Preparing for Transplant
- Pre-transplant testing is of the heart, lungs, liver, and kidneys
- Chemotherapy may be given to kill remaining cancer cells
- Growth factor drugs are given to stimulate bone marrow growth
- Bone marrow begins making new stem cells
Once you and your doctor have made the decision that you should receive an autologous stem cell transplant, you'll undergo a series of tests to determine that your body is strong and otherwise healthy enough to benefit from the procedure.
Read MoreRevving Up Stem Cell Production
Dr. Costello explains that the first steps involve revving up the body’s production of stem cells so there will be enough to transplant. This process, also an outpatient procedure, involves a combination of drugs. It may involve chemotherapy as well as growth factors. The chemotherapy will likely be drugs that you're familiar with already, having received them before as cancer treatment. The purpose of the chemotherapy at this point is to destroy as many cancerous cells as possible before the transplant. The growth factor "is to stimulate your bone marrow, your normal bone marrow, to make stem cells like it normally does. . . just in excess," says Dr. Costello, explaining that the system has to go into overdrive to make extra cells for the transplant.If the preparation involves only growth factors, there will be few side effects. "It involves injections, which can be uncomfortable, but more often than not it's well-tolerated," says Dr. Costello. She says that some people have some bone aches or pains, or flu-like muscle aches, that last throughout the four to seven days of the injections. "But we have a handful of tricks that can mitigate these symptoms to make them more manageable."
Dr. Costello tells her patients to think of it as if their bones are working and stretching to grow the extra cells that need to be removed for the transplant.
If chemotherapy is part of the preparation for the transplant, you may experience any of the usual chemotherapy side effects, including fatigue, nausea, and mouth sores. Your doctor can help you deal with these symptoms, too.
The Transplant
Finally, preparation completed, it's time for the actual transplant. This is not a surgical procedure. The cells are delivered through a special catheter or sometimes an IV in the arm.
"Then we connect you to a machine," says Dr. Costello. "It's not unlike a dialysis machine, where blood comes out of your body through one arm and goes into the machine. The machine separates the stem cells from the rest of the blood, and then the stem cells are put back into your body."
The good news, says Dr. Costello, is that the procedure is nothing like the bone marrow biopsy which most non-Hodgkin lymphoma patients have had at some point during their diagnosis and treatment. "Nowadays we can do it all as if you're donating blood," she says. "We just happen to be taking the stem cells out of your bloodstream."
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