A transplant using your own stem cells

About an autologous transplant

It's more usual to have stem cells collected from your bloodstream. But some people might have stem cells collected from their bone marrow. 

Read more about stem cells and how a transplant works

There are different steps or stages of an autologous transplant.

Preparation

To prepare you for your transplant, you have:

• various tests

• a central line put in

Central line

The central line can stay in your vein for many months. So you don't need to have needles in your hand or arm each time you have treatment. You can also have anti sickness medicines and antibiotics through your central line. And your nurses can take blood samples from your line.

As part of your preparation, you might have chemotherapy to get rid of as many cancer cells as possible. This chemotherapy might also help the bone marrow make more stem cells.

Fertility

Your treatment could mean it is difficult to become pregnant or father a child in the future. Talk to your healthcare team if this is a concern for you. You might be able to store sperm or eggs before starting treatment.

Treatment can cause an early menopause in some women. Sometimes it is possible for women to freeze their eggs or embryos before cancer treatment. But it takes time to stimulate your ovaries to collect the eggs. Your doctor may not want you to delay starting cancer treatment.

Men may be able to bank sperm before starting any treatment.

Ask your doctor and nurse if you're not sure about anything. They can explain what your options are.

Growth factors

You have injections of a growth factor if you are going to have stem cells taken from your bloodstream. Growth factors are natural substances that make the bone marrow produce more stem and blood cells.  

You have growth factor before and after a stem cell transplant. You have them as small injections under the skin.

Depending on your situation you have daily injections of growth factor for between 5 and 10 days. Some people have low doses of a chemotherapy drug alongside the growth factor injections.

The chemotherapy and growth factor help your bone marrow make lots of stem cells. These stem cells then spill out of the bone marrow into the bloodstream. 

Side effects include itching around the injection site. Some people have a high temperature (fever). You might have pain in your bones after you have had a few injections. This is because there are lots of blood cells being made inside your bones.

Collection of stem cells

You have stem cells collected from your bloodstream through a drip. 

To collect stem cells from your bone marrow, you have a general anaesthetic. A doctor puts a needle into your hip bone to remove the bone marrow.

Conditioning treatment

You have conditioning treatment after your stem cell collection. You have high doses of chemotherapy and you might have targeted drugs, depending on your type of cancer. Your medical team will explain which drugs you are going to have and the possible side effects. You may also have radiotherapy to your whole body. This is called total body irradiation or TBI. 

You have chemotherapy and other drugs over about 5 or 6 days. If you have TBI, you might have it at the beginning or end of your chemotherapy.

You have your stem cells back

After treatment you have your defrosted stem cells back. You have these through your central line into your bloodstream.

Blood count recovery

These stem cells find their way back into your bone marrow where they make the blood cells you need. This recovery of blood cells is called engraftment.  

You have regular blood tests to check when your bone marrow starts to make new blood cells. The time it takes for the new blood cells to appear (and blood counts to recover) can vary. This might take 1 or 2 weeks and sometimes longer. It can take between 2 to 3 weeks.

During this time, you continue to have treatment for any side effects and symptoms. This might include:

• antibiotics and antiviral medicines to treat and prevent infection

• platelet transfusions if the number of platelets in your blood are low

• blood transfusions if your red blood cells are low

• medicines to relieve a sore mouth, diarrhoea and sickness

Find out more about total body irradiation

Hospital stay

After consolidation treatment, you have low numbers of blood cells for some time. This means you are at risk of picking up infections.

You may stay in hospital until:

• your blood cells have recovered enough to go home

• you no longer have any severe side effects 

This may take 3 to 4 weeks, although it can vary from one person to another. 

Some people become outpatients straight after their stem cell transplant. This is more likely if you have a transplant using your own stem cells. You need to attend the hospital daily for blood tests and treatment. You only stay in hospital if you develop complications.

Outpatient transplant treatment is becoming more common.

Side effects of transplants

The possible side effects of a stem cell transplant are caused by high dose treatment and total body irradiation. These treatments lower the number of the different blood cells. Side effects include:

• increased risk of getting an infection

• tiredness and lacking energy

• increased risk of bleeding

• sickness and diarrhoea

Find out about the side effects of a transplant