Understanding Multiple Myeloma: Stem Cell Transplant
A stem cell transplant, in combination with high dose chemotherapy, is a treatment plan that offers a chance for durable remission of multiple myeloma. High-dose chemotherapy, though effective in killing myeloma cells, also destroys normal blood-forming cells, called hematopoietic stem cells, found in the bone marrow. Stem cell transplantation replaces these important cells.
After you complete the high dose chemotherapy, you receive healthy stem cells through a large vein. (It's similar to getting a blood transfusion.) New blood cells develop from the transplanted stem cells. The new blood cells replace the ones that were destroyed by treatment.
Some people with myeloma have two or more transplants over time.
What to Expect
Stem cell transplants may or may not take place in the hospital depending on the type of treatment. Healthy blood-forming stem cells are given to you through a flexible tube placed in a large vein in your neck or chest area. New blood cells develop from the transplanted stem cells.
The stem cells may come from your own body or from a donor. There are 3 main types of stem cell transplants:
Autologous stem cell transplantation: This process uses your own stem cells. These stem cells are collected before you receive high doses of chemotherapy. The cells are then preserved, frozen, and stored until the time of transplant. This enables you to receive high doses of chemotherapy. These are called the “preparative regimen” or “conditioning regimen.” These high doses destroy myeloma cells in your bone marrow, creating a new space for the transplant cells to live.
Once the chemotherapy drugs have cleared from your body, you are ready to receive new stem cells. Your stored stem cells are thawed and given back to you similar to a blood transfusion. This procedure is done through a flexible tube placed in a large vein in your neck or chest. The infusion time can range from 30 minutes to a few hours. Your body develops new blood cells from the transplanted stem cells.
Allogeneic stem cell transplantation: In this process, healthy stem cells come from a donor. Doctors use blood tests to make sure the donor’s cells match yours. Often the donor is a close relative—parent, brother or sister.
Syngeneic stem cell transplantation: This process is just like allogeneic stem cell transplantation except that the stem cells come from your healthy identical twin.
Stem cells come from a few sources. Usually they come from the blood. This is called a peripheral blood stem cell transplant. They can also come from the bone marrow. This is called a bone marrow transplant.
In time, the transplanted stem cells will begin to produce healthy blood cells. After a stem cell transplant, you may stay in the hospital for a short time. You'll be at risk for infections because of the large doses of chemotherapy you received.
Questions to Ask About a Stem Cell Transplant
You may want to ask your doctor these questions before having a stem cell transplant:
- What kind of stem cell transplant will I have? If I need a donor, how will we find one?
- How long will I be in the hospital? Will I need special care? How will I be protected from germs? Will my visitors have to wear a mask? Will I?
- What care will I need when I leave the hospital?
- How will we know if the treatment is working?
- What are the risks and the side effects? What can we do about them?
- What changes in normal activities will be necessary?
- What is my chance of a full recovery? How long will that take?
- How often will I need checkups?