Question 1

How long will I be in the hospital if I am undergoing a stem cell transplant?

Accepted Answer

The duration of stay varies from 3-4 weeks, depending on the nature of the stem cell transplant treatment you will receive. You may have to stay in the hospital for up to 3 weeks for an autologous process. For an allogeneic stem cell transplant, the stay at the hospital could extend to 4 weeks.

Question 2

How soon after a stem cell transplant can I get back to work?

Accepted Answer

Getting time to recover completely is more critical as the immune system is weakened and the body is more susceptible to attacks. It is advised to return to work 3-6 months after an autologous stem cell transplant, and the time is 6-12 months for an allogeneic process. However, it is recommended to consult a medical practitioner before considering returning to work.

Question 3

What are the most common stem cell transplants?

Accepted Answer

The most common ones are:

Autologous stem cell transplant
Allogeneic stem cell transplant
Cord transplant
Reduced-intensity transplants

Question 4

Which of these is best suited for me?

Accepted Answer

your consulting cardiologist will decide on the best treatment option based on the nature, severity, and availability of donor stem cells. Various factors are considered before finalising a stem cell transplant to avoid complications after the procedure.

Question 5

I am a caregiver, what are the things I should keep in mind while caring?

Accepted Answer

The caregiver and the patient experience a very close relationship on the road to recovery after the procedure. Before you leave the hospital premises, the doctor will walk you through the steps involved in navigating the road to recovery.

Question 6

How does a stem cell transplant work?

Accepted Answer

The stem cell transplant team works in coordination with you, your family and the consulting physician to deliver the best possible care and outcome. The transplant procedure may differ among patients, it includes the following.

Pre-transplant testing
Deciding which type of transplantation will be most appropriate – autologous, syngeneic or allogeneic
Extracting stem cells from you or a donor—Stem cells can be obtained through a process called apheresis. It is a painless procedure that involves taking blood from a vein and circulating it through a machine, which can remove the stem cells and infuse the remaining blood and plasma back into your body.
The bone marrow stem cells are harvested from the donor by placing a needle in the soft centre or marrow of the bone. The procedure may cause some pain to the donor after it is complete.
Conditioning—In conditioning treatment, chemotherapy and radiation therapy are used to destroy the affected cells. This creates space in the bone marrow for the transplanted stems to populate.
Infusion of healthy stem cells – The stem cells are transplanted into your body through intravenous infusion.
Engraftment and recovery – The transplanted stem cells enter the blood and bone marrow and produce healthy cells. The engraftment process can take two to three weeks, and you will have to stay in the hospital during this period to monitor the recovery and identify any potential side effects.

Question 7

What complications can develop from stem cell transplants?

Accepted Answer

Some common complications that can develop from autologous transplants are:

Infections
Bleeding and anaemia
Interstitial pneumonia - Inflammation of the tissues in the lungs
Liver damage
Dry and damaged mouth, oesophagus and other organs
Cataracts
Infertility, in some cases, where total body radiation is given
Secondary cancers

Complications can also occur from donor cells as well. They may include:

Graft versus host disease (GvHD) – Around 30 to 70 percent of patients will experience some form of GvHD, in which their cells may be treated as foreign bodies by the donor cells and attacked. It can be mild or severe. The symptoms of GvHD are rashes, scaly and itchy skin, hair loss, liver problems like jaundice, abdominal cramps, etc.
Graft failure –This rare complication occurs when the recipient’s body rejects the donor cells. To fix this, a second transplant may be required, or else an infusion of residual lymphocytes may be given from the donor.
Cancer relapse – Cancer relapse may happen if all the cancer cells weren’t destroyed in chemotherapy and radiation. In the case of some aggressive cancers, the relapse rate could be quite high.

Question 8

What are the typical side effects and recovery time after a stem cell transplant for myeloma?

Accepted Answer

The side effects of stem cell transplantation are mainly caused due to the use of chemotherapy in high doses. It can cause nausea, vomiting, diarrhoea, skin rash, mouth sores and hair loss. Individuals undergoing chemotherapy are also susceptible to bleeding, anaemia and infection as blood-producing cells are destroyed in the process.

If the transplant was performed using your own stem cells (autologous transplant), you can expect to stay in the hospital for about two weeks or less. Usually, it takes two to three months to recover physically following such a procedure, and it may take a year to get back on your everyday routine. However, if you have a desk job, you can resume working within one to two months, provided your blood count has stabilised.

If you had an allogeneic stem cell transplant that uses the donor’s cells, four to six weeks is the minimum that you need to stay in the hospital. The stay may be more extended if you develop GvHD, a condition in which the donor’s immune system turns against the patient’s cells.

Stem Cell Transplant