Stem Cell Transplant, Bone Marrow Transplant | Patient

What is a stem cell transplant?

A stem cell transplant may be used so that you can have intensive high-dose chemotherapy (and sometimes radiotherapy) to kill cancerous cells. The chemotherapy is higher than conventional chemotherapy and also kills the stem cells in the bone marrow that would normally make blood cells. Therefore, following the chemotherapy, you are given back (transplanted) stem cells which can then make normal blood cells again.

A stem cell transplant is sometimes called a bone marrow transplant. However, stem cells can be obtained from blood as well as from the bone marrow. So, the term stem cell transplant is now used.

I've been concerned about lymphoma for two years.

Blood cells are made in the bone marrow, by stem cells. Bone marrow is the soft sponge-like material in the centre of bones. Large flat bones such as the breastbone (sternum) and pelvis contain the most bone marrow. To make blood cells constantly you need a healthy bone marrow. You also need nutrients from your diet, including iron and some vitamins.

Stem cells are immature (primitive) cells. There are two main types in the bone marrow - myeloid and lymphoid stem cells. These derive from even more primitive cells called common pluripotent stem cells. Stem cells constantly divide and produce new cells. Some new cells remain as stem cells and others go through a series of maturing stages (precursor or blast cells) before forming into fully formed (mature) blood cells.

Mature blood cells are released from the bone marrow into the bloodstream. Mature blood cells are:

Stem cells rapidly multiply to make millions of blood cells each day. Because of this they are more easily killed by chemotherapy than most other cells in the body. This is because chemotherapy medicines work by killing rapidly dividing cells (such as cancer cells).

A stem cell transplant is an option which is considered for various cancer conditions. For example, for types of leukaemia, lymphoma and myeloma. Your specialist will advise when it may be an appropriate option. As a rule, it is not often a first-line treatment. Conventional chemotherapy or other treatments tend to be used first. However, the treatment of cancer and leukaemia is a changing and developing area of medicine. Techniques such as stem cell transplant continue to be refined and improved and may be considered in various different circumstances.

The higher doses of chemotherapy and radiotherapy that can be used in conjunction with a stem cell transplant can improve the chance of a cure for some conditions in certain circumstances.

There is now a great deal of research about using stem cell transplants for many other conditions. For example:

This means that the stem cells used for the transplant come from your own body. They are usually collected when you are free of any sign of disease (when you are in remission) following conventional chemotherapy or other treatments. The stem cells can be used soon after being collected. They can also be frozen, stored and used in the future if needed. An autologous stem cell transplant is also called stem cell support, as the stem cells come from your own body. So, strictly speaking, it is not a transplant from a donor.

This means the stem cells used for the transplant come from someone else - a donor. This is often a close relative such as a brother or sister where there is a good chance of a close match. Unrelated donors are sometimes matched to people needing a transplant.

Stem cells can be collected:

It is very similar to a blood transfusion. Following the intense course of chemotherapy (and sometimes radiotherapy), the solution containing stem cells is given into one of your veins via a drip. The stem cells travel through your bloodstream and end up in your bone marrow. Here they start to make blood cells.

It can take several weeks for your bone marrow to recover, to take up the transplanted stem cells, and to make enough new blood cells. During this time you will need to be in hospital and be closely monitored. You may need several blood transfusions during this time until you are making enough blood cells. Antibiotic medicines are given to minimise the risk of infection. Also, medicines are given to help the stem cells to multiply as quickly as possible.

There is a risk of serious problems with a stem cell transplant. For example:

Your specialist will discuss with you the risks and possible side-effects of a stem cell transplant.

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Stem Cell Transplant, Bone Marrow Transplant | Patient