What is a stem cell transplant?

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 treat a disease, such as aplastic anemia or leukemia. The transplant may be done using your own stem cells or donor stem cells.

Having the transplant is a serious decision for you and your treatment team. A stem cell transplant is a long and difficult procedure. Many things can affect the outcome, such as the type and stage of the disease, as well as your age and health. There are serious risks, including death. But when the transplant works, it can increase the chances of remission of the disease.

How is it done?

A stem cell transplant is done in several stages. Parts of the treatment may be done in a hospital. Others may be done in an outpatient centre. How long your treatment takes depends on how you respond and any problems you may have from the treatment. Your doctor can tell you more about this.

Testing

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.

Deciding on treatment

After the tests, you and your doctor will look at your test results. You'll consider 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:

• The stem cells come from your own body (autologous). Your blood is sent through a machine that separates stem cells from your blood. The cells are stored until you need them for transplant.
• The stem cells come from a donor (allogeneic). The donor takes medicine to help make more stem cells. When you're ready for the transplant, the donor's cells are taken out and given to you.

Conditioning

You'll have chemo (and possibly radiation) to destroy all the damaged stem cells. 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.

Transplant

In this step, the healthy stem cells are put into your bloodstream. This usually takes several 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.

When you are in the hospital:

• You may be in isolation and given antibiotics to prevent or treat infection. The chemotherapy destroys your white blood cells. So your body can't fight infection until it starts to make new white blood cells.
• Your blood will be tested often to check the levels of red blood cells, white blood cells, and platelets in your body.
• You may need several transfusions of blood cells and platelets until your body starts to make its own.
• You may need more antibiotics or other medicines if you get an infection.

What can you expect after a stem cell transplant?

You may spend up to 4 weeks or longer in the hospital after the transplant. How long you stay depends on whether you got your own stem cells or donor stem cells. It also depends on your health and whether you have problems during or after the transplant.

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.

Your doctor will let you know when it's safe for you to go public places where you could be exposed to germs from other people.

Your immune system will need time to get back to normal. It may take several years.