What to Expect

Welcome to our Autologous Stem Cell Transplant program at UAMS Winthrop P Rockefeller Cancer Institute. You and your family will spend a lot of time with us in the weeks to come. We want it to be as comfortable as possible. This information will help you learn more about autologous stem cell transplantation and why you will need special care.

Before and during your transplant, you will learn how you and your family can help with your care. Your doctors and nurses will review this information with you and answer any questions you have. Your social worker will also talk with you and your family.

The Autologous Transplant Team

The Service works as a team. Your doctor you see in the clinic is in charge of your care throughout your treatment. However, your doctor may not be the one to manage your day-to-day care while you are in the hospital. Attending doctors rotate on the inpatient unit. One attending will be responsible for your care for 2 weeks before another attending takes over. Any important decisions are made with your doctor.

Fellows, nurse practitioners, hospitalists and house staff are also partners in your care. The fellow is an internist doing special training in cancer. A nurse practitioner is a nurse who has an advanced degree in an area of care. This nurse practitioner can take patient histories, do physical exams, and prescribe treatments and medicine. He or she can also provide medical care with the doctors. The hospitalist is a doctor who only sees patients in the hospital. He or she will cover the unit at night. House staff are doctors who are completing their residency. They work under the supervision of the fellows and attending doctors. While you are here, you will come to know all of the members of your team. You can always contact your doctor if you have any questions. A team of primary nurses will be responsible for your day-to-day nursing care.

What is an Autologous Stem Cell Transplant?

Bone marrow is found in the spaces in the center of the long bones in your body. Blood cells are made in the bone marrow: white blood cells (WBC) fight infection; red blood cells (RBC) carry oxygen; and platelets (PLT) help form clots to prevent bleeding. Stem cells are blood cells that have not yet become a specific kind of blood cell. All blood cells begin as stem cells; thus, by transplanting stem cells we can regenerate your blood cell forming ability. Stem cells tend to remain in the bone marrow, where they can become any type of blood cell the body needs, but some go into general circulation in the blood vessels.

Autologous Stem Cell Transplant

Autologous means “from yourself.” Stem cells will form your new bone marrow after you have been treated. The stem cells in your blood are collected (harvested) before you are treated with high-dose chemotherapy called the “conditioning regimen.” We call this stem cell harvesting. You will have injections of G-CSF to help your body make more stem cells.

Stem cell harvesting is done in the Aphersis Center. It is very similar to giving blood. You will sit in a chair or lie in a bed and can read or bring music to listen to. It takes three to four hours for each collection. Several harvesting procedures (1-5) are usually required to get enough stem cells to support an autologous stem cell transplant.

Why You Need an Autologous Stem Cell Transplant

Your type of cancer responds to high doses of chemotherapy, radiation, or both. A side effect of these is that your bone marrow will be wiped out. When your treatments are finished, the stem cells will be given back to you (“transplanted”) through your catheter. The stem cells will allow your bone marrow to again produce blood cells. The stem cell infusion takes 15 to 30 minutes. It is very much like having a blood transfusion.

Stem cell transplants are used to rescue patients’ bone marrow after treatment for many forms of cancer. These cancers are often treated differently. Your doctors and nurses will tell you about your treatment.

Relapse

Relapse of your original disease can occur if the treatments did not destroy all the cancer cells. Some conditions may put a patient at a higher risk for relapse. Your doctor will discuss these with you.