Autologous Bone Marrow Transplant

What is Autologous Bone Marrow Transplant

Autologous bone marrow transplant is a treatment to replace abnormal stem cells with healthy stem cells.

Stem cells can divide and develop into many things. Bone marrow is spongy tissue inside the bones that has stem cells that can develop into blood cells.

Autologous means that the healthy stem cells are from your own bone marrow that was donated (harvested), frozen, and stored before starting radiation or chemotherapy.

After the Autologous Bone Marrow Transplant, the harvested stem cells are thawed and put back into your body. Autologous stem cells are more likely to be accepted by the body than cells that are donated from someone else (allogeneic stem cells).

You may need an Autologous bone marrow transplant because of:

  • Cancer.
  • Radiation therapy.
  • Chemotherapy.

Tell a health care provider about:

  • Any allergies you have.
  • All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems you or family members have had with anesthetic medicines.
  • Any surgeries you have had.
  • Any medical conditions you have.
  • Any blood disorders you have.
  • Whether you are pregnant or may be pregnant, if applicable.

What are the risks of Autologous Bone Marrow Transplant?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding or blood clots.
  • Damage to other structures or organs.
  • Allergic reactions to medicines or dyes.
  • Graft failure. This means your body rejects the new stem cells.
  • Inability to have children (infertility).
  • Formation of new cancers.
  • Emotional problems and stress caused by the long recovery and the need to limit contact with other people after the procedure.

What happens before the procedure?

Testing

  • You will have blood tests and physical exams to make sure you can accept the stem cells. You may also have:
    • Imaging tests, such as a CT scan and MRI.
    • Tests to check your heart function. These may include an electrocardiogram (ECG), an echocardiogram, or both.
    • A chest X-ray.
    • Lung tests.
    • A urine sample taken.
    • A dental exam.

Preparing for the transplant

  • You may need to stay in the hospital for 1–2 weeks before the procedure.
  • You will get radiation and chemotherapy to prepare for the transplant (conditioning therapy). These procedures may:
    • Kill cancer cells.
    • Kill other abnormal cells.
    • Kill some healthy cells to make room for new cells.
    • Prepare your bone marrow for the new cells.
  • You may have to take medicines to weaken your body’s disease-fighting (immune) system so your body will be able to accept the new stem cells. Steps will be taken to protect you from getting infections.
  • A long, thin tube (central venous catheter,CVC) may be inserted into your arm to reach a large vein (usually in your chest) to give you medicines and take your blood.

General instructions

  • Ask your health care provider about:
    • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
    • Taking over-the-counter medicines, vitamins, herbs, and supplements.
    • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do not take these medicines unless your health care provider tells you to take them.
    • Protecting your ability to have children (fertility preservation).
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • You may need to plan for a long recovery time with restricted activity. You may need psychological and emotional counseling to prepare for the procedure.

What happens during the procedure?

  • To lower your risk of infection:
    • You may stay in a private room (isolation) in the hospital.
    • Your health care team will wash or sanitize their hands.
    • Your health care providers may wear gowns, gloves, and masks while they are in your room.
  • If you do not have a CVC, an IV will be inserted into one of your veins.
  • One or several bags of harvested stem cells will be hung and attached to the CVC or IV.
  • The harvested stem cells will be given to you through the CVC or IV in your vein. The cells will travel through your body to your bone marrow. This may take several hours. During this time:
    • Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored.
    • You may experience:
      • Pain in the chest, head, or other places in the body.
      • Chills, fever, or skin redness.
      • A strange taste in your mouth.
      • A drop in your blood pressure.
      • A skin rash or hives.
      • Problems breathing.
      • Weakness.
  • The empty bags of harvested stem cells will be removed.
  • The CVC or IV may stay in your vein after your procedure.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your blood pressure, heart rate, breathing rate, and blood oxygen level will continue to be monitored.
  • You may continue to receive fluids and medicines through your CVC or IV.
  • You may be given medicine to help relieve pain.
  • You may need to receive donated blood through your CVC or IV (blood transfusions).
  • Steps will be taken to limit your exposure to possible infections (contact precautions). Health care providers and visitors will have to wear protective clothing such as gowns, gloves, masks, and shoe covers when visiting your room.
  • You may have blood or urine tests.
  • The fluid that goes into and out of your body may be measured.

