A stem cell transfusion introduces stem cells into the blood of a patient who needs them. Stem cell blood often comes from bone marrow, although it can also come from the umbilical cord. These cells can come from either the patient or a donor.
Patients may need a stem cell transfusion when their bone marrow does not produce enough healthy stem cells. Reasons for this include cancer and certain kinds of anemia. Stem cell transfusion has helped save many lives since it was first used in 1968, but has risks, some of which are fatal.
Before a stem cell transfusion takes place, the patient's bone marrow is destroyed with drugs or radiation. If donor cells are used, the immune system is suppressed to prevent rejection. An intravenous catheter called a central line is placed in the chest and provides a port for the transfusions, chemotherapy, and possibly nutrition. Side effects of this phase include nausea, vomiting, diarrhea, bleeding, ulcers in the mouth, hair loss, fatigue, cataracts, and organ failure. Infertility may also occur.
The stem cell transfusion itself lasts from one to five hours. Transfused stem cells find their way into the bones where they create new marrow and stem cells. The patient is monitored for fever or hives during the procedure. Blood counts will normalize within a few weeks. Patients may remain hospitalized until this happens.
After the transplant, the patient's blood will be monitored frequently. Supplemental nutrition may be needed because of vomiting and diarrhea. Blood transfusions may be given until the new bone marrow produces enough of its own. Medications will help reduce complications of the procedure. Multiple antibiotics and precautions will help prevent infection.
If donor cells are used, there is a possibility of graft-versus-host disease. This happens when the donor cells attack the recipient's. It can occur days or years after the stem cell transfusion. Symptoms include skin rashes, diarrhea, nausea, and vomiting, along with complications such as liver damage and secondary illness. Graft-verses-host disease is treated with intravenous corticosteroids.
Some patients tolerate the procedure very well, while others have many complications. Patients with better general health before the procedure may have better chances of avoiding complications, but there is no sure way to know. Most patients experience remission after treatment. Patients who were very ill previously find themselves able to return to normal activities.
For patients too ill to undergo a normal transfusion, mini stem cell transfusions are available. Instead of destroying all cancer cells with drugs and radiation, this technique relies on the donor cells to attack the patient's diseased cells. This allows much lower doses of chemotherapy and radiation before the procedure, reducing side effects. The procedure may be appealing to many patients, but it is generally not as effective as the standard treatment and is reserved for only the sickest patients.
