Stem Cell Transplant 101

When you think of a transplant, you may have an image of a major surgical procedure to replace a diseased organ. But stem cell transplants don't involve surgery. And the "organ" involved is bone marrow — not a solid organ such as a liver.

If your bone marrow stops working, your body won't produce enough healthy stem cells. And that means you may not have enough healthy white blood cells, red blood cells or platelets, putting you at risk of life-threatening infections, anemia and bleeding.

A stem cell transplant is the infusion of healthy stem cells into your body. If all goes well, these healthy stem cells take hold in your body and begin normal production of blood cells.

Although the procedure is generally called a stem cell transplant, it's also known as a bone marrow transplant or an umbilical cord blood transplant, depending on the source of the stem cells.

Credit: MayoClinic
http://www.mayoclinic.com/health/stem-cell-transplant/CA00067 

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Stem cell transplantation usually refers to cases of transplantation in which the stem cells are collected from the peripheral blood by apheresis. When stem cells are collected by harvesting them from the bone marrow, it is called bone marrow transplantation. Collecting stem cells from the blood stream is less inconvenient for the donor than harvesting stem cells from bone marrow, which requires hospitalization and general anesthesia. Stem cell collection is done on an outpatient basis.

You can be a hero and help save a life by joining the bone marrow registry to possibly donate your bone marrow or stem cells to a potential match. You must be 18 to 60 years old and in good health with no history of cancer or diseases. Not everyone qualifies and there are guidelines to follow.

To learn about these guidelines: visit
Marrow.Org Guidelines or
DKMSAmerica.Org

NOTE: There is an urgent need for those of ethic extraction such as Asian, Hispanic and African/Americans to join the registry

There are 3 basic types of stem cell transplants: autologous, allogeneic, and syngeneic. The type of transplant is determined by where the stem cells come from.

Autologous stem cell transplant - This kind of transplant is mainly used to treat lymphomas and multiple myeloma, although it is sometimes used for other cancers. In this type of transplant, you are your own donor, using stem cells from either your bone marrow or circulating blood. Your stem cells are removed or harvested before treatment and then frozen. After you have received high doses of chemo, radiation, or both, the stem cells are thawed and given back to you.

Allogeneic stem cell transplant - This type of transplant is commonly used to treat leukemias and other bone marrow disorders. Here, the stem cells do not come from the patient, but from a donor whose tissue type (described under "HLA Matching" in the "Allogeneic Transplant: Importance of a Matched Donor" section) best matches the patient. The donor is most often a family member, usually a brother or sister. If you do not have a good match in the family, a donor may be found from the general public through a national registry.

Syngeneic stem cell transplant - This is a special kind of allogeneic transplant because the donor is an identical twin with identical tissue types. Since few people are identical twins, this type of transplant is very rare. An advantage of syngeneic stem cell transplant is that graft-versus-host disease is not a problem. A disadvantage is that this type of transplant won't help destroy any remaining cancer cells.

Day + 1 to 30 is categorized as "Protective Isolation".

Day +10 to +32 is the Engraftment period.

Day +30 to 100 is "Home Care and Outpatient Management" and

Day +100 and on is Graduation from your Stem Cell Transplant or Bone Marrow Transplant Day 100 is a great milestone and a turning point in our recovery. That's when the greatest risk for critical side effects is past and when the stem cells have engrafted and begun making new blood cells.

NOTE: We encourage you to ask your treating physician questions about the process of a Stem Cell Transplant or a Bone Marrow Transplant. Each case is individualized.

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BEFORE you agree to a transplant, you may want to ask your doctor the following questions. For some of these, your doctor may refer you to the transplant team or people who work on insurance issues for the doctor's office and/or the hospital:

1. Is a transplant the best option for me? Why? Are there other options I should consider?
2. What type of stem cell transplant will I have? Why?
3. What is the chance of finding a good match?
4. What are the chances that the transplant will work?
5. Is stem cell transplant considered experimental for my disease? Why?
6. What are the risks to me?
7. What type of conditioning treatment will I need?
8. What is the estimated cost?
9. What costs, if any, will be covered by my insurance? How much will I have to pay?
10. What side effects might I expect? How bad will they be? How long will they last?
11. Will I be able to have children after the transplant? What options do I have if I do want to have children later?
12. What types of medicine or self-care will be used to control the side effects?
13. Will I be able to have visitors?
14. When will I be able to return to work?
15. What type of follow-up will be needed after I am discharged? How often?
16. What are the chances that my cancer will come back after treatment?

