What is Stem Cell Transplant?
A stem cell transplant, also called a hematopoietic stem cell transplant, replaces damaged or diseased blood-forming stem cells with healthy ones. The stem cells may be collected from the patient’s bloodstream, from a donor’s bloodstream, from bone marrow or, in selected cases, from stored umbilical cord blood.
Most stem cells used for transplantation are now collected from peripheral blood. A transplant using the patient’s own cells is called an autologous transplant, while one using cells from a donor is called an allogeneic transplant. The appropriate approach depends on the diagnosis, disease status, previous treatment, donor availability and the patient’s general health.
How the Treatment Is Performed
Stem cell transplantation involves several coordinated stages:
Assessment and Treatment Planning
The care team evaluates the disease, previous treatments and the patient’s fitness for transplantation. Tests may assess blood counts, infections, organ function and disease status.
Stem Cell or Donor Selection
For an autologous transplant, the patient’s own stem cells are collected. For an allogeneic transplant, family members, unrelated donors or cord blood units may be assessed using HLA matching.
Stem Cell Mobilisation and Collection
Medicines may be given to move stem cells from the bone marrow into the bloodstream. The cells are then collected through apheresis, during which blood passes through a machine that separates the stem cells and returns the remaining blood to the body.
Conditioning Treatment
The patient receives chemotherapy, with or without radiation therapy, to treat the disease, suppress the immune system when required and prepare the bone marrow for the transplanted cells.
Stem Cell Infusion
The collected stem cells are infused into the bloodstream through an intravenous line. They then travel naturally to the bone marrow.
Engraftment and Follow-up
The care team monitors blood counts until the transplanted cells begin producing new blood cells. Supportive treatment may include antibiotics, transfusions, nutritional support and medicines to prevent or manage complications.
Clinical Indications
Stem cell transplantation may be considered for selected patients with:
Leukaemia
Lymphoma
Multiple myeloma
Myelodysplastic syndromes
Certain germ-cell tumours or other selected solid tumours
Aplastic anaemia
Sickle cell disease or thalassaemia
Certain inherited metabolic or immune-system disorders
Disease that has relapsed or remains at high risk of recurrence
Not every patient with these conditions requires a transplant. The potential benefit must be weighed against the intensity and risks of treatment.
Advantages of Stem Cell Therapy
Rebuilds the Blood and Immune System
Transplanted stem cells can restore the body’s ability to produce healthy blood cells.
Different Transplant Options
Stem cells may come from the patient, a matched donor or cord blood, depending on clinical requirements.
Enables High-Dose Treatment
Autologous transplantation can restore bone marrow function after intensive chemotherapy for selected cancers.
Potential Anti-cancer Immune Effect
Donor immune cells may attack residual cancer cells after an allogeneic transplant.
Treatment Tailored to the Patient
The stem cell source, donor, conditioning regimen and supportive care can be selected according to individual clinical needs.
Possibility of Lasting Disease Control
Stem cell transplantation may provide durable remission or potentially curative treatment for appropriately selected patients.
When to Contact Your Care Team
Contact the transplant care team promptly if the patient develops:
- Fever, chills or flu-like symptoms
- New cough, breathlessness or chest discomfort
- Persistent vomiting or diarrhoea
- Inability to eat or drink adequately
- Unusual bleeding or widespread bruising
- A new or worsening rash
- Yellowing of the skin or eyes
- Severe abdominal pain
- Pain, swelling or discharge around the intravenous line
- Reduced urination or sudden swelling
- Severe headache, confusion, drowsiness or weakness
- Exposure to chickenpox, measles or another contagious infection
- Any sudden or rapidly worsening symptom
The transplant team may provide a specific temperature threshold or emergency contact instructions. These should always be followed.
Frequently Asked Questions
01
What is the difference between a stem cell transplant and a bone marrow transplant?
Stem cell transplant is the broader term. The blood-forming stem cells may be collected from peripheral blood, bone marrow or umbilical cord blood. A bone marrow transplant specifically uses stem cells collected from bone marrow.
02
What are autologous and allogeneic transplants?
An autologous transplant uses the patient’s own stem cells. An allogeneic transplant uses stem cells from a donor. The appropriate type depends on the disease, treatment objective, donor availability and the patient’s health.
03
How are peripheral blood stem cells collected?
Medicines may first be given to move stem cells into the bloodstream. The cells are then collected through apheresis, during which blood passes through a machine that removes the stem cells and returns the remaining blood to the body.
04
Is the stem cell infusion painful?
The cells are usually infused through an intravenous line, similar to a blood transfusion. The infusion itself is generally not painful, although some patients may experience temporary reactions that require monitoring.
05
Will the patient need to stay in hospital?
Many patients require hospitalisation during conditioning, infusion and early recovery. The duration depends on the transplant type, treatment protocol, engraftment and whether complications develop.
06
Are vaccinations needed again after transplantation?
Some immunity from previous vaccinations may be lost. The transplant team may recommend a planned revaccination schedule once the immune system has recovered sufficiently.
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