Autologous Stem Cell Transplant

There are different types of bone marrow transplants, including an allogeneic and an autologous transplant. In allogeneic bone marrow transplants, stem cells come from a donor. According to Memorial Sloan-Kettering Cancer Center, during an autologous transplant, the patient's own stem cells are used. Although an autologous stem cell transplant can involve months of recovery and may have side effects, it can be lifesaving in certain situations.

Facts

• Bone marrow, which produces white and red blood cells along with platelets, can become damaged from different types of cancer. A transplant is done to replace the damaged marrow with stem cells so healthy cell production can occur. With an autologous transplant, certain complications, such as graft versus host disease, don't occur because a patient's own stem cells are used. However, according to the Seattle Cancer Care Alliance, patients who undergo an autologous transplant do have a higher rate of relapse than those who undergo an allogeneic transplant.

Indications

• Because of the higher rate of relapse, an autologous transplant is not used for some types of cancer. However, there are certain kinds of cancers which may be treated with an autologous transplant. Cancers such as, non-Hodgkin's lymphoma and Hodgkin's lymphoma may be treated with a transplant. Multiple myeloma, which is a cancer of the plasma cells, may also be treated with an autologous transplant.

Procedure

• According to the Multiple Myeloma Research Foundation, stem cells are often collected from the peripheral blood using a procedure called apheresis. A medication is given which stimulates the stem cells to be released into the blood. The patient's blood is circulated through a machine and the stem cells are taken out and the blood is returned to the patient. The stem cells are frozen. The patient then goes through high doses of chemotherapy to destroy old marrow. The stem cells are given back to the patient through a central line inserted into the body.

Side Effects

• Although all patients are different, most will have some side effects after an autologous stem cell transplant. Most of the side effects, such as a skin rash, are caused by the high dose chemotherapy given to prepare for the transplant. A condition called mucositis, which is severe mouth sores is common. Fatigue, diarrhea and vomiting are also a possibility. Most patients also lose some or all of their body hair. Medications can be given to help reduce side effects.

Recovery

• Engraftment occurs when the stem cells start working and produce healthy white blood cells, red blood cells and platelets. Although engraftment may occur at a different rate depending on the patient, the average according to the University of Pennsylvania, is about 1 week to 12 days after transplant. However, the cell counts may still not be normal for weeks. Appetite and energy level may take several months to get back to normal. According to the University of Pennsylvania, patients should gradually resume normal activities as they feel able.