The Stem Cell Transplant, a Day-by-Day Guide

Getting high doses of chemotherapy rids your body of cancer cells. The problem is, chemotherapy damages all quickly growing cells, which includes not only cancer cells but also the blood cells you need. The chemotherapy is so strong that, “if we did nothing else, if we did not put any of those stem cells back in you, your body would never grow bone marrow again,” Dr. Costello says.

Harvesting Your Stem Cells

The stem cells you’ll receive during the transplant will come from you. Your doctor will remove them about a week or so before you get chemotherapy.

“Once we have adequate stem cells, we can throw them in the freezer and save them for when we’re ready,” Dr. Costello says. It might sound odd to store your blood cells in the same place you’d normally keep frozen peas and ice cream, but be assured that these are in a medical-grade freezer and they will be safe. “They have a preservative in the bag. There is no concern for the stem cells dying or not working.”

When the Magic Happens

The next step “is the true magic” of an autologous stem cell transplant, Dr. Costello says. It’s when you’ll receive a cocktail of chemotherapy drugs to wipe out your cancer cells. Often the four-drug combination doctors choose is BEAM, which is an acronym for:

• B – Carmustine
• E – Etoposide
• A – Cytarabine
• M – Melphalan

Getting that flood of chemotherapy is like “hitting the reset button,” she says. It’s going to kill lymphoma cells wherever they are, including in your blood and bone marrow. “If there’s lymphoma hiding anywhere, it kills it off.”

You’ll get this treatment over a period of about five days. Either you can stay in the hospital for the length of the treatment, or commute back and forth from home to get your chemotherapy.

On the sixth day, which Dr. Costello and other doctors call “a day of rest,” you don’t get any chemotherapy. “Have a day off. Visit with family. People are feeling well at this point. The chemotherapy’s kind of in and out of your system and the side effects haven’t really started,” she says.

After a few days you might develop side effects from the chemotherapy, such as nausea, vomiting, diarrhea, and mouth sores. Your doctor can recommend treatments to manage them.

Transplant Day

Day seven is transplant day. Your frozen stem cells arrive at the hospital on dry ice to keep them cold. “It literally looks like frozen bags of blood,” Dr. Costello explains. “We thaw those bags out and, like a blood transfusion, just drip those stem cells right into you.”

After chemotherapy has wiped out your own natural stem cells, the infusion is “rescuing you.” It helps your body recover from the effects of the chemotherapy, Dr. Costello tells SurvivorNet.

Now your part is essentially finished. All that’s left for you to do is wait. “The next steps are just letting those stem cells get in there, get comfortable, and start growing,” she says. If all goes well, they’ll replenish the stem cells you lost during chemotherapy, and give you a fresh start.

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