Bone Marrow Or Stem Cell Transplantation

WHAT YOU SHOULD KNOW:

• A stem cell transplant is a procedure where stem cells are put into your blood. Stem cells are found in bone marrow (spongy tissue inside bone), blood, and the umbilical cords of newborns. The umbilical cord is attached to a baby's abdomen and brings nutrition to a child before he is born. Stem cells are able to become other cells, such as red blood cells (RBCs) or white blood cells (WBCs). RBCs deliver oxygen to parts of your body and WBCs help fight infection caused by germs. If you have an autologous transplant, the stem cells come from your own body. During an allogeneic transplant, the stem cells come from a family member or someone not related to you. Once stem cells are transplanted into your blood, they travel to your bone marrow and start growing into new cells.
  
  
• Your cells may become damaged from cancer (such as leukemia) or cancer treatment, such as chemotherapy (chemo) or radiation. Cells also may become damaged by non-cancer diseases, such as sickle cell anemia or problems with your immune system. Your immune system is the part of your body that fights infection. When new stem cells enter your body, they may turn into healthy cells that replace damaged cells. New cells may help decrease the symptoms from your disease or treatment, such as fatigue (feeling very tired). If you have cancer, new cells may help kill cancer cells in your body and you may be less likely to get your cancer again.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

• Your body may reject the new stem cells. You may get graft-versus-host-disease (GVHD). GVHD may cause you to have stomach pain and nausea (feeling sick to your stomach). You may also vomit (throw up) or have diarrhea (loose, watery stools). You may get engraftment syndrome, which causes you to gain weight and have a fever, rash, and diarrhea. You may get sores inside your mouth. You may be unable to have sex or create a baby. You may lose too much blood and you may need a blood transfusion. Your immune system may not work as well as before the transplant, and you may get a serious infection.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• If you have your own stem cells transplanted back into your body, the cells may have cancer in them. These cancer cells may spread to other parts of your body. One or more of your body organs may become damaged, such as your lungs, heart, brain, kidneys, and liver. Liver problems may cause your skin to turn yellow. Brain damage may cause you to have a seizure (convulsion) or have trouble thinking clearly. You may have a heart attack, a stroke, or trouble breathing, and you may die. Without a stem cell transplant, your condition may become worse and you may die. Call your caregiver if you have questions or concerns about your condition, transplant, or care.

WHILE YOU ARE HERE:

Before your procedure:

• Informed consent: A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.
  
  
• Antibiotics: Antibiotic medicine may be given to help you prevent an infection during and after your stem cell transplant.
  
  
• Antirejection medicine: Antirejection medicine is given to help your body accept your new stem cells and to keep your body from rejecting them.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Central line: This is a special IV catheter or tube. It is put into a large vein (blood vessel) near your collarbone, in your neck, or in your groin. The groin is the area where your abdomen meets your upper leg. Other central lines, such as a PICC, may be put into your arm. You may need a central line to receive medicines or IV fluids that need to be given through a big vein. You may need a central line if it is hard for caregivers to insert a regular IV. Also, a central line may stay in longer than a regular IV can. Some central lines may also be used to take blood samples.

During your procedure:

Your caregiver puts the stem cells into your body through a central line. If your stem cells are harvested right before your transplant, your central line is attached to a harvesting machine. During harvesting, the machine removes stem cells from your blood or bone marrow. Before your transplant, harvested stem cells are checked for infection and cancer. RBCs are removed from the bone marrow to help stop your immune system from attacking your new stem cells. Your stem cells are transplanted into your body through the central line. Stem cell harvesting and a stem cell transplant may take several hours.

After your procedure:

You may be taken to a room where you will rest. Do not get out of bed until your caregiver says it is okay. If you feel weak or dizzy while standing up, sit or lie down right away and call your caregiver. Your caregiver will check your blood to see if you have enough healthy blood cells. If you have trouble breathing, you may need chest x-rays. If you have a seizure (uncontrolled shaking) after your transplant, you may need a special x-ray called a CT scan.

• Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.
  
  
• TPN: TPN stands for total parenteral nutrition. It is also called hyperalimentation. It provides your body with nutrition such as protein, sugar, vitamins, minerals, and sometimes fat (lipids). TPN is used when you have problems with eating or digesting food. TPN is usually put into your body through a large IV catheter, such as a central line. You may need TPN for several days or longer.
  
  
• Blood transfusion: If you lose too much blood during your transplant, you may need a blood transfusion. During a blood transfusion, you will get whole blood, or parts of blood through an IV. Many people are worried about getting AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus.
  
  
• Medicines:
  
  
  • Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
    
    
  • Antifungal medicine: This medicine helps kill fungus that can cause illness.
    
    
  • Antirejection medicine: Antirejection medicine is given to help your body accept your new stem cells and to keep your body from rejecting them.
    
    
  • Antiviral medicine: This is given to prevent or treat an infection caused by a germ called a virus. Antiviral medicine may also be given to control symptoms of a viral infection that cannot be cured.
    
    
  • Pain medicine: Caregivers may give you medicine to take away or decrease your pain.
    
    
    • Do not wait until the pain is severe to ask for your medicine. Tell caregivers if your pain does not decrease. The medicine may not work as well at controlling your pain if you wait too long to take it.
      
      
    • Pain medicine can make you dizzy or sleepy. Prevent falls by calling a caregiver when you want to get out of bed or if you need help.
    
    
  • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling. Steroid medicine also may help stop your body from attacking your new stem cells.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Bone Marrow Or Stem Cell Transplantation (Inpatient Care)