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Things To Know About An Autologous Stem Cell Transplant

Cade Hildreth (CEO)
Feature | Things To Know About An Autologous Stem Cell Transplant

“Autologous stem cell transplant” can be a mouthful to say. Many people don’t know what it means – let alone what a reliable option it is for defeating blood and bone-borne cancers. It has also demonstrated improvements in progression-free survival (PFS). Many of those who undergo the procedure can drive their cancer into remission or permanently defeat it.

What Autologous Stem Cell Transplant Can Do For Diseases

In this article:

Autologous Stem Cell Transplant for Various Diseases

Those who suffer from multiple myeloma, Hodgkin disease, other types of lymphoma, or leukemia may well be candidates for autologous stem cell transplant. Of course, one can’t move forward with any treatment plan without understanding the procedure and surrounding details.

This guide will discuss exactly what an autologous stem cell transplant is and how it works, as well as the benefits and risks. Many people are curious how this treatment will affect their fertility, so it will discuss that too, along with what needs to happen in order to prepare the home for patient recovery.

Those who are looking for possible treatments for cancer in the blood or bones will find this post and autologous stem cell transplants in general very effective tools, so for now, keep that hope alive. Here’s a closer look.

What Is Autologous Stem Cell Transplant?

Stem cells are immature cells that become a range of different types of cells. Blood stem cells, also called hematopoietic stem cells, are capable of turning into all of the components in blood, from macrophages and natural killer cells to basophils and neutrophils, to plasma cells and white blood cells. However, the types of cells into which blood stem cells can turn is less important than the fact that stem cells are capable of repopulating the blood and bones after all cells get destroyed by radiation, chemotherapy or both.

The definition of autologous means something obtained from and then donated back to the same individual. The word usually refers to cells or tissues, just as it does in this case when stem cells return to the patient from whom they got harvested.

Therefore, an autologous stem cell transplant is when physicians collect hematopoietic stem cells from blood through a process known as apheresis (pronounced A-fer-E-sis), then give them back to the same patient at a later date. (This is in contrast to other types of stem cell transplant, which will factor into this discussion later.) Because it will be sometime between harvesting stem cells and giving them back to the patient, the physician will store it those cells by freezing them.

Harvesting Autologous Stem Cells

Harvesting it is only half of the transplant. Chemotherapy and radiation kill off existing blood and bone cells partially or entirely. Of course, that’s not the goal of these treatments. The goal is to kill all of the cancer cells in the body, but that usually causes collateral damage. By harvesting and storing stem cells, the patient can later re-create marrow and bone cells after the cancer is gone. That’s where the word “transplant” comes in – when the cells return to the body.

Why Get Stem Cell Transplants?

There are several reasons to get autologous stem cell transplants. Either the body cannot make those blood cells on its own because the marrow and blood cells are too diseased to function properly, or the disease calls for high levels of chemotherapy or radiation, which again, cause serious health issues – even while simultaneously fighting cancer.

Consider multiple myeloma, for instance. This disease causes plasma cells, and type of white blood cell, to turn against the body. When they are functioning normally, white blood cells make antibodies to attack germs and other bodily indicators. However, when they are malfunctioning, they make abnormal proteins that build up in the bones and crowd out healthy, necessary blood cells. In cases where this process gets out of hand, the blood and bone marrow may need replacement.

The same goes for other diseases that affect the blood and bones. If the patient’s existing tissue cannot recover, then the best bet is to remove it and provide new tissue. This offers a very good chance of saving the patient’s life.

From Where in the Body Are Stem Cells Gathered?

Stem cells reside in many places in the body, both adult humans as well as embryos. In fact, many people associate stem cells with embryos, which is another place from which to harvest them. However, this practice has given rise to much criticism from certain sectors, so researchers have worked hard to find replacement sources.

Cord blood is blood that is harvested from the umbilical cord of newborns. It is another rich source of stem cells. Many mothers have started to donate umbilical cord blood to public cord blood banks, because stem cells collected during live births are among the most flexible and easily used. In addition to umbilical cord blood, the physical matrix of the umbilical cord, as well as the placental blood and tissue, are rich sources of stem cells.

Common Sources of Stem Cells

In more recent years, adult stem cells have become a more common source. The blood and bone marrow are two of the most common places in which to find adult stem cells. However, other tissues, such as fat or dental tissues, also give rise to stem cells. This is great news, because it means that people who will benefit from their own stem cells have a variety of sources from which to obtain them.

In autologous stem cell transplantation, blood is the most common source of these cells. While physicians may also harvest them from bone marrow, this requires anesthesia and a more in-depth procedure. Learning to effectively collect blood stem cells through apheresis has proven much easier all around.

Allogeneic Versus Autologous: What’s the Difference?

