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.

Getting Ready

Before your procedure:

• Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.
  
  
• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• Your caregiver will ask you about your health history. Tell your caregiver if you have any problems with your heart, lungs, or liver. Your caregiver will examine you and may test your heart and lungs. You also may need blood taken for tests before your transplant. Ask your caregiver for more information about tests that you may need. Write down the date, time, and location of each test.
  
  
• Your caregiver may want you to see a dentist. The dentist will check your teeth for cavities or infection. If you have chemo, your dentist may want you to rinse your mouth several times each day. He may want you to brush your teeth with a soft regular toothbrush. Ask your caregiver about dental care that is right for you.
  
  
• Your caregiver may want you to take medicine called antibiotics before your transplant. This medicine is given to fight or prevent an infection. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's okay may make the medicine unable to kill all of the germs. Never "save" antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Before your stem cell transplant, you may receive cancer treatment, such as chemo, radiation, or both. These treatments help kill cancer and other damaged cells. Chemo and radiation also may help stop your immune system from attacking the new transplanted cells.
  
  
• If you are having an autologous stem cell transplant, you may have your own blood harvested a couple of weeks before your transplant. During bone marrow harvesting, stem cells are taken from bone marrow that is removed from your bones. During peripheral blood stem cell harvesting, your stem cells are removed from blood taken from a vein (blood vessel). Your caregiver may give you medicine that helps your stem cells move from your bone marrow to your blood. Ask your caregiver for more information about stem cell harvesting.

The night before your procedure:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your procedure:

• Write down the correct date, time, and location of your procedure.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

Treatment

What will happen:

• You will be taken to the room where your procedure will take place. Your caregiver will put a central line (tube) into your body. The central line 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.
  
  
• If the stem cells are frozen, they will be thawed and put in your body through the central line. If your stem cells are harvested right before your transplant, your central line will be attached to a machine. During harvesting, this machine will remove stem cells from your blood or bone marrow. Before your transplant, harvested stem cells will be checked for infection and cancer. RBCs will be removed from bone marrow to help stop your immune system from attacking your new stem cells. Your stem cells will be transplanted into your body through a 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 may check your eyes, your memory, and how easily you wake up. Your hand grasp and balance also may be tested. This helps tell caregivers how your brain is working after your stem cell transplant.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your stem cell transplant appointment on time.
  
  
• You have a fever (high body temperature).
  
  
• You have pain in your bones, muscles, stomach, or head, even after taking medicine to decrease it.

Seek Care Immediately if

• You have a faster heart rate than normal, even when not exercising.
  
  
• You have sudden trouble breathing.
  
  
• You have new chest pain.
  
  
• You have trouble concentrating, feel dizzy, or you have fainted.

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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 (Precare)