Summary

  • Blood cells and bone marrow can be damaged by disease or by treatment with radiation or chemotherapy.
  • Bone marrow transplants are done to treat cancer or other problems that affect the blood, the bone marrow, or both.
  • Autologous stem cells for transplants come from your bone marrow and are more likely to be accepted by your body than cells that are donated from someone else.
  • You may need to plan for a long recovery time with restricted activity.

Care After Autologous Bone Marrow Transplant

What can I expect after the procedure?

After the procedure, it is common to have:

  • A weak disease-fighting (immune) system.
  • Mouth sores.
  • Pain in the mouth and throat.
  • Problems eating and drinking, and loss of appetite.
  • Nausea and vomiting.
  • Diarrhea.
  • Problems with bruising or bleeding too easily.
  • Hair loss.
  • Skin problems, such as a rash or hives.
  • Tiredness and lack of energy.

Follow these instructions at home:

Medicines

Take over-the-counter and prescription medicines only as told by your health care provider. These may include:

  • Pain medicines.
  • Anti-nausea medicines.
  • Antibiotic medicines. If you were prescribed antibiotic medicine, take it as told by your health care provider. Do notstop taking the antibiotic even if you start to feel better.

Preventing bleeding and infection

  • Your risk of having an infection is higher after a bone marrow transplant. To help prevent infection:
    • Avoid public and crowded spaces. Your health care provider may recommend that you wear a face mask for protection while you are in public.
    • Avoid other people, especially if they are sick.
    • Avoid contact with soil, stool (feces), and mold.
    • Avoid contact with certain exotic animals because they may carry bacteria.
    • Avoid sharing cups, bottles, utensils, or other personal items, such as a toothbrush.
    • Wash your hands frequently with soap and water. If soap and water are not available, use hand sanitizer.
    • Talk to your health care provider about your vaccinations. Some of your vaccinations may need to be given again after your transplant.

Your risk of bleeding is higher after a bone marrow transplant. To lower your risk of bleeding:

  • Avoid activities that put you at risk for injury.
  • Use a soft-bristle toothbrush to limit gum bleeding.
  • Avoid or limit shaving and use a safety razor.

Activity

  • Do notdrive or use heavy machinery while taking prescription pain medicine.
  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

Eating and drinking

  • Follow instructions from your health care provider about eating or drinking restrictions. You may need to:
    • Avoid eating certain fresh fruits and vegetables that may contain bacteria or funguses. Ask your health care provider what foods you need to avoid.
    • Avoid eating raw foods. These are foods that have not been cooked or processed.
    • Avoid drinking alcohol.
  • Make sure all of your food is cooked completely and is safe to eat.

General instructions

  • Do notuse any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important. You may need blood tests. You may also need therapy to help you:
    • Exercise muscles and keep joints moving (physical therapy).
    • Adapt or learn new ways to do daily activities, depending on how severe your symptoms are (occupational therapy).
    • Manage stress and provide you with emotional support (psychological therapy).

Contact a health care provider if:

  • You have a fever.
  • You have a cough that does not go away.
  • You cannot eat or drink without vomiting.
  • You have diarrhea.
  • You bruise and bleed easily.
  • You have pain that does not get better with treatment.
  • Your urine is darker than normal.
  • You are extremely tired.
  • You develop a rash or hives.
  • You have problems caring for yourself.

