At the Weill Cornell Medicine and NewYork-Presbyterian Myeloma Center, we often get questions from patients and families regarding what an autologous stem cell transplant entails. Typically, there are five phases to autologous stem cell transplant. We’ve outlined what you should expect before, during and after transplant:
Conditioning involves treatment with high-dose chemo and/or radiation therapy that usually lasts about a week or two. This makes room for the transplanted stem cells, suppresses your immune system to lessen the chance of infection, and helps destroy remaining cancer cells.
Your cells will be taken from the lab and brought to your hospital room or outpatient transplant facility. During this time, your white blood cell, red blood cell and platelet counts will be low. You will be given medications to prevent an infusion reaction approximately 30 minutes prior to the cells arriving. The stem cells will then be given to you through your central line and will then flow through the infusion pump.
After your transplant, you will go through a period where your blood counts will drop. At this point, it is normal to feel very tired. The most important thing to do during this time is to try and prevent infection. You can do this by frequently washing your hands, showering daily, wearing a face mask and encouraging visitors who are ill to keep their distance. You can expect your blood cells to recover between 10 and 16 days after your transplant. Sometimes, it can take longer.
Your physician will send you home based on specific criteria. First, engraftment will need to have taken place, which occurs when new blood cells begin to grow in your bone marrow and you reach healthy levels of blood cells. In addition, you must be able to tolerate both liquids and solid food and take your medications by mouth 48 hours prior to discharge. You also must have minimal and controlled diarrhea. To ensure you do not have infections when you return home, you’ll need to be without fever and off IV antibiotics for 48 hours prior to discharge. Finally, your healthcare team will need to know who your designated caregiver is, as he or she will play a vital role during your transplant process and recovery.
Your immune system will gradually recover, and you will return to normal activities. Since you now have a new immune system, you will need to continue taking precautions to minimize risk for infection. You may also need to complete a series of vaccinations even if you’ve already received them as a child.
At Weill Cornell Medicine and NewYork-Presbyterian, we will be with you every step of the way before, during and after transplant. It’s important that you talk to your healthcare team about any concerns you have throughout the entire transplant process so we can help you get the support you need. Our team can also help you manage any changes that you may go through or side effects you may experience as you recover from transplant, in addition to guiding you through the recovery process.