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Stem cell transplants



What stem cell transplants are

Stem cell transplant is a treatment to try to cure some types of cancer, leukaemia and other conditions affecting the bone marrow. You have very high doses of chemotherapy, sometimes with radiotherapy. This has a good chance of killing the cancer cells but also kills the stem cells in the bone marrow.
Stem cells are very early blood cells. Red cells, white cells and platelets can all develop from them. So after the high dose treatment you have stem cells through a drip to replace those that the cancer treatment has killed off.
Stem cell transplant means that you can have higher doses of treatment. So there may be more chance of curing the cancer than with standard chemotherapy.

 
 

Growth factors

You have injections of growth factors before, and sometimes after, the stem cell transplant. Growth factors are natural proteins that make the bone marrow produce blood cells. You have them as small injections under the skin.
Before your stem cell collection (harvest) the growth factor injections help the bone marrow to make lots of stem cells. The stem cells move out into the blood so they can easily be collected. The injections can sometimes help after the transplant too. They help your stem cells to make blood cells more quickly so it takes less time to recover from the transplant.
Growth factor injections do not have many side effects. Some people have itching around the injection site. Some people get a high temperature (fever). You may have some pain in your bones after you have had a few injections. This is because there are a lot of blood cells being made inside the bones. Very, very rarely patients may have a ruptured spleen and the spleen may need to be removed during an operation.

 
 

Collecting the stem cells

Before your stem cell collection, you will have daily injections of growth factor for between 5 and 10 days. Sometimes you may have low doses of a chemotherapy drug alongside the growth factor injections. The chemotherapy and growth factor injections help your bone marrow to make lots of stem cells. These stem cells then spill out of the bone marrow into the bloodstream. You will have blood tests every day to see if there are enough stem cells in your bloodstream. When the levels are right, your stem cells are collected.
Collecting the stem cells takes 3 or 4 hours. You will be asked to lie down on a couch. Your nurse puts a drip into each of your arms and attaches it to a machine.
collecting stem cells
Your blood passes out of one drip, through the machine and back into your body through the other drip. The machine filters the stem cells out of your blood. The stem cells are collected and frozen until you are ready to have them back.
It is common for patients to feel very tired after donating stem cells. You may get tingling around your mouth or muscle cramps if your calcium level gets low during the collection. If this happens doctors or nurses will give you calcium, usually through a drip.

 
 

About donor stem cells

Some people have stem cells from another person. Stem cells from another person are called donor stem cells. The donor stem cells are collected from the donor as described above.
The donated bone marrow needs to closely match your own. A brother or sister is most likely to be a close match. Sometimes, if you don't have a brother or sister (a sibling donor) who is a match, you can have marrow from a matched donor who is not related to you. There is information about how bone marrow is matched in the question and answer section.

 
 

Cord blood stem cells

Some people, usually children, may have a stem cell transplant using stem cells from umbilical cord blood. There are cord blood banks which store blood taken from the umbilical cord. After the baby is born and the umbilical cord has been cut, a doctor takes blood from the umbilical cord and placenta. The blood bank may then give the donated stem cells to a person whose blood cells closely match the donated cells.

 
 

Mini transplants

Stem cells can be used in mini transplants. In a mini transplant, you have lower doses of chemotherapy than in a traditional stem cell transplant. So this treatment can be given to people who are too old or not well enough for a traditional transplant. Research is going on to see how we can best use mini transplants in leukaemia and lymphoma treatment. There is information about this in the pages about research for each particular type of cancer or leukaemia. On each page, the information is listed in the section about mini transplant.

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