Get help right away if:

  • You have severe pain, and medicines do not help.
  • You have trouble breathing or shortness of breath.
  • You have trouble urinating or you stop urinating.
  • You have a rash, burning, or redness on your palms and the bottoms of your feet (soles).
  • You have yellowing of the skin and the whites of the eyes (jaundice).
  • You are confused or have trouble speaking.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.). Do not drive yourself to the hospital.

Summary

  • During recovery, you are at risk for infection, bleeding, and fatigue.
  • To lower your risk of problems, you should follow safety and activity instructions as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important. You may need blood tests and some types of therapy.

Autologous Bone Marrow Transplant, Pediatric

Autologous bone marrow transplant is a treatment to replace abnormal stem cells with healthy stem cells. Stem cells can divide and develop into many things. Bone marrow is spongy tissue inside the bones that has stem cells that can develop into blood cells.

Autologous means that the healthy stem cells are from your child’s own bone marrow that was donated (harvested), frozen, and stored before starting radiation or chemotherapy. After treatment, the harvested stem cells are thawed and put back into your child’s body. Autologous stem cells are more likely to be accepted by the body than cells donated from someone else (allogeneicstem cells).

Your child may need a bone marrow transplant because of:

  • Cancer.
  • Radiation therapy.
  • Chemotherapy.

Tell a health care provider about:

  • Any allergies your child has.
  • All medicines your child is taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
  • Any problems your child or family members have had with anesthetic medicines.
  • Any surgeries your child has had.
  • Any medical conditions your child has.
  • Any blood disorders your child has.
  • Whether your child is pregnant or may be pregnant, if applicable.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

  • Infection.
  • Bleeding or blood clots.
  • Damage to other structures or organs.
  • Allergic reactions to medicines or dyes.
  • Graft failure. This means your child’s body rejects the new stem cells.
  • Inability to have children (infertility).
  • Formation of new cancers.
  • Emotional problems and stress caused by the long recovery and the need to limit contact with other people after the procedure.

What happens before the procedure?

Testing

  • Your child will have blood tests and physical exams to make sure he or she can accept the stem cells. Your child may also have:
    • Imaging tests, such CT scans and MRI.
    • A test to check heart function. This may be an electrocardiogram (ECG), an echocardiogram, or both.
    • A chest X-ray.
    • Lung tests.
    • A urine sample taken.
    • A dental exam.

Preparing for the transplant

  • Your child may need to stay in the hospital for 1–2 weeks before the procedure.
  • Your child will get radiation and chemotherapy to prepare for the transplant (conditioning therapy). These procedures may:
    • Kill cancer cells.
    • Kill other abnormal cells.
    • Kill some healthy cells to make room for new cells.
    • Prepare your child’s bone marrow for the new cells.
  • Your child may have to take medicines to weaken his or her body’s disease-fighting (immune) system so that his or her body will be able to accept the new stem cells. Steps will be taken to protect your child from getting infections.
  • A long, thin tube (central venous catheter,CVC) may be inserted into your child’s arm to reach a large vein (usually in the chest) to give medicines and take blood.

General instructions

  • Ask your child’s health care provider about:
    • Changing or stopping your child’s regular medicines.
    • Giving over-the-counter medicines, vitamins, herbs, and supplements.
    • Giving medicines such as aspirin or ibuprofen. These medicines can thin your child’s blood. Do notgive these medicines unless your child’s health care provider tells you to give them.
    • Protecting your child’s ability to have children (fertility preservation).
  • You and your child may need to plan for a long recovery time with restricted activity. You and your child may need psychological and emotional counseling to prepare for the procedure.

What happens during the procedure?

