Autologous Stem Cell Transplant

As the only adult, FACT accredited program in the Washington, D.C. region, we offer multiple treatment options, including autologous stem cell transplant treatment. This type of transplant involves using your own stem cells to fight your disease after receiving high-dose chemotherapy.

Many cancers and other autoimmune diseases, such as multiple sclerosis, are sensitive to chemotherapy or radiotherapy. High doses of chemotherapy can destroy cancer while damaging the blood-forming stem cells in the bone marrow.

The transplantation infuses previously collected stem cells to regrow the patient's bone marrow and immune systems and allow treatment with dose-intensive chemotherapy.

We often use dose-intensive chemotherapy with autologous stem cell transplantation in the treatment of bone marrow diseases such as:

Multiple myeloma
Hodgkin lymphoma
Non-Hodgkin’s lymphoma
Amyloidosis (light chain)
Certain types of acute leukemia
Certain pediatric cancers
Certain auto-immune disorders such as multiple sclerosis, systemic sclerosis

Other diseases of the bone marrow are best treated with allogeneic transplantation.

Your healthcare team will help you decide whether this transplant treatment could effectively treat your disease.

These peripheral blood stem cells are collected as a blood donation process through the Blood and Marrow Collection Program.

After adequate quantities of hematopoietic stem cells are stored, you will undergo transplant procedures involving dose-intense chemotherapy followed by thawing and infusion of your stem cells.

Unlike other types of organ transplantation, there is no surgical component involved in this procedure.

What to expect before autologous stem cell transplantation

You will first be seen by a physician on the transplant team. In this consultation we will review your medical history and start the teaching process for you, your family, and your support system. You will also meet a transplant nurse coordinator who will help you schedule any pre-transplant testing needed. This testing determines your health and disease status to allow the transplant physician to develop a specific plan for your treatment.

This testing could include:

Blood tests
Tests of lung function
Dental consultation
Bone marrow tests
Echocardiogram
Gynecology consultation
X-rays
EKG

Your physician and nurse coordinator will review the purpose of these tests and help you in scheduling these tests promptly.

Our team will contact your insurance provider to determine if they will cover your transplant treatment. We understand that medical bills and questions about insurance coverage can be a significant source of concern and stress for patients and their families, so we prioritize keeping you well-informed before you begin your treatment.

We require that any patient undergoing a stem cell transplant have a caregiver, typically a friend or family member, who can stay with them 24/7 after being discharged from the hospital for at least two weeks, possibly longer. Your caregiver must attend a caregiver class to learn about these responsibilities.

Your nurse coordinator and referring hematologist will work with you to develop a treatment calendar that shows the expected dates for collection of stem cells, admission date, chemotherapy dates, radiation dates (if to be given), transplant date, and expected discharge date.

What to expect during stem cell collection

Your healthcare team will recommend one of two options for collection with the Blood and Marrow Collections Program:

Peripheral stem cell collection requires harvesting stem cells through a blood donation process called apheresis. Before collection, you will receive chemotherapy or growth factor injections to ‘mobilize’ stem cells from the bone marrow into the bloodstream. Your physician will recommend your mobilization therapy and discuss any side effects. Apheresis involves a blood donation machine that can process large volumes of your blood over a few hours. Each apheresis procedure lasts several hours, and you may undergo daily collection until adequate stem cells are collected and frozen for your use. The collection procedures are performed at the Blood and Marrow Collection program.
Bone marrow collection involves a one-day visit to the surgery center at the Blood and Marrow Collections program. Under general anesthesia, we collect bone marrow through a series of aspirations from the posterior pelvic bone. This process is rarely used in autologous stem cell transplantation.

We will freeze and store your hematopoietic stem cells. These cells may remain functional even after years of storage.

The transplant involves giving you the dose-intense chemotherapy regimen followed, one or more days later, by infusion of your frozen/thawed hematopoietic stem cells. You will require an intravenous catheter for the chemotherapy and cell infusion. After your bone marrow recovers, we will remove this catheter (which we may have placed for the apheresis procedure). You will be admitted to the hospital for 2 to 3 weeks for chemotherapy and transplant. You will then receive supportive medical and nursing care until your bone marrow recovers, and the immediate side effects of the dose-intensive chemotherapy improve.

The side effects of the dose-intense chemotherapy or radiotherapy will be discussed with you in detail by your transplant physician and your transplant nurse coordinator. These will also be listed in the consent form you will be given before the hospital admission. We anticipate you will recover bone marrow function about 10-12 days after the stem cell infusion.

When discharged, you must go home with your designated caregiver, who has agreed to be with you and has received the required training.

What to expect after your autologous stem cell transplant

Your caregiver must stay with you for at least 14 days after discharge from the hospital. Your caregiver is not expected to perform any nursing or medical care but will assist you at home with activities of daily living, such as cooking, cleaning, and taking medication. The caregiver is expected to stay in touch with the medical team at the hospital if you or your caregiver believes you are not recovering as expected.

Your primary hematologist/oncologist and your transplant physician may recommend additional treatment for your disease after you recover.

Your immune system may be weakened by the chemotherapy you receive and the transplant procedures. We recommend re-vaccination against common infectious diseases such as tetanus and polio at intervals after the transplant according to a vaccine schedule that will be provided. You must receive the influenza vaccine each year after transplantation.

Remember to practice hand washing and be vigilant about the cleanliness of your food and water.

Clinical trials

Patients have access to clinical trials through the Georgetown Lombardi Comprehensive Cancer Center, the area’s only National Cancer Institute (NCI)-designated comprehensive cancer center.

View Open Trials