Transplants have about seven phases:

1. Determining if you are a bone marrow or stem cell transplant candidate
2. Deciding the treatment that's best for you
3. Selecting a transplant center
4. Preparing for your transplant
5. Doing your transplant
6. Recovering from chemotherapy and/or radiation treatment
7. Maintaining your health post-transplant

Determining if you are a bone marrow or stem cell transplant candidate.

There are now millions of people in the U.S. who have diseases or disorders that are treatable with BMTs or PBSCTs. The National Marrow Donor Program lists over 70 diseases and disorders.

Here are Web sites you can visit to learn if you're disease makes you a bone marrow transplant or stem cell transplant candidate:

National Marrow Donor Program
http://www.marrow.org

National Institutes of Health Clinical Trials Database
http://www.health.nih.gov

Mayo Clinic
http://www.mayoclinic.org/bone-marrow-transplant/diseases.html

U.S. Department of Health and Human Services Health Resources and Services Administration
http://www.hrsa.gov/osp/dot/treat.htm

The National Health Information Center
http://cis.nci.nih.gov/fact/7_41.htm.

NexProfiler Treatment Tool
http://www.cancerfacts.com

Age is almost never a factor in bone marrow or stem cell transplantation. Transplants are preformed on kids and senior citizens alike.

1. Deciding the treatment that's best for you.

2. Your doctor will decide whether you should enter a clinical trial or if an individualized treatment plan is best.

If at all possible, visit a doctor who specializes in your disease. You can search for doctors by specialty at:

People Living with Cancer (http://www.peoplelivingwithcancer.org) and the American Medical Association (http://www.dbapps.ama-assn.org).

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Want to see more?  Visit our new
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Awareness Gifts at www.stemcelltransplantshirts.com



BE SURE TO JOIN The Bone Marrow Registry

For those who are going through a stem cell transplant or a bone marrow transplant, below is a list of tips of things you may need for those long hospital stays:

* Bring a list of drugs you take - for your own records and for the hospital files
* Bring a list of medicines you are allergic to (very important)
* Keep a list of family and friend's phone numbers
* Consider a Healthcare Power of Attorney and Living Will (check legalzoom.com)
* Apply for Social Security Benefits prior to your SCT. If rejected, appeal or contact an attorney
* Bring a notepad and pen to write notes and names of doctors, nurses, PCAs, etc.
* Buy a calling card (most hospitals only allow you to dial within their area code)
* Check with your hospital if cell phones are allowed
* Bring a laptop -- it's a great to keep in touch and/or watch movies
* Bring light reading material like magazines to help pass the time
* Bring movies - subscribe to Netflix (this proved very helpful in helping pass the time)
* Bring your iPod or a CD player - music is therapy to the soul
* Bring games or cards - to help pass the time
* Bring hobby/craft stuff - to help pass the time
* Bring reminders of home - to keep you going strong (pictures, bible, etc.)
* Bring a fluffy pillow and a soft blanket
* Definitely bring your own PJs, robe, socks, slippers & sneakers (you may be asked to walk after your SCT)
* Pack cotton low v-neck shirts (for easy port or Hickman access)
* Pack warm sweats (it gets cold)
* Pack sleeping caps or comfortable knit caps & hats
* Bring plastic bags to store your laundry so your caregiver can take it home to wash
* Bring anti-bacterial wipes (to clean phones, counters, door knobs, etc.)
* Bring sugar free candy to lessen the taste of the heparin shots
* Go ahead, have your room decorated (it makes for a supportive environment)
* Try to keep visitors to a minimum and only essential visitors.
* Keep anyone with a cold away from you during your transplant to prevent infections and such
* WALK (exercising is very important to the health of your lungs after your stem cell transplant).
* Keep your medical team informed when you need pain relievers or when you have any side effects even if you think it's minor. Any side effect during an SCT or BMT needs to be mentioned to your medical team so that they can help you.
* ALWAYS seek the advice of medical experts and have your caregiver take notes
* Allow yourself to get some rest. This is a tough journey and sleep helps
* When in doubt, GET A SECOND MEDICAL OPINION. Go with your guts.

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