It's normal for someone battling cancer to feel a little scared when the doctor says, "We're going to do a stem cell transplant." But when the word "autologous" is mentioned, it means that this treatment is being done using your own cells. This is really a great way to give your body the power to fight cancer. Okay, so let's talk about how complicated this is, what it actually does, and how this process works in a very simple, step-by-step way.
Simply put, what is an autologous stem cell transplant?
Imagine this. Your computer is completely messed up by a virus. Now, to remove this virus, you have to completely `format` the computer. But what do you do before that? Do you `back up` your most important files to a separate location?
Autologous stem cell transplant is the same.
What happens here is that before you receive high-dose chemotherapy or radiation therapy to kill the cancer cells, some of your own healthy blood stem cells are removed from your body and kept safely aside. These stem cells are the "mother cells" in our bone marrow that make new red blood cells, white blood cells, and platelets.
When powerful anti-cancer treatments kill cancer cells, they also damage our healthy cells, especially the bone marrow. Then, your own healthy stem cells that were kept safe are reintroduced into your body. These cells go back to the bone marrow and start making the healthy blood cells that the body needs.
This may not cure the cancer completely, but it can put the cancer into long-term remission, meaning it is symptom-free and undetectable on tests.
This treatment is usually used primarily for the cancer condition `Multiple Myeloma`. It is also used for cancer conditions such as `Hodgkin lymphoma` and `Non-Hodgkin lymphoma` that do not respond to other treatments.
What happens before this treatment?
Before undergoing such a powerful treatment, doctors carefully examine your overall health, as your body needs to be strong enough to withstand high-dose chemotherapy.
Some tests that can be done:
- An `ECG` (Electrocardiogram) test that checks the heartbeat.
- An `Echocardiogram`, which checks the functioning of the heart.
- A `CT` (Computed Tomography) scan.
- A complete blood count (CBC).
- Other blood tests that check liver and kidney function.
- A biopsy is a test to study cancer cells.
Nowadays, to save you from having to keep getting needles, doctors can insert a small tube called a `Central Venous Catheter (CVC)` into a large vein in your upper chest. Then, everything from taking blood to giving medicine can be done easily through this `CVC`.
The three main steps in the treatment process
This entire process can be divided into three main stages.
1. Harvesting stem cells
This is where those healthy stem cells we mentioned are removed from your body. This is also called `Apheresis`.
- The veins in both of your arms will be connected to a cell separation machine.
- A little blood goes into the machine from one arm.
- The machine filters only the stem cells from that blood and injects the remaining blood back into the body through the other arm.
This can take three to four hours. During that time, you may have to stay still, but you can read a book or watch TV.
2. Conditioning the body
This is the hardest part. This is when you will receive high-dose chemotherapy and possibly radiation therapy to kill the cancer cells. This may take several days. Your medical team will be with you to manage any side effects that may occur during this time.
| Possible side effects of conditioning treatment | |
|---|---|
| Short-term side effects | Long-term side effects |
| Anemia (low blood count), nausea and vomiting, diarrhea, extreme fatigue, loss of appetite, mouth sores, hair loss. | Osteoporosis, cataracts, early menopause, infertility, risk of developing a second cancer. |
3. Cell Transplantation / Infusion
This is similar to giving a saline solution or a blood pack. Your own stem cells, which have been collected and stored safely, are then put back into your body through an IV or CVC. During this time, the medical team will be constantly monitoring you for symptoms such as fever and chills.
What happens after treatment? Let's learn about the recovery period
After treatment, your body will slowly begin to recover.
- Engraftment: The newly infused stem cells travel through the bloodstream, settle in the bone marrow, and begin to produce new healthy blood cells. This process is called `Engraftment`.
- Risk of Infection: After the engraftment, your risk of infection is very high until your white blood cell count returns to normal. Therefore, it is extremely important to protect yourself from infections during this time.
- Recovery time: It can take anywhere from 3 to 12 months for your immune system to fully recover. So don't rush it. Here are some things to help you:
- Get plenty of rest: Some days you may feel very tired. Take a break at those times.
- Eat nutritious foods: Eating protein-rich foods helps rebuild the body.
- Exercise: As soon as you feel stronger, start doing simple exercises like walking. But be sure to talk to your doctor before starting anything new.
- Update your vaccinations: After this treatment, the protection you received from childhood vaccinations will be lost. Therefore, your doctor will tell you when to get vaccinated again and which vaccines to get.
What is the difference between Autologous and Allogeneic transplants?
The main difference between the two is the source of the cells. To understand this simply, see the table below.
| Transplant Type | From whom are stem cells obtained? |
|---|---|
| Autologous | From yourself. Your own cells are collected before cancer treatment. |
| Allogeneic | From a healthy donor. Usually, the tissue is obtained from a compatible family member or someone else. |
When to see a doctor immediately
Even if you have regular medical checkups after treatment, it is important to notify your medical team immediately if you develop any signs of complications. Watch for the following symptoms:
- Fever
- Feeling cold and shivering
- Difficulty breathing (Dyspnea)
- Coughing, sneezing, or runny nose
- Frequent urination or pain during urination (Dysuria)
- Skin rash
- Dizziness
Take-Home Message
- An autologous stem cell transplant involves collecting your own healthy stem cells before cancer treatment and then returning them to your body after treatment.
- This is a multi-step process: cell collection, high-dose conditioning, and cell reintroduction.
- The main risk after treatment is the development of serious infections, so it is very important to protect yourself from infections.
- It can take months for the body to fully recover, so be kind to yourself and take care of your rest and nutrition.
- Every patient is different, so always talk openly with your treating doctor about whether this treatment is right for you, its success, and its risks.
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