Stem cell transplant for myeloma
You may be offered a stem cell transplant where diseased blood cells are destroyed by high-dose chemotherapy and then replaced with blood stem cells. This is also known as high-dose therapy and stem cell rescue.
Learn more about:
- How does it work?
- Who is it suitable for?
- Stem cell transplant steps
- Side effects of stem cell transplant
This treatment aims to destroy as much as possible any remaining myeloma cells and increase the length of the plateau phase (remission). Your own stem cells are most frequently used for this procedure. This is called an autologous transplant.
Occasionally, stem cells from a donor may be recommended. This is called an allogeneic transplant.
An autologous transplant is done in several stages. Before the process begins, you have induction treatment to put the myeloma into a plateau phase. Once this is achieved, the stem cells are removed and frozen. You then have high-dose chemotherapy followed by the return of your stem cells. See below for a detailed description of this process.
Although a stem cell transplant can help some people, it is not suitable for everyone. The high-dose chemotherapy that is given before the transplant can have a lot of side effects.
To work out whether a stem cell transplant is suitable for you, your haematologist will consider your general health, age, the type of myeloma you have, how fast it is growing and how it responds to treatment. The haematologist will discuss the risks and benefits of a stem cell transplant with you. Stem cell transplants are available only at some hospitals, so you may need to be referred to another hospital.
The entire procedure, including recovery, can take months and even up to a year.
A general autologous transplant process is described here, but the process varies from person to person. Learn more at the Leukaemia Foundation.
1. Collecting stem cells
2. Separating and storing stem cells
3. Receiving high-dose chemotherapy
4. Transplanting stem cells and engraftment
Some people continue to have drug therapies after a stem cell transplant. This is known as maintenance treatment. It is used to keep myeloma responding to treatment for longer.
Recovery time after a stem cell transplant varies depending on your situation. After the transplant, your blood count will be low. You may be more at risk of infections and need transfusions of blood products and intravenous antibiotics. You will be able to go home when your blood count has risen and your general health has improved. You will have regular follow-up care to check your blood counts and progress.
Infection, fatigue and diarrhoea are common side effects during engraftment. The diarrhoea usually stops by the time you go home, but the fatigue can last for months or even up to a year.
Prof John Gibson, Haematologist, Institute of Haematology, Royal Prince Alfred Hospital and The University of Sydney, NSW; Dr Stephanie Anderson, Registrar, Institute of Haematology, Royal Prince Alfred Hospital, NSW; Tanya Carney, Consumer; Jacqui Keogh, NSW State Manager/Senior Myeloma Nurse NSW, Myeloma Australia; Dr Silvia Ling, Haematologist, Liverpool Hospital, NSW; Rachel McCann, Myeloma Support Nurse NSW, Myeloma Australia; John McMath, Consumer; Karen Robinson, 13 11 20 Consultant, Cancer Council NSW.
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