Frequently Asked Questions
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- What Is Bone Marrow?
- What Are Stem Cells?
- Why An Allogeneic Stem Cell Transplant?
- Why An Autologous Stem Cell Transplant?
- What Tests Will I Need Before A Stem Cell Transplant?
- What Happens After Transplant?
- How Should I Prepare For My First Visit To CTCA?
- Will My Insurance Cover Stem Cell Transplantation?
What Is Bone Marrow?
Bone marrow is the spongy tissue found inside your large bones. It is responsible for making blood cells including red blood cells, white blood cells and platelets. It is also home to your immune system.
What Are Stem Cells?
Blood cells grow in the same way as other human cells. They are developed in the bone marrow from a parent cell known as a “stem cell.” These stem cells begin to divide and mature until they are fully developed, forming all the different types of blood cells: white blood cells, platelets and red blood cells.
Stem cells are usually found inside the bone marrow spaces of large bones, however, they can also travel from one bone to the other by way of the blood system. A very small percentage of the white blood cells circulating through your veins are stem cells.
Why An Allogeneic Stem Cell Transplant?
Many factors are considered when selecting an autologous or an allogeneic stem cell transplant. In general, autologous stem cell transplants are safer and simpler than allogeneic (donor) stem cell transplants. Autologous transplants rely completely on the ability of the chemotherapy and radiation ("preparative regimen") to kill the cancer cells, and require the collection of your healthy stem cells. Allogeneic stem cells come from healthy donors, and thus have not been exposed to chemotherapy and are never contaminated with cancer cells. Since the donor and the recipient are different (allo = other), immunological differences exist. The new stem cells may attack the your tissues (graft-versus-host disease), but they may also attack the cancer (graft-versus-tumor effect). Therefore, while more difficult, allogeneic transplants are potentially able to attack your cancer more effectively than autologous transplants.
Why An Autologous Stem Cell Transplant?
Many factors are considered when selecting an autologous or an allogeneic stem cell transplant. In general, an autologous stem cell transplant is safer and simpler than an allogeneic stem cell transplant. Autologous transplants rely completely on the efficacy of the chemotherapy and radiation ("preparative regimen") to kill the cancer cells. Since the donor and the recipient are the same (auto = you), no immunological differences exist. The new stem cells will not attack the cancer or your body.
What Tests Will I Need Before A Stem Cell Transplant?
Pre-transplant testing includes infectious disease blood tests, complete pulmonary function tests, cardiac ultrasound for left ventricular ejection fraction, liver and renal function blood tests and confirmatory HLA tissue typing and blood typing.
What Happens After Transplant?
Following an autologous stem cell transplant, most patients are back to work and feeling their old self again after 8-12 weeks. At times energy may still be low, appetite may vary, and emotionally patients may feel up and down.
Following an allogeneic stem cell transplant, most patients recover slowly. The mind tends to recover more rapidly than the body, and patients often become impatient with their progress. Before you leave the hospital, the nursing staff will discuss with you the routines of outpatient care. You will receive written information, and should ask about any aspect of which you feel uncertain. Discharge does not mean that the process is over. Very frequent hospital visits are necessary, initially probably two or three times a week. During such visits, infusions of drugs, fluids and electrolytes, and transfusion of blood products may be needed. At home, you will continue to take many medications. Among these are cyclosporine or prograf, antibiotics, magnesium, and vitamins. Complications are frequent, and may lead to readmission to the transplant unit. Patients will slowly start feeling better and complications become less frequent. Your medication will be reduced, and your visits less frequent. You may be able to go back to work 6 months after transplant, but if complications occur, 12 months is not uncommon.
How Should I Prepare For My First Visit To CTCA?
Please forward an updated, complete history, physical records, and records of initial and recent bone marrow biopsies and pathologic data, initial and recent imaging reports and pertinent labs.
Patients must sign a written informed consent and attend a two-to-three hour education session with Dr. Redei, Director of the Stem Cell Transplant and Cell Therapy Program.
Will My Insurance Cover Stem Cell Transplantation?
An insurance coordinator at CTCA will approach your insurance company to help obtain approval for a future stem cell transplant.
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