When your doctor thinks youвre ready, youвll have the transplant. The procedure is similar to a blood transfusion. If youвre having an allogeneic transplant, bone marrow cells will be harvested from your donor a day or two before your procedure. If your own cells are being used, theyвll be retrieved from the stem cell bank. Cells are collected in two ways. During a bone marrow harvest, cells are collected from both hipbones through a needle. Youвre under anesthesia for this procedure, meaning youвll be asleep and free of any pain. During leukapheresis, a donor is given five shots to help the stem cells move from the bone marrow and into the bloodstream. Blood is then drawn through an intravenous (IV) line, and a machine separates out the white blood cells that contain stem cells. A needle called a central venous catheter, or a port, will be installed on the upper right portion of your chest. This allows the fluid containing the new stem cells to flow directly into your heart. The stem cells then disperse throughout your body. They flow through your blood and into the bone marrow. Theyвll become established there and begin to grow.
The port is left in place because the bone marrow transplant is done over several sessions for a few days. Multiple sessions give the new stem cells the best chance to integrate themselves into your body. That process is known as engraftment. Through this port, youвll also receive blood transfusions, liquids, and possibly nutrients. You may need medications to fight off infections and help the new marrow grow. This depends on how well you handle the treatments. During this time, youвll be closely monitored for any complications.
Before the transplant, or both may be given. This may be done in 2 ways: Ablative (myeloablative) treatment. High-dose chemotherapy, radiation, or both are given to kill any cancer cells. This also kills all healthy bone marrow that remains, and allows new stem cells to grow in the bone marrow. Reduced intensity treatment, also called a mini transplant. Lower doses of chemotherapy and radiation are given before a transplant. This allows older people, and those with other health problems to have a transplant. Autologous bone marrow transplant.
The term auto means self. Stem cells are removed from you before you receive high-dose chemotherapy or radiation treatment. The stem cells are stored in a freezer. After high-dose chemotherapy or radiation treatments, your stems cells are put back in your body to make normal blood cells. This is called a rescue transplant. Allogeneic bone marrow transplant. The term allo means other. Stem cells are removed from another person, called a donor. Most times, the donor\’s genes must at least partly match your genes. Special tests are done to see if a donor is a good match for you. A brother or sister is most likely to be a good match. Sometimes parents, children, and other relatives are good matches. Donors who are not related to you, yet still match, may be found through national bone marrow registries. Umbilical cord blood transplant. This is a type of allogeneic transplant. Stem cells are removed from a newborn baby\’s umbilical cord right after birth. The stem cells are frozen and stored until they are needed for a transplant. Umbilical cord blood cells are very immature so there is less of a need for perfect matching.
Due to the smaller number of stem cells, blood counts take much longer to recover. A stem cell transplant is usually done after chemotherapy and radiation is complete. The stem cells are delivered into your bloodstream usually through a tube called a central venous catheter. The process is similar to getting a blood transfusion. The stem cells travel through the blood into the bone marrow. Most times, no surgery is needed. Bone marrow harvest. This minor surgery is done under. This means the donor will be asleep and pain-free during the procedure. The bone marrow is removed from the back of both hip bones. The amount of marrow removed depends on the weight of the person who is receiving it. Leukapheresis. First, the donor is given several days of shots to help stem cells move from the bone marrow into the blood. During leukapheresis, blood is removed from the donor through an IV line. The part of white blood cells that contains stem cells is then separated in a machine and removed to be later given to the recipient. The red blood cells are returned to the donor.