A stem cell transplant is a medical miracle. It offers the possibility of a cure for diseases that were once thought to be incurable. It offers you the chance to fight with your cancer and a chance to win.
The learning process of an allogeneic stem cell transplant is very complicated and it can be confusing. However, it is very important for you to understand the stem cell transplant process as well as possible.
At Cancer Treatment Centers of America we believe that as you come to understand more about stem cell transplantation and the more involved you become, the more successful your recovery can be.
In an allogeneic stem cell transplant your bone marrow is replaced with new healthy stem cells from another person. Stem cells are special parent cells that develop into blood cells and immune cells. The best stem cell donor for you is your sibling whose tissue types matches yours as closely as possible. For patients who do not have a family member with matching tissue it is possible to find a donor in the general population through bone marrow registry.
Allogeneic stem cells can be harvested from bone marrow, blood or umbilical cord blood. Bone marrow is part of the body’s immune system and it manufactures not only blood cells but immune cells too. The immune cells can recognize foreign substances such as bacteria, the viruses and cancer cells.
Your tissue type is defined by genetic markers, similar to fingerprints, on the white blood cells. These markers called Human Leukocyte Antigens – HLAs – appear in pairs. One of each pair inherited from your mother and father. The more closely the donor’s and your markers match the more successful an allogeneic stem cell transplant is likely to be.
If your HLA type is very different from your donors your immune system may recognize your donor stem cells as foreign and launch an attack against them, a process called ‘graft rejection’. More commonly, your donor’s immune cells may recognize your tissues as foreign and launch an attack against them, a condition called ‘graft versus host disease’.
To decrease the incidents of these complications every effort is made to find a donor whose tissue type matches yours as closely as possible. To perform HLA typing you and your siblings will be asked to provide a sample of blood. There is a one in four chance that your sibling’s tissue type will match your own. If tissue typing reveals that your siblings are not a good match or you do not have any co-siblings the search widens to the general population to find an unrelated donor.
Stem cells from your donor’s blood can be harvested through a relatively simple non-surgical procedure known as apheresis. This procedure is similar in many ways to blood clot. Under normal circumstances stem cells make up only a small portion of the cells found in the blood. That is why before apheresis stem cells from the bone marrow must be induced to lead the bone marrow and enter the bloodstream, a process called mobilization.
Your donor will receive colony-stimulating factor also known as hematopoietic growth factor via injection under the skin for four to five days prior to stem cell collection. During the stem cell collection your donor’s connected to an apheresis machine, also known as a cell separator. A needle is inserted into a vein in each arm. Blood is withdrawn from one arm and circulated through the machine, and the remaining blood components are returned through the needle in the other arm.
One to four collection sessions on subsequent days are usually necessary to collect the nerve stem cells to use in an allogeneic transplant. Each session typically lasts approximately four hours and daily administration of colony-stimulating factors is continued as long as stem cells are being collected.
Before the stem cell transplant begins you will be tested to make sure that you are a good candidate for the procedure. Tests may include CT scans, EKG, bone marrow biopsy, blood tests, PFT – Pulmonary Function Test, and Echocardiogram.
The preparative regimen which consists of chemotherapy or total body radiation or combination of both, will start approximately one week prior to your transplant. The purposes of the conditioning regimen are to destroy cancer cells, empty the bone marrow to make room for the new cells, and suppress your immune system to prevent rejection.
Usually two days after you completed your preparative regimen you will receive your stem cell transplant. Your donor stem cells will be administered into your vein via your central line in a very similar way to a blood transfusion. As soon as your new stem cells are infused they begin their trip through your circulatory system into your bones where they belong. It takes two to three weeks before the transplant takes or engrafts and begins to produce healthy new blood cells.
Graft Versus Host Disease can occur when your donor’s immune cells - a graft, engraft and they recognize your body – the host, as foreign. The donor cells responsible for this attack are primarily a type of white blood cell called T-lymphocytes. These T-cells may attack certain organs impairing their ability to function and increasing your susceptibility to infection. The organs usually affected are the skin, gastrointestinal tract and liver.
The graft failure is an inability of the transplant to function normal. This can occur when your immune system recognizes the graft as foreign and mounts an attack against it, or when the transplant simply does not begin to produce new blood cells.
Graft versus host disease is a treatable condition. Treatment involves administration of steroids and other immunosuppressive medication. To prevent graft versus host disease and graft rejection you will receive medications usually in the first three to six months following transplant. These medications like Cyclosporin and Prograf are used to suppress your immune system and your donor origin key lymphocytes.
You will stay in the hospital about three weeks. During this time you will be monitored closely to ensure that your bone marrow and immune system are functioning effectively. After being discharged from the hospital you will be followed in the outpatient clinic 80 to 100 days after transplant.
You will be encouraged to stay in our guest quarters which provide a comfortable experience for both you and your loved ones, including private patient rooms and many of the amenities of home.
When you visit Cancer Treatment Centers of America you will consult with a team of caring professionals who will listen to you, learn about your experiences, examine your medical history and then apply their collective knowledge for developing a treatment strategy just for you.
Your Cancer Treatment Centers of America team practices integrative medicine – a unique care philosophy that combines advanced stem cell transplant options with supportive therapies like nutritional support, mind-body medicine, physical therapy, and spiritual support – all under one roof.
Explore your stem cell transplant options at Cancer Treatment Centers of America today. Call or click to chat with an oncology information specialist to schedule a consultation with our team of compassionate professionals.