Autologous transplant

What is a bone marrow transplant?

• Bone marrow transplant (BMT) is a treatment that replaces damaged bone marrow with healthy stem cells
• It is also called a stem cell transplant
• Stem cells help make: Red blood cells White blood cells Platelets
• Red blood cells
• White blood cells
• Platelets
• Healthy stem cells are given through a vein like a blood transfusion
• The new cells travel to the bone marrow and start making healthy blood cells

Why is a bone marrow transplant done?

• To treat certain cancers and blood disorders
• To replace damaged or diseased bone marrow
• To allow high-dose chemotherapy or radiation treatment
• To help the body produce healthy blood cells again
• To build a new immune system in some patients

Which diseases may need a bone marrow transplant?

• Leukemia
• Lymphoma
• Multiple myeloma
• Aplastic anemia
• Sickle cell disease
• Immune deficiency disorders
• Myelodysplastic syndromes
• Neuroblastoma
• Some autoimmune diseases

What are the types of bone marrow transplant?

Autologous transplant

• Uses the patient’s own stem cells
• Stem cells are collected and stored before treatment

Allogeneic transplant

• Uses stem cells from a donor
• Donor may be: Brother or sister Parent Unrelated matched donor Umbilical cord blood donor
• Brother or sister
• Parent
• Unrelated matched donor
• Umbilical cord blood donor

Syngeneic transplant

• Uses stem cells from an identical twin

How are stem cells collected?

Peripheral blood stem cell collection

• Stem cells are collected from blood using a machine
• Procedure is called apheresis
• Blood is removed, stem cells are separated and remaining blood is returned

Bone marrow harvest

• Stem cells are collected from bone marrow using a needle
• Usually taken from the hip bone
• Done under anesthesia

How is a donor matched?

• Doctors check HLA (human leukocyte antigen) matching
• Better matching lowers the risk of complications
• Siblings are often the best match
• National donor registries may help find unrelated donors

What tests are done before transplant?

• Physical examination
• Blood tests
• Heart, kidney, liver and lung tests
• Infection screening
• Placement of a central venous catheter

What is conditioning treatment?

• Treatment given before transplant
• Includes high-dose chemotherapy and/or radiation
• Helps: Destroy cancer cells Suppress the immune system Prepare bone marrow for new stem cells
• Destroy cancer cells
• Suppress the immune system
• Prepare bone marrow for new stem cells

What are the side effects of conditioning treatment?

• Nausea and vomiting
• Hair loss
• Mouth sores
• Fatigue
• Diarrhea
• Bleeding
• Infection risk
• Infertility
• Organ damage in some patients

What happens during the transplant?

• Stem cells are infused through a central line
• Procedure is painless
• Similar to receiving blood through an IV
• Patient is usually awake during infusion
• Infusion may take 1–5 hours

What symptoms may occur during infusion?

• Fever
• Chills
• Chest pain
• Hives
• Mild discomfort

What happens after the transplant?

• New stem cells travel to the bone marrow
• They begin making healthy blood cells
• Blood tests are done regularly
• Hospital stay may last several weeks
• Blood transfusions may be needed temporarily
• Medicines may be given to prevent infection and complications

What is engraftment?

• Engraftment means the new stem cells start producing blood cells
• Usually happens within 2–4 weeks
• Recovery of the immune system may take months or longer

What is graft-versus-host disease (GVHD)?

• GVHD happens only in donor transplants
• Donor immune cells attack the patient’s body tissues
• It may affect: Skin Liver Digestive system Lungs
• Skin
• Liver
• Digestive system
• Lungs

Symptoms may include:

• Rash
• Dry mouth
• Diarrhea
• Nausea
• Yellowing of skin or eyes
• Joint pain
• Cough or breathing difficulty

What precautions should be followed after transplant?

• Avoid crowded places and sick people
• Follow food safety guidelines
• Wash hands regularly
• Take medicines exactly as prescribed
• Attend regular follow-up visits
• Avoid smoking and alcohol
• Use sunscreen outdoors

What diet is recommended after transplant?

• Eat healthy balanced meals
• Include: Fruits Vegetables Whole grains Lean protein
• Fruits
• Vegetables
• Whole grains
• Lean protein
• Drink enough fluids
• Avoid unsafe or raw foods
• Avoid grapefruit and grapefruit juice

Q. How long does recovery take?

• Blood counts may improve within weeks
• Full immune recovery may take: Several months after autologous transplant 1–2 years after allogeneic transplant
• Several months after autologous transplant
• 1–2 years after allogeneic transplant
• Regular follow-up is needed long term

Myths and facts

FAQs