Overview
What Is An Allogeneic Stem Cell Transplant?
An allogeneic stem cell transplant is a procedure in which a patient receives stem cells from a donor. Allogeneic transplants are preferred in certain cases, such as in the treatment of leukemia.
The donor used in an allogeneic stem cell transplant can be the patient's identical twin, sibling, family member or an unrelated donor.
One limitation of allogeneic stem cell treatment is that this procedure carries the risk of developing GVHD, whereby the patient's body rejects the donor stem cells. Human leukocyte antigens (HLA) matching can help minimize this risk; in this procedure, the HLA of the patient and donor are matched as closely as possible.
HLA are found on the surface of all types of cells in the body and help to identify an object that is foreign to the body, in which case the immune system is alerted in order to fight the perceived threat. In addition, allogeneic stem cell transplant require the use of strong medication in order to prevent this risk of GVHD.
Preparation
Advances in the treatment of cancer and improvements in supportive care over the past 10 years have improved the results and tolerability of bone marrow transplants. However, a bone marrow transplant remains a dangerous and difficult procedure. For allogeneic transplantation, the patient receives bone marrow or blood stem cells from a donor who may or may not be a relative. Identical twin allogeneic transplants are called syngeneic transplants.
You will be admitted to the hospital on the day your chemotherapy begins. Your admission date may be changed based on your health status or bed availability. The length of your admission will be about four to six weeks.
Procedure
High Dose Chemotherapy
Chemotherapy begins soon after you are admitted to the hospital. Your doctor will discuss all of the drugs you will receive and their side effects. Your nurse practitioner, inpatient nurse and pharmacist also will be available to answer questions. In addition, you may receive written information on these drugs in the consent form.
Precautions are taken to minimize side effects from these drugs. For example, when receiving some types of chemotherapy, patients must shower thoroughly twice a day to remove the drug that is excreted through the skin -- this is done to help prevent severe skin rashes. The inpatient nurse will go over any special precautions that you may need to take.
Total Body Irradiation
Some patients receive total body irradiation (TBI) in addition to chemotherapy. This radiation therapy is intended to destroy remaining cancer cells and further suppress the immune system. TBI treatments are given in the radiotherapy department usually over a period of three to four days. The treatment itself is painless, but there may be uncomfortable side effects after treatment, such as mouth and throat sores, nausea, stomach and intestinal irritations, and skin redness. Antinausea medication is usually given before each treatment to reduce nausea.
The Transplant Procedure
The transplant or stem cells will be infused one to three days after the last chemotherapy or radiation dose. The day of transplantation is referred to as Day 0. The days before the transplant are counted as minus days and the days after the transplant are plus days.
Recovery
Delayed Side Effects
The body feels the effects of the chemotherapy or radiation about a week after a bone marrow transplant. When the blood counts are low, you feel like you have the flu and may not want to do much. This will last for about two weeks and will decrease as your blood counts improve.
You may notice a number of other symptoms as well, including:
- Loss of appetite
- Nausea and vomiting
- Changes in vision
- Mouth and throat soreness
- Diarrhea
- Difficulty sleeping and fatigue
- Infection
- Hair loss
- Skin reactions
- Graft-versus-host disease
Find detailed information about these side effects in the Treatment section of the Allogeneic Transplant Guide.
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