Stem cell transplant 1 of 2

Definition

A stem cell transplant is the infusion of healthy stem cells into your body. A stem cell transplant may be necessary if your bone marrow stops working and doesn't produce enough healthy stem cells. A stem cell transplant can help your body make enough healthy white blood cells, red blood cells or platelets, and reduce your risk of life-threatening infections, anemia and bleeding.

Although the procedure to replenish your body's supply of healthy blood-forming cells is generally called a stem cell transplant, it's also known as a bone marrow transplant or an umbilical cord blood transplant, depending on the source of the stem cells. Stem cell transplants can use cells from your own body (autologous stem cell transplant) or they can utilize stem cells from donors (allogenic stem cell transplant).

Why it's done

Stem cell transplants are used to treat people whose stem cells have been damaged by disease or treatment of a disease. Stem cell transplants can benefit people with a variety of both cancerous (malignant) and non-cancerous (non-malignant) diseases. A stem cell transplant may help your body:

• Replace dysfunctional bone marrow. For instance, in aplastic anemia, a non-cancerous condition, your bone marrow doesn't make enough new blood cells. A stem cell transplant procedure destroys the dysfunctional marrow, and healthy stem cells are infused. If all goes well, the new stem cells migrate to the marrow and begin working normally.
• Destroy unhealthy bone marrow that may contain cancer cells. In the case of cancer, such as leukemia, a stem cell transplant procedure may help rid the bone marrow of cancer cells. When healthy stem cells are transplanted, normal cell production can resume. In addition, immune factors in the transplanted cells may help destroy any cancer cells that remain in your bone marrow.

Risks

A stem cell transplant poses many risks of complications, some potentially fatal. Although some people experience few problems with a transplant, others must endure frequent tests and repeated hospitalizations.

Complications that can arise with a stem cell transplant include:

• Graft-versus-host disease
• Stem cell (graft) failure
• Organ damage
• Blood vessel damage
• Cataracts
• Secondary cancers
• Death

Your doctor can explain your risk of complications from stem cell transplant. Together you can weigh the risks and benefits to decide whether stem cell transplant is right for you.

Graft-versus-host disease: A potential risk when stem cells come from donors

If you're undergoing a transplant that will use stem cells from a donor (allogenic stem cell transplant), you may be at risk of graft-versus-host disease. This condition occurs when a donor's transplanted stem cells attack your body. Graft-versus-host disease can be mild or severe. It can occur soon after your transplant or months to years later.

Graft-versus-host disease can cause skin rashes, abdominal pain, diarrhea, nausea and vomiting. Over time it can cause other complications and chronic illnesses. Your doctor will monitor you closely for signs and symptoms of graft-versus-host disease.

How you prepare

Pre-transplant tests and procedures

Once donor stem cells become available, you undergo many tests and procedures to assess your health and the status of your condition, and to ensure that you're physically prepared for the transplant.

In addition, an intravenous (IV) catheter is typically surgically implanted, usually in your chest near your neck. This is often called a central line, and it usually remains in place for the duration of your treatment. It's through the central line that the transplanted stem cells will be infused. The central line is also used to collect blood samples, give chemotherapy, provide blood transfusions and even supply nutrition when necessary.

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