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Most stem cells are in your bone marrow. You also have some in your blood that circulate from your bone marrow. Bone marrow stem cells turn into red blood cells, white blood cells, or platelets to help your body stay healthy. If your bone marrow is attacked by a disease such as multiple myeloma, it can no longer make normal blood cells. In a stem cell transplant, healthy stem cells are placed in your body through an IV to help your bone marrow start to work right.
When the stem cells come from your own blood or bone marrow, it is called an autologous transplant.
Stem cell transplants are used to:
Your doctor will consider your overall health and your age. People who are good candidates usually are younger than 70, do not have other diseases such as heart disease or diabetes, and have a normal kidney and liver. Your doctor will also consider how much your disease has grown and how aggressive your cancer is. People with aggressive cancer that has spread to many areas of the body are not usually thought to be good candidates. Your doctor may also consider whether you have cancer that has come back, such as relapsed non-Hodgkin's lymphoma.
Autologous stem cell transplants are done using peripheral blood stem cell transplantation (PBSCT). With PBSCT, the stem cells are taken from blood. The growth factor G-CSF may be used to stimulate the growth of new stem cells so they spill over into the blood. G-CSF is a protein that is produced naturally in the body. The blood is removed from a vein and passed through a machine that separates the stem cells. The machine then returns the remaining blood through a needle in the person's arm or through a central venous catheter. This way of collecting stem cells is called apheresis.
In adults, most autologous transplants use stem cells from blood. In a child, the decision whether to use cells from the bone marrow or the blood depends on the size of the child.
Before you have chemotherapy and radiation, you have blood taken and stored (banked) for later. Then you have chemotherapy and radiation to destroy the diseased cells in your bone marrow and the rest of your body. This gets rid of the cancer cells in your bone marrow. Later, when you get your stored blood cells back, those new stem cells will be able to take over the job of making new blood cells.
A central venous catheter is inserted in your chest. The stem cells travel from the blood bag through the catheter into your blood, and to your bone marrow, where they will begin to produce new cells in 1 to 3 weeks. During this time:
Some people are able to receive part or even all of their treatment in an outpatient clinic. Even if you need to be in a hospital, you will not usually have to stay longer than 3 weeks.
Severe, often life-threatening infection can develop after a stem cell transplant. You will need to take antibiotics for several months to prevent infection.
Your immune system may take 1 to 2 years or longer to recover after a transplant. Bone marrow aspiration or biopsy is used to check your bone marrow. You will need to have many immunizations updated. Check with your doctor to find out which immunizations you will need.
Autologous stem cell transplant is used:
The success of a transplant depends on the type and stage of the disease and your age and general health.
The original disease may come back after the transplant. If relapse occurs after autologous transplant, chemotherapy or other treatments may be used.
Early complications usually occur within 5 to 10 days and include:
Other possible complications include:
Using your own stem cells in a transplant is safer than using someone else's, because your body will not reject your own stem cells. But stem cells from your own marrow or blood may still contain some cancer cells. So the stem cells may be treated to get rid of any cancer cells before being put back into your body.
Not every hospital is able to perform transplants. You may have to travel to a hospital that has special equipment and specially trained doctors and nurses.
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