If you are considering bone marrow or stem cell transplant it is important for you and your family to know what to expect before, during and after your transplant. Our goal is to provide you with the best information available to help you understand the potential treatments and to help the transplant process work for you.
At Cancer Treatment Centers of America we believe the more you understand, the better you and your family members will be able to navigate the complex roads of transplantation that lie ahead.
Sometimes it takes exceptionally large doses of chemotherapy or radiation to destroy all the cancer cells in your body. Receiving aggressive treatment however can be very hard on your body and can destroy healthy stem cells which are vital to your survival because they replace your supply of red blood cells, white blood cells and platelets.
In order to deliver higher doses of chemotherapy and radiation to destroy the cancer cells and leave the body with healthy stem cells a process called stem cell transplantation was developed. Until recently there were only two types of transplant procedures.
In an autologous transplant your own stem cells are removed from your body prior to receiving heavy doses of chemotherapy and radiation. After the treatment is complete and the cancer has been destroyed your still healthy stem cells are then returned to your body.
In an allogeneic transplant your own stem cells are not removed prior to the delivery of heavy doses of chemotherapy and radiation. The treatment destroys the cancer cells and immune system filling your stem cells in the process. Because your immune system has been suppressed it is then possible to take the stem cells from a healthy donor and engraft them into your body with less chance of rejection. This condition can be especially trying on more vulnerable patients.
For some cancer patients, particularly those who are older or in poor health, a traditional stem cell transplant is not an option. Even though the number of transplant-related graft has declined markedly over the past 30 years the risk of developing significant complications after a traditional allogeneic transplant is substantial.
Some patients may experience temporary or permanent organ damage from the high doses of chemotherapy or radiation they receive prior to treatment.
Graft versus host disease (GVHD), a condition that occurs when donor cells called lymphocytes trigger an attack on the patient’s body, can damage tissues and organs. Drugs used to control GVHD suppress the patient’s immune system, putting the patient at risk of developing a serious infection. Because of these toxic side effects, allogeneic transplants have been used primarily to treat younger patients and those without pre-existing organ damage.
Older patients and patients with significant organ dysfunction have been routinely deprived of the benefits of this potentially curable approach. Unfortunately, the median age at diagnosis of most hematologic malignancies ranges between 60 and 70 years. And therefore, a large number of potentially older patients with such diseases are being excluded from allogeneic stem cell transplantation.
When traditional stem cell transplantation is not an option, Cancer Treatment Centers of America may offer a mini transplant. In a mini transplant, lowered doses of chemotherapy drugs are used. This lower dosage makes conditioning more tolerable and suppresses your immune system to allow donor engraftment. This approach relies on the new immune system provided by the donor to help fight the disease, a benefit called graft versus tumor effect.
Unlike traditional transplants, both donor and patient bone marrow cells frequently coexist in the body for some time after a mini transplant – a condition called mixed chimerism. It may work cooperatively to make graft versus host disease in check- at least in the short term.
Following a mini transplant, patients typically experience fewer side effects including nausea and diarrhea, or organ damage. Because the side effects are so minimal, the transplants are performed in the outpatient clinic and have been referred to as outpatient allogeneic transplants. The mini transplant has become a potentially promising treatment option for older people and those with pre-existing organ damage who could not tolerate a traditional allogeneic transplant.
Although this approach may be appropriate, and patients have achieved a remission of their disease following mini transplant, follow-up has been short. It remains to be seen whether these patients will remain in remission long-term.
Although the graft versus tumor effect is very powerful, and can help eradicate cancer cells after transplant, it may act too slowly for some patients with rapidly progressing cancers, such as acute leukemia and rapidly progressing solid tumors.
At CTCA, you and your healing are at the center of our hearts, minds, and actions everyday. We are always looking for new hope and new options. Explore your stem cell treatment options at Cancer Treatment Centers of America today. Call or chat with an oncology information specialist to schedule a consultation with our team of compassionate professionals.