Types of stem cell transplants: autologous vs. allogeneic
What Is Autologous Stem Cell Transplantation?
Autologous stem cell transplantation represents a big step forward in myeloma treatment.
By Chris Iliades, MD
Medically Reviewed by Lindsey Marcellin, MD, MPH
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If your doctor has recommended autologous stem cell transplant as part of your myeloma treatment, you are not alone. More than 10,000 autologous myeloma stem cell transplants — meaning transplants using cells from your own body — are performed in North America each year.
"Higher-dose therapy followed by autologous stem cell transplant improves the complete remission rates and can prolong the life of patients with myeloma," says Cristina Gasparetto, MD, a multiple myeloma researcher at the Duke University Comprehensive Cancer Center in North Carolina.
Understanding Autologous Stem Cell Transplantation
When doctors give very high doses of chemotherapy drugs to kill myeloma cells, the drugs may also kill normal blood-producing "stem cells" in the bone marrow. Stem cells are special cells that can divide and turn into any of the three major types of blood cells: red cells, white cells, and the platelet cells that are needed to control bleeding.
The first step in autologous stem cell transplantation is to collect stem cells from your own blood. In the past, stem cells were collected directly from bone marrow. This required a surgical operation under anesthesia. Now your doctor can get the stem cells by a procedure called "aphoresis."
During aphoresis, blood is removed through a needle in your vein, similar to the needle used in a blood transfusion. The blood is then circulated through a cell separator that removes the stem cells and lets the rest of the blood flow back into the bloodstream. The procedure is painless and can be done in an outpatient setting. It usually takes several sessions of two to four hours each to get enough stem cells. The stem cells are then frozen and stored until it is time for your chemotherapy.
Within a few days after you get the high-dose chemotherapy, the stored stem cells are warmed in a bath and given back to you, again through a vein. The stem cells travel through your bloodstream and back to your bone marrow, where they begin to produce healthy new blood cells. Autologous stem cell transplant, combined with high-dose chemotherapy, has revolutionized myeloma treatment. "High-dose therapy and stem cell transplantation has been used to treat myeloma for more than 20 years," Dr. Gasparetto says.
Side Effects of Autologous Stem Cell Transplant
During the first few weeks after the transplant, there is some danger of infection, bleeding, or anemia. Sometimes a blood transfusion may be needed to strengthen the blood until new blood cells return. Antibiotics may also be used to guard against or treat any infections. Although it will be important to be near the treatment center where you received the transplant so that your doctor and treatment team can closely monitor you for two to three months, you should know that autologous stem cell transplant myeloma treatment is very safe and may be done as an outpatient procedure.
A recent study done by the Mayo Clinic on 716 people who underwent autologous stem cell transplant for multiple myeloma treatment concluded that outpatient transplant was possible and safe for patients with multiple myeloma.
And that's reinforced by the Multiple Myeloma Research Foundation. It reports that people who undergo stem cell transplants along with high-dose chemotherapy as myeloma treatment have a better chance of both improvement of their cancer and survival compared with people who get conventional chemotherapy alone.
Video: Stem Cell Transplantation Program Video – Dana-Farber/Brigham and Women’s Cancer Center
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