Dr. James Hoffman of the Sylvester Comprehensive Cancer Center at the University of Miami Health sat down with SurvivorNet to explain how stem cell transplants work for multiple myeloma treatment.
According to Dr. Hoffman, an autologous stem cell transplant is a common part of the second phase of multiple myeloma treatment. The goal is to kill the cancerous cells with high-dose chemotherapy and then reintroduce healthy blood cells back into the bloodstream.
Read MoreAutologous Stem Cell Transplant Process
Autologous transplant is a four-step process. It may be done as inpatient treatment or through an outpatient center. Even as an outpatient, you’ll need to stay nearby the transplant center for several weeks for labs, testing, and monitoring. RELATED: Stem Cell for Multiple Myeloma Patients — Inpatient or Outpatient?“There are obviously some advantages to an outpatient transplant,” says Dr. Hoffman. “You get to sleep in your own bed, or at least not a hospital bed. On the other hand, a lot of our patients see the benefits of being inpatient.”
Dr. Hoffman recommends talking with your medical team about your transplant stay options to determine what’s best for you.
Step 1: Stem cell collection
Your doctor will collect, or harvest, stem cells from your blood using a special catheter. This is similar to the process of giving blood.
Before doing so, you’ll receive injections of a drug that causes your bone marrow to release more stem cells into your bloodstream. These medications signal stem cells to be released from the marrow and into the bloodstream so they can be collected more easily.
After collection, the stem cells are frozen and stored until you’re ready for stem cell infusion (step three).
Step 2: Chemotherapy
After stem cell collection, you’re given high-dose chemotherapy to kill the unhealthy cells.
You may feel sick and tired during this time, but chemotherapy is necessary to prepare your body for stem cell transplant.
Step 3: Stem cell infusion
This will take place in a hospital room or treatment center. Before your stem cell infusion, doctors may give you medication to help control your body’s reaction to the transplant.
Using the same type of catheter used in the collection process, your doctor will infuse the harvested stem cells back into your body.
During the process, your healthcare team will closely monitor your blood pressure, heart rate, and other vital signs.
Doctors may prescribe medications to help control common transplant discomforts, including:
- Nausea and/or vomiting
- Cough
- Fever
- Chills
- Body aches
Step 4: Recovery time
Stem cell transplant recovery takes time. Your body will be working hard to get healthy blood cells to circulate.
Since your blood counts are low, you’ll be at higher risk for infection and bleeding. This immune status also means you need to be extra cautious about exposure to germs.
RELATED: Transplant After Induction Therapy — Is It Controversial?
Dr. Hoffman notes that the average patient is able to return home within two to three weeks of transplant. During this time, your treatment team will monitor your blood counts to ensure they’re rising. Once they reach a certain threshold, you’ll be discharged to finish recovering at home.
Post-transplant care may include:
- Regular blood tests to monitor your blood cell counts, especially during the first several weeks after transplant
- Neutropenic diet precautions to minimize the risk of infection
- Medications to control the side effects of transplant
Preparing for Stem Cell Transplant
Although the entire transplant process takes about three weeks, it’s important to understand that you may need to be near the transplant center for months for follow-up exams and testing.
It’s important that you follow your doctor’s instructions for caring for yourself before, during, and after the transplant procedure. Proper care will help protect you from infection and other risks associated with your compromised immune system.
For most patients, autologous stem cell transplants are safe and effective procedures. However, as with any medical treatment, there are risks associated with the procedure. Discuss these risks with your care team before deciding whether to undergo a stem cell transplant.
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