When considering autologous stem cell transplants, it is also important to understand allogeneic transplants. A physician can explain this as well, if both treatment options for the patient. Nevertheless, it’s helpful to get clear on both beforehand, because they are beneficial in cases such as lymphoma, leukemia and multiple myeloma.

As discussed, an autologous transplant means the cells came from the patient to whom the physician will later give them. In an allogeneic transplant, the stem cells come from a different person.

In short, allogeneic versus autologous is defined as:

Regardless of whether an allogeneic or autologous transplant is used, that donor undergoes the same procedure to harvest the stem cells, after which physicians store them in the same way to await transplant day.

Allogeneic Stem Cell Transplant

Allogeneic stem cells may provide two different services. In the first, physicians use the same process as in autologous stem cell treatments. They obtain the stem cells from another, then administer high doses of chemotherapy and radiation to the diseased patient. Once the diseased cells have died, doctors then introduce the donor stem cells. Ideally, these take root and repopulate the patient’s blood and marrow.

In the second approach, physician’s reply on the immunological services of the donor stem cells. When they get introduced to the patient, they recognize and attack the cancer. This avoids the necessity of large doses of chemotherapy and radiation, both of which are very hard on the body. Scientists refer to this as the graft-versus-tumor effect.

Allogeneic stem cell transplants are useful when the patient’s blood and marrow are so deceased that reintroducing them to the body will simply reintroduce the cancer as well. Unfortunately, allogeneic procedures carry the risk of graft-versus-host disease (GvHD).

What Are the Benefits of Autologous Stem Cell Transplants?

Graft-versus-host disease occurs when donor cells attack the host body following an allogeneic stem cell transplant. Instead of recognizing the cancer for taking root, these cells harm the patient. Patients may experience relatively mild symptoms, such as rashes or diarrhea. These often last only a few weeks. However, others experience the symptoms over periods of months or years. In more severe cases, graft-versus-host disease can result in considerable health problems, such as the liver damage.

For this reason, it is better for physicians to take donors stem cells from the patient when it is possible.

How Does Autologous Stem Cell Transplant Affect Fertility?

It is important to consider fertility options before pursuing autologous stem cell treatment. Chemotherapy and radiation both affect fertility, so men and women who still wish to produce offspring should take steps beforehand. Although men do in some cases regenerate sperm after the treatment, this is not common. It is better to produce and bank sperm in preparation.

Women who wish to get pregnant should freeze their eggs in case those in their bodies do not survive the process. While pregnancy is absolutely possible after stem cell transplantation, the risks are higher. Babies are more likely to arrive prematurely and exhibit low birth weight. Former patients should always advise physicians that they have undergone the procedure.

How Do You Prepare Your Home for Your Return?

The patient will leave the hospital long before their immune system is fully recovered, so it is very important that caretakers do not neglect to prepare the home environment. According to the Dana-Farber Cancer Institute, this takes thoughtful efforts beforehand.

While it is not strictly necessary to hire a cleaning service, it is important to do a thorough deep clean before returning home. For patients whose stay in the hospital will likely last a few weeks, it’s not enough to do this before leaving home. It is best if the patient asks a loved one to clean the home directly before their return. In case there is no one available to do this, a cleaning service is also a good option.

Steps to Take for Home Recovery

While this represents additional work on top of an already complex and lengthy caretaking process, it will do much to reduce risk and lead to a healthy recovery.

What Are the Five Phases of Autologous Stem Cell Transplant?

And autologous stem cell transplant takes place over five phases. The transplant begins not when stem cells get collected, but when physicians reintroduce cells to the body. The phases, according to the Memorial Sloan Kettering Cancer Center, are as follows:

  1. The patient received chemotherapy and possibly radiation as well to kill off remaining cancer cells. Phase 1 is completed when physicians introduce the stem cells to the patient’s body.
  2. The second phase begins immediately upon the end of the procedure. It continues until the patient reaches engraftment, which is the partial recovery of blood cell counts.
  3. Phase 3 refers to the patient’s stay in the hospital. Specifically, this phase lasts from when blood cell counts begin to recover until the day of discharge.
  4. The penultimate phase is early recovery, in which blood counts increase continually, but the patient’s immune system is still compromised. During this time, the risk of infection is strong and the medical team continues to monitor the patient closely.
  5. The last phase is late convalescence. In this phase, the immune system will function almost normally. However, the patient may have lost many immunities developed in childhood, so they often receive rounds of vaccinations usually given to children.

Is Remission a Sure Thing?

Unfortunately, the completion of these phases does not guarantee that the patient will not experience a relapse or other complications. However, as time goes on, their chances of survival increase.

How can autologous stem cell transplant help you beat lymphoma? Watch this video from Lymphoma Action below:

Now that you know more about autologous stem cell transplants, what do you think about this therapeutic approach? Share your thoughts in the comments below!

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