Multiple Myeloma Stem Cell Transplantation

Stem Cell Transplantation for Multiple Myeloma

The Hematology Oncology Department at Cancer Treatment Centers of America (CTCA) provides advanced medical therapies for individuals with blood-related diseases, including multiple myeloma.

Many multiple myeloma patients undergo Hematopoietic Progenitor Cell Transplantation (commonly referred to as a stem cell transplant). Our doctors provide stem cell transplantation, in conjunction with other multiple myeloma treatments, to destroy the disease and reduce the possibility of a relapse.

Understanding Stem Cell Transplantation

When multiple myeloma develops, an excess of abnormal plasma cells (myeloma cells) form tumors in multiple locations throughout the bone marrow, crowding out normal blood cells.

Since stem cells can develop into any of the three main blood cells, a stem cell transplant can be used to destroy as many myeloma cells in the body as possible and replace them with healthy stem cells, helping to stimulate new bone marrow growth and restore the immune system.

Stem cells can be found in the bone marrow, circulating (peripheral) blood and umbilical cord blood. 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.

Types of Stem Cell Transplants

There are two main types of multiple myeloma stem cell transplants:

Autologous Stem Cell Transplant

In this type of transplant, stem cells are collected from the patient themselves. The stem cells are removed from the patient’s blood, harvested, frozen and stored. The stem cells are then given back to the patient after high doses of chemotherapy and/or radiation therapy are used to destroy the cells in the bone marrow.

Some multiple myeloma patients may be eligible for two autologous transplants (also called a tandem transplant). In a tandem transplant, the patient undergoes a second transplant within six to 12 months after the first one.

Allogeneic Stem Cell Transplant

In this type of transplant, stem cells are harvested from a matching donor. The patient undergoes a human leukocyte antigens (HLA) test to determine if a donor’s stem cells are the right match. The test compares the patient’s blood and tissue type against blood samples from the donor.

Donors may include:

• HLA-matched relative (most often a sibling)
• HLA-matched unrelated donor
• HLA miss-matched family member
• Unrelated umbilical cord blood

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.

The Stem Cell Transplant Process

Before receiving the multiple myeloma stem cell transplant, you'll undergo a conditioning regime, 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 regime is complete, you're ready to undergo the transplant.

Much like a blood transfusion, you’ll 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

Recovery from a multiple myeloma stem cell transplant can take several months. Our hematology oncology team will work together with the rest of your CTCA 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 naturopath 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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