Pre-transplant tests and procedures
You'll undergo a series of tests and procedures to assess your health and the status of your condition, and to ensure that you're physically prepared for the transplant. The evaluation may take several days or more.
In addition, a surgeon or radiologist will implant a long thin tube (intravenous catheter) into a large vein in your chest or neck. The catheter, often called a central line, usually remains in place for the duration of your treatment. Your transplant team will use the central line to infuse the transplanted stem cells and other medications and blood products into your body.
Collecting stem cells for transplant
If an autologous stem cell transplant is planned, you'll undergo a procedure called apheresis (af-uh-REE-sis) to collect blood stem cells. Before apheresis, you'll receive daily injections of growth factor to increase stem cell production and move stem cells into your circulating blood so they can be collected.
During apheresis, blood is drawn from a vein and circulated through a machine. The machine separates your blood into different parts, including stem cells. These stem cells are collected and frozen for future use in the transplant. The remaining blood is returned to your body.
If an allogeneic stem cell transplant is planned, you will need a donor. When you have a donor, stem cells are gathered from that person for the transplant. This process is often called a stem cell harvest or bone marrow harvest. Stem cells can come from your donor's blood or bone marrow. Your transplant team decides which is better for you based on your situation.
The conditioning process
After you complete your pre-transplant tests and procedures, you begin a process known as conditioning. During conditioning, you'll undergo chemotherapy and possibly radiation to:
- Destroy cancer cells if you are being treated for a malignancy
- Suppress your immune system
- Prepare your bone marrow for the new stem cells
The type of conditioning process you receive depends on a number of factors, including your disease, overall health and the type of transplant planned. You may have both chemotherapy and radiation or just one of these treatments as part of your conditioning treatment.
Side effects of the conditioning process can include:
- Nausea and vomiting
- Hair loss
- Mouth sores or ulcers
- Infertility or sterility
- Organ complications, such as heart, liver or lung failure
You may be able to take medications or other measures to reduce such side effects.
Based on your age and health history, it may be better for you to receive lower doses or different types of chemotherapy or radiation for your conditioning treatment. This is called reduced-intensity conditioning.
Reduced-intensity conditioning kills some cancer cells and somewhat suppresses your immune system. Then, the donor's cells are infused into your body. Donor cells replace cells in your bone marrow over time. Immune factors in the donor cells may then fight your cancer cells.
May 05, 2015
- Bone marrow transplantation and peripheral blood stem cell transplantation. National Cancer Institute. http://www.cancer.gov/cancertopics/factsheet/Therapy/bone-marrow-transplant. Accessed June 9, 2014.
- Holmberg LA, et al. Determining eligibility for autologous hematopoietic cell transplantation. http://www.uptodate.com/home. Accessed June 9, 2014.
- Barbara Woodward Lips Patient Education Center. Autologous blood and marrow transplant (BMT). Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2009.
- Stem cell transplant (peripheral blood, bone marrow, and cord blood transplants). American Cancer Society. http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/BoneMarrowandPeripheralBloodStemCellTransplant/index. Accessed June 9, 2014.
- Hogan WJ (expert opinion). Mayo Clinic, Rochester, Minn. June 15, 2014.