You need healthy bone marrow and blood cells to live. If you have a condition that affects your bone marrow or blood, then a stem cell transplant could be the best treatment option. For some people, a transplant offers hope of a potential cure.
A bone marrow or stem cell transplant means that doctors or nurses will put healthy stem cells into your bloodstream. These cells make their way to your bone marrow where they begin to grow and make healthy blood cells.
If you are having an autologous transplant (also known as an ‘autograft’ or ‘auto’), doctors use your own stem cells that are collected and then put back into your body after you have had chemotherapy.
Who can have an autologous transplant?
An autologous transplant could be a treatment option for you if you have:
- Blood cancer - If you have already had chemotherapy but your blood cancer has come back, your doctors may recommend an autologous transplant. If you have myeloma or a type of lymphoma, your doctors may suggest an autologous transplant as a ‘consolidation treatment’ that could help stop your disease coming back after chemotherapy.
- Other cancers - Certain cancers such as germ cell tumours or sarcomaneed to be treated with doses of chemotherapy that are so strong it can destroy your immune system. Having an autologous transplant following treatment allows your immune system to recover.
- Non-cancerous conditions that affect your immune system - In rare cases, where standard treatments have failed, severe autoimmune diseases such as multiple sclerosis and Crohn’s disease can be treated with an autologous transplant. When you have an autoimmune disease your own cells have started to attack your body. In these cases chemotherapy removes the faulty immune cells and the transplant allows your immune system to be ‘reset’.
What will happen before the transplant?
Depending on your disease or condition, you might have chemotherapy to prepare for the transplant weeks or months beforehand. If you have blood cancer, for example, the chemotherapy will get your condition into ‘remission’, which means there is no sign of cancer in your body.
Collecting your stem cells
You will go to hospital to have your own stem cells collected weeks or months before your transplant day. This timing can vary and will depend on your particular situation.
Stem cells are normally collected in a process called peripheral blood stem cell collection (PBSC). You’ll be connected to a machine which takes blood from one arm, removes the stem cells and returns your blood to the other arm. Sometimes your transplant team may need to collect stem cells directly from your bone marrow during a small operation, but this is much less common. Your stem cells are then frozen and stored, to be used on the day of your transplant.
Before your stem cell transplant, your bone marrow and immune system need to be treated and prepared for the new cells. This is done with chemotherapy. You’ll normally start your conditioning therapy the day you go into hospital. It can take one day, 10 days, or sometimes even longer depending on your treatment.
What will happen during the transplant?
Your transplant normally takes place the day after the conditioning therapy has finished. The transplant involves having your previously collected stem cells thawed out and given to you through your PICC line or into your bloodstream. This is a bit like having a blood transfusion. The transplant isn’t painful and you’ll be awake the whole time.
Recovering from an autologous stem cell transplant
You’ll probably be in hospital for about two to three weeks after your transplant and you’ll need to spend some time in protective isolation. You’ll usually be in a single hospital room with precautions taken to protect you from infection. For information about how to cope during this time see our webpage Your Stay in Protective Isolation.
It usually takes at least three to six months before your level of activity starts to get back to normal.
What side effects can I expect?
Having a transplant is a very intensive treatment that has a big physical and emotional impact on your life. Your transplant team will talk to you about the risk of complications and side effects so you can make the best decisions for your care.
Side effects of an autologous transplant vary from person to person and can be short term or long term. They are often caused by the conditioning therapy you have before the transplant, as well as the effect of the transplant itself.
Short-term side effects include:
- need for blood and platelet transfusions
- increased risk of infections
- sore mouth (mucositis)
- liver and kidney problems
- diarrhoea and feeling or being sick
- loss of appetite.
It’s also common to feel a bit down or anxious during the early stages of recovery. We have further information on this in our Recovery: Mind section.
Your transplant team will be monitoring you closely and there will be treatment and support available.
Long-term side effects include:
Information published: 04/08/21
Next review due: 04/08/24