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Stem cell transplantation for multiple myeloma

What is stem cell transplantation?

A stem cell transplant (also called Hematopoietic Progenitor Cell Transplantation) infuses healthy blood-forming stem cells into the body. Stem cells can be collected from the bone marrow, circulating (peripheral) blood, and umbilical cord blood.

There are two main types of stem cell transplants:

  • Autologous stem cell transplant: In this type of stem cell transplant, stem cells are collected from the patient themselves. The stem cells are removed from the patient's blood, harvested, frozen and stored until needed, then given back to the patient after he/she has received high dose chemotherapy and/or radiation therapy to destroy the cancer cells.
  • Allogeneic stem cell transplant: In this type of transplant, stem cells are taken from a matching donor. Donors may include a relative/family member (e.g., sibling), unrelated individual, or saved umbilical cord blood. To determine if a donor’s stem cells are the right match, the patient undergoes a human leukocyte antigens (HLA) test. In an HLA test, we compare the patient’s blood and tissue type with blood samples from the donor.

An advantage of an allogeneic transplant is that the stem cells come from a healthy donor with no malignant cells. However, since it can be difficult to find a matching donor, an autologous transplant is usually more common.

Stem cell transplantation for multiple myeloma

A stem cell transplant can be used to treat multiple myeloma by restoring bone marrow with healthy cells, which help stimulate new bone marrow growth and restore the immune system. Typically, individuals with advanced stage multiple myeloma who are under 70 years old and in otherwise good health are candidates for a stem cell transplant.

Before a stem cell transplant for multiple myeloma, you will undergo a conditioning regimen, which involves intensive treatment to destroy as many myeloma cells as possible. You may receive high doses of chemotherapy and, in some cases, radiation therapy. Once this preparative regimen is complete, you are ready to undergo the transplant.

Much like a blood transfusion, you will receive the stem cells intravenously. The procedure takes about an hour. After entering the bloodstream, the stem cells travel to the bone marrow and start to make new blood cells in a process known as engraftment.

In the months following the transplant, your care team will monitor your blood counts. You may need transfusions of red blood cells and platelets. Sometimes, the intensive treatments you receive before the stem cell transplantation for multiple myeloma can cause side effects, like infection. In this case, your doctor may administer IV antibiotics.

If you had an allogeneic stem cell transplant, your doctor may prescribe certain drugs to reduce the risk of graft-versus-host-disease (GVHD), a condition where the donated cells attack the patient's tissues.

Helping you maintain your quality of life after a transplant

Recovery from a multiple myeloma stem cell transplant can take several months. Dr. Redei and his team will work together with the rest of your care team to support you throughout the entire process.

For example, your dietitian will recommend a healthy diet to nutritionally fortify your body, and your naturopathic clinician will recommend natural therapies to help reduce side effects, such as neuropathy. Your rehabilitation therapist will recommend safe levels of physical activity to help you stay active and independent.

Additionally, your pain management practitioner will use various techniques to help alleviate discomfort and control bone and neuropathic pain, while your mind-body therapist will provide counseling and relaxation techniques.

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