Stem Cell Treatment Complications

Stem cell treatments are used for a variety of diseases, such as aplastic anemia, multiple myeloma, Hodgkin's and non-Hodgkin's lymphoma, and other cancers. Also called bone marrow transplants, stem cell treatments offer patients a life-saving procedure when other treatments prove inadequate. In a stem cell transplant non-functioning bone marrow is destroyed and healthy stem cells are infused. If successful, the stem cells migrate to the marrow and function normally. While stem cell transplants offer hope for many patients of a cure or remission, there are serious side effects and complications that may occur.

Types

• There are different types of stem cell transplants. An allogeneic transplant is when the donor is a relative or a close genetic match to the patient. Siblings have a 1 in 4 chance of being a match. If no relatives provide a match, bone marrow registries are searched for a close match. These are called matched unrelated donor (MUD) bone marrow transplants. A special type of allogeneic match is when the donor is an identical twin, and this is called a syngeneic transplant.

  In an autologous transplant, healthy stem cells are taken from the patient's bone marrow prior to chemotherapy or radiation treatments, then frozen and stored until needed.

  Peripheral blood stem cell transplant (PBSCT) is the process of obtaining stem cells from the circulating blood system rather than the bone marrow. PBSCT can be allogeneic, but is usually autologous.

  Cord blood transplants or CBT are performed by using stem cells from umbilical cord blood. These are allogeneic transplants and require matching donors.

Infections

• According to the the American Cancer Society, the immediate risk after stem cell treatment is infection. The critical period is the first six weeks after the procedure, before the bone marrow has started producing white blood cells. A patient is consider to be neutropenic, which means having a very low white blood cell count. Bacterial infections are quite common, but even a little cold virus can be dangerous during this time. Prophylactic or preventative antibiotics may be given during this time to help protect the patient from infection.

Bleeding

• Prior to transplants, patients go through conditioning treatments to prepare for transplant. Those treatments destroy platelets in the blood that help blood to clot. Due to this, patients are at risk for bleeding, and platelet levels are closely monitored. It typically takes three weeks for platelet levels to normalize. During this time, nosebleeds, easy bruising and bleeding gums are common. If the platelets drop to below 20,000/mm3, the patient is said to have thrombocytopenia, and a platelet transfusion may be necessary. Red blood cells take awhile to rebound as well, and for that reason transfusions may be necessary on occasion for transplant patients.

Graft-Versus-Host Disease

• Graft-versus-host disease (GVHD) occurs primarily in allogeneic transplants and is when the donor cells attack the patient's organs as if they are foreign and the patient's immune system is too weak from the conditioning process that happened prior to the transplant to fight back. Mostly they attack the skin, gastrointestinal tract and liver. This reaction can happen anytime from 10 to 70 days following a transplant, but typically happens around 25 days later. GVHD can be mild or life-threatening. According to the Amercian Cancer Society, about one-third to one-half of allogeneic transplant patients experience GVHD. It affects fewer young patients and those closer genetic matches.

Other Risks

• Some other risks or complications of stem cell transplants include organ damage, blood vessel damage, cataracts and secondary cancers, typically tumors of the skin, mouth or lungs. Of course, there is also a risk of death with stem cell transplants, although the survival, cure and remission rates continue to improve, according to Association of Cancer Online Resources.