Hematopoietic stem cell transplantation can treat several types of cancers and some noncancerous conditions. It involves giving healthy stem cells to someone to replace damaged or depleted reserves of stem cells and to help treat disease.
This article will provide more information about the process and why it can be helpful in treating different types of cancer and noncancerous conditions.
A hematopoietic stem cell is an immature cell. It can develop into any kind of blood cell, including white blood cells and platelets. These kinds of cells are found in the bone marrow and blood in your veins.
However, certain kinds of cancers as well as chemotherapy can destroy or deplete bone marrow and cells that are important in the body’s functioning.
This infusion of healthy cells helps destroy disease or, in the case of immune disorders, helps provide functional cells to replace those that are impaired.
What is a stem cell?
Stem cells are the cells in the body that later develop into the brain, blood, bones, and organs. They’re sometimes called “master cells.”
Stem cells may be able to:
- repair or replace cells
- help cells regenerate or regrow
- be used as a treatment for various conditions
There are two main kinds of stem cell transplantations:
- Autologous HSCT uses a person’s own stem cells. The cells are removed, treated, and then returned to the body after a special conditioning regimen.
- Allogeneic HSCT uses stem cells from a donor, which can be a family member or an unrelated person.
HSCT can be used for both cancerous and noncancerous diseases. Cancers it can help treat
- multiple myeloma
- Hodgkin’s and non-Hodgkin’s lymphoma
- acute myeloid leukemia
- acute lymphocytic leukemia
- myelodysplastic syndrome
- chronic myeloid leukemia
- chronic lymphocytic leukemia
- essential thrombocytosis
- polycythemia vera
- solid tumors
Noncancerous diseases it can help treat include:
- aplastic anemia
- severe combined immune deficiency syndrome (SCID)
- sickle cell anemia
- various other noncancerous diseases, including primary immunodeficiency diseases
Many times, the terms “bone marrow transplant” and “stem cell transplant” are interchangeable. However, the location where doctors harvest the stem cells can help guide the most precise terminology.
Your pelvic bones have the most marrow. This is typically where bone marrow is taken from when doing a bone marrow transplant.
In hematopoietic stem cell transplantation, the stem cells can come from:
- bone marrow
- blood in your veins (peripheral blood)
- umbilical cord blood
Stem cells that are drawn from bone marrow, blood from a vein, and from an umbilical cord can come from several places in your body:
Hip bones have the most marrow and a lot of stem cells. This is where doctors often source stem cells to do transplantations.
Transplantations are done under general anesthesia, so you won’t feel pain. A doctor inserts a large needle through the lower back into the hip bone. The marrow is filtered, put into special bags, and frozen.
When it’s used, it’s inserted into a vein.
In this case, a doctor places a catheter into a vein. The blood goes into a special machine that separates the stem cells from the rest of the blood products. The rest of the blood is returned to the person’s body.
The stem cells are filtered, put into special bags, and frozen until the transplantation.
Newborns have a lot of stem cells. The blood left in the umbilical cord can be saved and stored for a possible stem cell transplantation later on.
Any medical procedure or treatment, including stem cell transplantation, has potential risks.
Acute (short-term) complications can include:
- myelosuppression with neutropenia
- low platelets
- acute graft-versus-host disease
- gram-positive and gram-negative infections
- herpes simplex virus
- yeast infection
Chronic (long-term) complications can include:
- chronic graft-versus-host disease
- infection with encapsulated bacteria
- varicella zoster virus
Before the transplantation, you will have
It takes about 1 to 2 weeks to complete. It’s done to destroy any remaining cancer cells in the body as well as make room for the transplanted stem cells.
Your pre-transplant treatment will vary depending on your cancer or disease, the kind of transplant needed, and your treatment history.
Pre-transplant treatments can cause significant side effects, such as:
- mouth sores
- hair loss
- trouble breathing
Your healthcare team can help you manage these symptoms.
After the conditioning, you’ll have a few days to rest before transplantation. You will most likely be in the hospital for the transplantation itself. Outpatient transplantations are rare.
Once you’re admitted to the hospital, you will be in a room that has special air filters to help reduce the chances of infection. Transplantation is done through a catheter, like a blood transfusion.
After an HSCT, you may also have some side effects from the infusion.
These side effects are
Other side effects can include:
- fever or chills
- shortness of breath
- low blood pressure
- chest pain
- less urinary output
- fatigue or weakness
Recovery time is typically about 2 to 6 weeks. You may be in the hospital during this time or return daily for several weeks for monitoring and follow-up care.
Your blood counts will be low. You may be given antibiotics to protect your immune system and prevent infection, along with regular blood transfusions.
Emotionally, you might have a variety of feelings, from happiness and loneliness to anxiety. There may be a post-transplantation support group at your treatment center or hospital that you can join for support as you recover.
As with many healthcare procedures in the United States, HSCT is costly, and costs continue to rise.
The type of HSCT, the pre-transplant regimen, and the age of the recipient can all affect the cost.
Pediatric HSCT tends to be more expensive than that of adults. This is likely due to precautions that need to be taken and longer hospital stays.
The cost to the transplant recipient can vary, depending on what insurance pays for and the expected copays and patient responsibility.
A patient financial adviser at the hospital, or with your insurance carrier, can help explain the individual financial costs and what is and isn’t covered with your specific insurance.
Life expectancy for people getting HSCT has improved over the last few decades, but it’s still lower than that of the general population, according to a
More research needs to be done to help understand subsequent infections, second cancers, heart and lung disease, and complications from the pre-transplant treatment.
Hematopoietic stem cell transplantation (HSCT) is a treatment option for various types of cancers and some noncancerous diseases.
HSCT involves taking healthy stem cells from bone marrow or peripheral blood, filtering them, and infusing those stem cells into the body. A pre-transplant routine is needed to condition the cells and body. The routine typically involves high dose chemotherapy or radiation.
There are possible risks and side effects for people getting stem cells from a donor, but research continues to learn more about these risks to improve people’s outcomes.