|
Index:
The goal of a blood and marrow transplant is to restore the body's ability to produce healthy blood cells. All blood cells develop from immature cells called stem cells. Most stem cells are found in your bone marrow, the spongy tissue inside your bones. They are also found in smaller numbers in your blood stream and in the blood of a baby's umbilical cord. As they divide and grow, stem cells can form more stem cells or become blood cells-white cells that fight infection, red cells that carry oxygen and platelets which help with clotting.
 Why People Need Stem Cell Transplants
People need stem cell transplants when they are unable to produce normal blood on their own because of blood diseases or cancers. In some patients with blood diseases, the stem cells in their bone marrow are defective. This marrow must be destroyed and replaced with healthy stem cells for normal blood production to occur. For patients with some cancers, the intensive chemotherapy and/or radiation needed to destroy the cancers will also destroy their bone marrow. They need stem cells transplanted to restore marrow functions. In either case, without healthy marrow containing healthy stem cells, people cannot produce blood cells or fight even the simplest infection.
 Although most of our patients receive stem cell transplants, some cancers that don't respond to standard therapy do respond well to dose-intensive treatment (DIT)-high-dose chemotherapy which can be given without a transplant. In those cases, patients are admitted to the Transplant Unit to receive treatment strong enough to suppress their bone marrow, but not destroy it. As they recuperate, their remaining normal stem cells slowly begin to produce healthy blood again.
How a Transplant Works
In a stem cell transplant, healthy stem cells collected from your body or from another person are infused into your bloodstream through an intravenous catheter in much the same way that a transfusion is given. The transplant occurs after high doses of chemotherapy and/or radiation have destroyed your own marrow cells. The transplanted cells then make their way to your empty bone marrow space, where they begin to grow and divide. While they are growing, you are susceptible to bleeding, infections and other complications. You will require close monitoring and intensive medical care during your recovery.
Types of Transplants
The type of transplant you will have depends on your disease and who donates the stem cells.
 Autologous
In an autologous transplant, you donate your own stem cells, which are stored for you while you undergo intensive chemotherapy and/or radiation. On some occasions, your stem cells may be treated before they are stored to remove any cancer cells mixed in with them. When your chemotherapy and/or radiation are complete, your healthy stem cells are given back to you. Most of the transplants performed in the United States and at our facility are autologous. Patients with breast cancer, lymphoma and multiple myeloma often have autologous transplants.
Allogeneic
In an allogeneic transplant, the person donating the stem cells is a family member, usually a brother or sister, or an unrelated donor found through a donor registry. Allogeneic transplants are often used to treat people whose own stem cells are defective. Because the donated cells may react to the cells in your body, even with a closely matched relative, this type of transplant is prone to more complications than other transplants.
Syngeneic
In a syngeneic transplant, the person donating the bone marrow or stem cells is your identical twin, with identical genetic makeup. Cell rejection is not an issue in syngeneic transplants.
Your transplant team will recommend which kind of transplant you need based on your particular disease and circumstances.
Return to top
This is a publication of the Blood and Marrow Transplatation Program of the Mary Babb Randolph Cancer Center and Ruby Memorial Hospital at West Virginia University’s Robert C. Byrd Health Sciences Center.
Acknowledgment: Funding for this handbook was provided by Annette, Marc and Darren Tanner in memory of Douglas H. Tanner.
|
