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Hematopoietic Stem Cell Transplantation

(HSCT; Bone Marrow Transplantation (BMT); Peripheral Blood Stem Cell (PBSC) Transplantation; Cord Blood Transplantation)

by Cynthia M. Johnson, MA

Definition

Stem cells produce red blood cells, white blood cells, and platelets. In some cases, stem cells in your bone marrow may not be functioning well or need to be destroyed to help treat a disease. If this happens, you will need new stem cells.

It may take about a month for the donor stem cells in the bone marrow to begin to function fully. If the transplant is successful, new bone marrow cells will produce healthy red blood cells, white blood cells, and platelets.

Stem cell transplantation may be:

  • Stem cells that were taken from your own bone marrow or blood and stored
  • Stem cells from a donor's bone marrow or blood

Location of Active Bone Marrow in an Adult

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Reasons for Procedure

This procedure is done if the stem cells in your bone marrow are not functioning or are deficient. This may be caused by:

Possible Complications

If you are planning to have a stem cell transplant, your doctor will review a list of possible complications, which may include:

  • Infection—until the donor blood-forming cells begin to work
  • Rejection of the donor stem cells
  • Graft versus host disease—immune cells in the donor's bone marrow attack your tissue

Stem cell transplant is usually avoided if you have:

  • Disease of the heart, lungs, liver, or kidneys
  • Diabetes

Be sure to discuss the risks with your doctor before the transplant.

What to Expect

Prior to Procedure

The donor will be carefully tested to check for diseases. Both you and the donor will be tested to ensure that your tissues are compatible. In order for the transplant to be successful, certain markers on the blood cells and bone marrow cells must match.

Medicine will be given to suppress your immune system. This is to prevent your body from rejecting the donor stem cells. In the weeks prior to the transplant, you may need to have:

  • Chemotherapy
  • Radiation therapy

This process is called conditioning. It will rid the body of diseased cells and clear the bone marrow cavities for the new bone marrow.

Anesthesia

Anesthesia will not be needed.

Description of the Procedure

The donation will be collected before your procedure. The donated stem cells will be filtered. An IV needle will be place through your skin into a blood vessel. The stem cells will be delivered through a tube to the IV. It will take a few hours for the treatment to finish. The stem cells will find their way to your bones. There they will grow new, healthy blood cells.

Immediately After Procedure

Conditioning will make your immune system weak. It will take some time for the new, healthy blood cells to develop. Your immune system will strengthen as the cells grow. You will need to be in isolation until the new cells develop. This is to help avoid infections while you recover.

How Long Will It Take?

It may take 1-5 hours for the transplant to complete.

How Much Will It Hurt?

There will not be pain while the stem cells are infused. You may have some nausea. This can be treated with medicine.

Average Hospital Stay

You will need to be in isolation in the hospital for 1 to 2 months.

Post-procedure Care

While you are recovering at the hospital, you may receive the following care:

  • Medicine—to keep your immune system low to decrease the chance of transplant rejection
  • Antibiotics—to prevent infection
  • Platelets, plasma, and red blood cell transfusions—to prevent bleeding and anemia
  • Frequent blood tests—to monitor whether the new stem cells in the bone marrow are taking hold or being rejected

Call Your Doctor

Once you are home contact your doctor if your recovery is not going as expected or you develop complications, such as:

  • Nausea and/or vomiting
  • Severe pain
  • New onset of pain
  • Signs of infection, such as fever and chills
  • Rash
  • Diarrhea

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Be the Match—National Marrow Donor Program
https://bethematch.org
BMT InfoNet
http://www.bmtinfonet.org

CANADIAN RESOURCES:

Canadian Association of Transplantation
http://www.cst-transplant.ca
Canadian Blood Services
https://www.blood.ca

References:

Blood-forming stem cell transplants. National Cancer Institute website. Available at:
...(Click grey area to select URL)
Accessed January 29, 2021.
Stem cell transplant for cancer. American Cancer Society website. Available at:
...(Click grey area to select URL)
Accessed January 29, 2021.
Last reviewed September 2020 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP
Last Updated: 1/29/2021