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What is a stem cell transplant?
Stem cell transplants can save your life if you have certain diseases like cancer. Like any medical procedure, they do come with risks. Learn more about the risks and side effects of stem cell transplants.
There are some conditions, such as blood cancers, that negatively affect your body's production of the cells that are made in the bone marrow. These include red blood cells, white blood cells, and platelets. You need all of these cells to stay healthy.
All the cells that make up blood start out as hematopoietic stem cells. These stem cells can develop into any of the three types of blood cells. A stem cell transplant, which is sometimes called a bone marrow transplant, is a method of replacing unhealthy blood cells with new stem cells.
Doctors first use high-dose chemotherapy to kill off all the bone marrow cells, including any unhealthy cells your body is producing. After that, they inject new stem cells into your bloodstream. The new cells make their way to the bone marrow, where they mature into new, healthy blood cells and platelets.
Types of stem cell transplants
There are two main types of stem cell transplants.
Allogenic
In an allogenic transplant, you get stem cells from a donor. A family member may be able to donate their stem cells for you. If not, you can be matched with a donor from the National Marrow Donor Program.
Another type of allogenic transplant is a stem cell transplant from umbilical cord blood. Some parents donate blood from their baby's umbilical cord so that it can be used for medical purposes. Cord blood is rich in stem cells and works well for transplants.
Autologous
With an autologous transplant, your doctor will harvest your own stem cells and reintroduce them after chemotherapy. Both types of transplants stimulate your body to produce new, healthy bone marrow.
Diseases treated with stem cell transplants
The type of transplant you need depends on what illness you're treating.
Autologous transplantation is used for:
- Amyloidosis.
- Germ cell tumors (testicular cancer).
Allogeneic transplantation is used for:
- Acute leukemia or chronic lymphocytic leukemia.
- Amegakaryocytosis or congenital thrombocytopenia.
- Aplastic anemia or refractory anemia.
- Familial erythrophagocytic lymphohistiocytosis.
- Myelodysplastic syndrome of another myelodysplastic disorder.
- Osteopetrosis.
- Paroxysmal nocturnal hemoglobinuria.
- Wiskott-Aldrich syndrome.
Diseases that respond to both types of stem cell transplant include:
- Hodgkin's lymphoma.
- Non-Hodgkins lymphoma.
- Multiple myeloma.
Stem cell transplant complications
The process of getting a stem cell transplant is complex. There are several steps to the process, and all of them come with a risk of complications. There are also side effects to some of the medications involved.
Chemotherapy side effects
With any stem cell transplant, you first need a round of chemotherapy drugs to kill off all the unhealthy cells in your body. The chemo treatment has significant side effects, including:
- Nausea and vomiting.
- Diarrhea.
- Fatigue.
- Mucositis (mouth sores).
These side effects usually start to get better several weeks after the treatment.
Chemotherapy can affect your future fertility. The drugs used to kill cancer cells can also cause organ damage. Many people have damage to their reproductive organs and cannot conceive without assistance after chemotherapy. Discuss your fertility concerns with your doctor before treatment.
Autologous stem cell transplant side effects
Your doctor will first give you medication to stimulate extra stem cell growth then harvest the cells that develop. The process can cause fatigue, fever, and achiness after the injection.
You will need a central venous catheter placed in your chest. That will be used for harvesting your cells before the procedure. There is a risk of infection at the catheter site as well as the possibility of pain from the procedure.
Allogenic stem cell transplant side effects
As with an autologous transplant, you will need a central venous catheter placed in your chest. The risks for that include infection and pain at the site.
There is also a risk of graft versus host disease (GVHD). White blood cells from donor stem cells can respond to your body's own cells like foreign tissue and attack them. Symptoms of GVHD include:
- Skin rash.
- Upset stomach.
- Bloating.
- Liver problems.
- Lung issues.
- Weight loss.
- Dry eyes.
You may be able to control GVHD with medication such as steroids or drugs to suppress immune reactions.
In rare cases, the donor stem cells don't multiply the way they're supposed to. This is called graft failure. If this happens, you may need to repeat the stem cell transplant to try again.
Other complications
With all stem cell transplants, there is a risk of infection in the months afterward. Your immune system will be very weak as it rebuilds itself, and you will have difficulty fighting off even mild diseases. Your doctor will advise you to limit activities to reduce your risk of getting sick.
You are also at risk of bleeding incidents. Your body will have low numbers of platelets, which are the cells responsible for making your blood clot. You will need to avoid activities where you could be injured until your platelet counts are sufficient.
Cancer can come back even after a stem cell transplant. Relapse can occur at any time. You should continue to see your doctor for follow-up care so that you can detect relapse early when it's easier to treat.
