Treatment Options – Stem Cell Transplantation

Collecting stem cells from bone marrow. Collecting, or "harvesting," bone marrow is usually done in a hospital operating room under general anesthesia. Using a needle and syringe, a surgeon will take bone marrow from several different areas of the hip bone (pelvis). The bone marrow, which appears as a thick red liquid, is typically frozen and stored until high-dose chemotherapy is completed.

Because most stem cells reside in the bone marrow, it is necessary to move stem cells from the bone marrow to the bloodstream prior to their collection. This procedure is called mobilization.

A commonly used mobilization technique is to administer a medication specifically designed to increase the number of stem cells in the blood. This medication is called a colony-stimulating factor, or "growth factor," and is usually injected under the skin, much like an insulin injection for diabetes.

Apheresis is a relatively painless procedure. Patients or donors usually do not need to be hospitalized for apheresis, but must come in for one to three sessions, lasting 2 to 4 hours each, in order to ensure that enough stem cells are collected.

Processing and Cryopreservation

High-dose Chemotherapy

Infusion

Engraftment and Recovery

Until engraftment is complete, a transplant recipient is susceptible to infection, anemia, and bleeding caused by low blood cell counts. Therefore, special precautions are necessary during recovery. Patients may be given red blood cell and platelet transfusions during the recovery period to help prevent anemia and bleeding. For the first 2-4 weeks after the transplant, patients are very susceptible to developing infections. This is because the effects of the high-dose chemotherapy and the loss of blood cells weaken the body's immune system. Antibiotics are often prescribed to help prevent infection.

The doctors, nurses, and other members of the healthcare team will do everything possible to ensure a successful recovery. However, patients and their family or caregivers are also active participants in the recovery process. Patients are asked to come in for frequent check-ups and tests during the early recovery period, which typically lasts about 6 weeks.

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Treatment Options - Stem Cell Transplantation