most insurance plans cover a portion of the cost of certain types of transplants. Talk to your health plan about the services they pay for. By talking to the business office where you are going for treatment, you can understand all the costs.
For information on groups that can provide financial assistance, go to the National Institute of Public Assistance database and search for “financial assistance.” Or call toll-free at 1-800-4-(1-800-422-6237) to learn about groups that can help.
When you need an allogeneic stem cell transplant, you must go to a hospital with a specialized transplant center. The National Marrow Donor Program® maintains a list of transplant centers in the United States that can help you find a transplant center.
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If you don’t live near a transplant center, you may need to travel from home for your treatment. You may need to stay in the hospital during your transplant, you may have it as an outpatient, or you may only need to stay in the hospital for a short time. When you are not in the hospital, you should stay in a nearby hotel or apartment. Many transplant centers can help you find housing nearby.
A stem cell transplant can take a few months. The process begins with treatment with high doses of chemotherapy, radiation therapy or a combination of these. This treatment continues for one or two weeks. When you’re done, you’ll have a few days off.
Next, you get blood-forming stem cells. The stem cells are given to you through an IV catheter. This process is like receiving blood. It takes 1-5 hours to receive all stem cells.
After you receive the stem cells, you begin the recovery phase. During this time, you wait for the blood cells you received to start producing new blood cells.
Ahsct In Ms (autologous Hematopoietic Stem Cell Transplantation)
Even after your blood counts return to normal, it takes longer for your immune system to fully recover—several months with an autologous transplant and 1-2 years with an allogeneic or syngeneic transplant.
Because people respond to stem cell transplants in different ways, your doctor or nurse cannot know for sure how the procedure will make you feel.
Doctors monitor the development of new blood cells by checking your blood levels regularly. As the new transplanted stem cells produce blood cells, your blood count will increase.
Advanced treatments you have before your stem cell transplant can cause side effects that make eating difficult, such as mouth ulcers and nausea. Tell your doctor or nurse if you have difficulty eating during treatment. You may also find it helpful to talk to a nutritionist. For more information on coping with eating disorders, see eating tips or side effects.
Making Stem Cell Transplants Safer
Whether you can work during a stem cell transplant may depend on the type of work you do. The stem cell transplant process, including advanced treatment, transplant and recovery, can take weeks or months. You are in and out of the hospital during this time. Even if you are not in the hospital, sometimes you need to stay close to it instead of staying in your own home. So if your job allows, you can plan to work remotely for a while.
Most employers are required by law to adjust your work schedule to meet your needs while you are receiving treatment. Talk to your employer about ways to modify your work during treatment. You can get more information about these rules by talking to a social worker. Allogeneic stem cell transplantation involves transplanting stem cells from a healthy person (donor) into the patient’s body after chemotherapy or high-energy radiation. The donated stem can come from nearby or from outside.
Before the allogeneic stem cell transplant, the patient receives a chemotherapy program and sometimes radiation therapy. This chemotherapy is given to destroy the remaining cancers in the body. This helps to weaken the patient’s immune system and prevent the body from rejecting the ce given after the transplant. It also allows the donor to travel through the bloodstream to the bone marrow, where the donor begins to grow and produce new blood, including red blood cells, platelets, and white blood cells. This process is called “adding”.
When the transplant is successful, the donor arm can replace the ce arm in the bone marrow. It can also provide a long-term cure for the patient’s illness. One of the advantages of allogeneic stem cell transplantation is that it creates a new immune system after the transplanted support in the patient. The donated cece produces white blood that attacks the remaining cancer in the patient’s body. This is called the “graft-versus-tumor effect”. and it may be more important than the sophisticated regimen used to destroy the cancer. This benefit can only occur in an allogeneic stem cell transplant.
Autologous Hematopoietic Stem Cell Transplantation For Refractory Lupus Nephritis
One problem with allogeneic transplants is that, despite immunosuppressive treatment, the patient’s body may reject the transplanted stem before it can penetrate the bone marrow. The patient’s immune system may see the donor cells as foreign and destroy them.
Another problem with allogeneic transplantation is that the immune system of the donor (graft) can attack healthy ce in the patient’s body (host). This is called “graft versus host disease” (GVHD). The body parts most often affected by GVHD are the skin, intestines, liver, muscles, organs, and eyes. GVHD can be mild, moderate, or severe. There are treatments for GVHD, but in some patients GVHD does not respond to treatment and can be fatal.
Stem cell transplants for elderly or unwell patients are not common. This is because
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