About Autologous Transplant

What is autologous transplant?

In an autologous transplant, some of the patient's own bone marrow or peripheral blood stem cells are removed and reserved. The patient then receives high doses of chemotherapy or radiation to destroy any cancer cells. Afterward, the patient receives back his or her own blood cells through a transfusion. These cells find their way to the bone marrow and begin to produce a new population of blood cells. Through this process, the patient's bone marrow and immune functioning returns to normal.

When is bone marrow or peripheral blood stem cell transplant an appropriate treatment?

Bone marrow/peripheral blood stem cell transplants are used to treat a number of life-threatening diseases. Transplants have also become the standard of care for certain diseases. The procedure offers hope of a cure when standard cancer treatment has not been able to destroy all of the cancer cell sin patient's body. The patient's body can withstand higher -- and possibly more effective -- doses of chemotherapy and/or radiation when bone marrow function can be bolstered with fresh bone marrow and/or stem cells.

Some of the diseases for which bone marrow/peripheral blood stem cell transplant may be used are Hodgkin's disease, Non-Hodgkin's lymphoma, multiple myeloma, acute leukemia, chronic leukemia, aplastic anemia, and myelodysplastic syndromes.

What is the difference between bone marrow and peripheral blood stem cell transplant?

Bone marrow is the spongy tissue found inside the bones. Bone marrow makes stem cells which grow and divide and become red blood cells (which carry oxygen to body tissues), white blood cells (which help fight off infection), and platelets (which aid in blood clotting). Stem cells are also found in the blood stream, normally at low concentrations. However, the number of stem cells in the peripheral blood can be increased by giving the patient a special "growth factor."

In a bone marrow transplant, some marrow (about 5 percent) is harvested from the patient's hip bone. These cells are pooled, processed and transfused into the patient. The patient may experience some discomfort or soreness with this procedure, but usually he or she can resume normal activity in a couple of days.

Peripheral stem cells, on the other hand, can be taken from the blood circulating in the body after the patient is injected with a growth factor called Granulocyte Colony Stimulating Factor or G-CSF. This medication stimulates the bone marrow to produce excess quantities of stem cells which are released into the circulating blood. The patient's blood is drawn and a special blood processing system concentrates the stem cells. These cells are transfused back into the patient. The donor experiences no surgical pain.

Peripheral blood stem cell transplants generally provide more stem cells and result in a more rapid recovery of white blood cells and platelets.

Whether bone marrow or peripheral blood stem cells are used, the transplants have the same purpose. Healthy cells are collected from the patient or a donor, and stored before a patient undergoes intensive chemotherapy and radiation treatment. After the treatment, the cells are returned to the patient to help restore the patient's blood counts and rebuild the immune system.

How are transplant recipients selected?

Patients are carefully evaluated to determine if transplant is the best treatment option. Factors that have to be considered are age, overall medical status, type and stage of disease, and disease progression. Your transplant team will thoroughly discuss all of the risks and benefits with you and your family.

What happens after the bone marrow or stem cells have been transplanted to the patient?

After entering the bloodstream, the transplanted cells travel to the bone marrow, where they begin to produce new white blood cells, red blood cells and platelets. This process is called "engraftment." It may take 10-16 days for engraftment to occur after transplantation. Doctors monitor whether new blood cells are being produced by checking blood counts daily. Periodic bone marrow aspirations (the removal of a small sample of bone marrow through a needle for examination under a microscope) can also help doctors determine if engraftment has been successful.