  • To lower the risk of infection:
    • Your child may stay in a private room (isolation) in the hospital.
    • Your child’s health care team will wash or sanitize their hands.
    • Your child’s health care providers may wear gowns, gloves, and masks while they are in your child’s room.
  • If your child does not have a CVC, an IV will be inserted into one of your child’s veins.
  • One or several bags of harvested stem cells will be hung and attached to the CVC or IV.
  • The harvested cells will be given to your child through the CVC or IV in his or her vein. The cells will travel through your child’s body to the bone marrow. This may take several hours. During this time:
    • Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored.
    • Your child may experience:
      • Pain in the chest, head, or other places in the body.
      • Chills, fever, or skin redness.
      • A strange taste in his or her mouth.
      • A drop in blood pressure.
      • A skin rash or hives.
      • Problems breathing.
      • Weakness.
  • The empty bags of harvested stem cells will be removed.
  • The CVC or IV may stay in your child’s vein after the procedure.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

  • Your child’s blood pressure, heart rate, breathing rate, and blood oxygen level will continue to be monitored.
  • Your child may continue to receive fluids and medicines through a CVC or IV.
  • Your child may be given medicine to help relieve pain.
  • Your child may need to receive donated blood through his or her CVC or IV (blood transfusions).
  • Steps will be taken to limit your child’s exposure to possible infections (contact precautions). Health care providers and visitors will have to wear protective clothing such as gowns, gloves, masks, and shoe covers when visiting your child’s room.
  • Your child may have blood or urine tests.
  • The fluid that goes into and out of your child’s body may be measured.

Summary

  • Bone Marrow transplants treat many diseases in children.
  • Transplants work by replacing damaged, missing, or diseased bone marrow with new stem cells that mature and make new cells.
  • With an autologous donation, your child’s cells can be harvested, frozen, stored, and then transplanted after chemotherapy or radiation treatment.
  • You and your child may need extra support to cope with recovery after your child’s procedure.

Autologous Bone Marrow Transplant, Pediatric, Care After

What can I expect after the procedure?

After the procedure, it is common for your child to have:

  • A weak disease-fighting (immune) system.
  • Mouth sores.
  • Pain in the mouth and throat.
  • Problems eating and drinking, and loss of appetite.
  • Nausea and vomiting.
  • Diarrhea.
  • Problems with bruising or bleeding too easily.
  • Hair loss.
  • Skin problems, such as a rash or hives.
  • Tiredness and lack of energy.

Follow these instructions at home:

Medicines

  • Give your child over-the-counter and prescription medicines only as told by your child’s health care provider. These may include:
    • Pain medicines.
    • Anti-nausea medicines.
    • Antibiotic medicines. If your child was prescribed antibiotic medicine, give it as told by your child’s health care provider. Do notstop giving your child the antibiotic even if she or he starts to feel better.

Do notgive your child aspirin because of the association with Reye syndrome.

Preventing bleeding and infection

  • Your child’s risk of having an infection is higher after a bone marrow transplant. To help prevent infection, have your child:
    • Avoid going to school.
    • Avoid public and crowded spaces. Your health care provider may recommend that your child wear a face mask for protection while in public.
    • Avoid other people, especially if they are sick.
    • Avoid contact with soil, stool (feces), and mold.
    • Avoid contact with certain exotic animals because they may carry bacteria.
    • Avoid sharing cups, bottles, utensils, or other personal items, such as a toothbrush.
    • Wash his or her hands frequently with soap and water. If soap and water are not available, have your child use hand sanitizer. You should also wash your hands frequently.
  • Talk with your child’s health care provider about vaccinations. Some of your child’s vaccinations may need to be given again after the transplant.

Your child’s risk of bleeding is higher after a bone marrow transplant. To lower the risk of bleeding, have your child:

  • Avoid activities that put him or her at risk for injury.
  • Use a soft-bristle toothbrush to limit gum bleeding.
  • Avoid or limit shaving and use a safety razor, if applicable.

Eating and drinking

  • Follow instructions from your child’s health care provider about eating or drinking restrictions or following a special diet. Your child may need to:
    • Avoid giving your child certain fresh fruits and vegetables that may contain bacteria or funguses. Ask your child’s health care provider what foods your child needs to avoid.
    • Avoid giving your child raw foods. These are foods that have not been cooked or processed.
  • Make sure all of your child’s food is cooked completely and is safe to eat.

General instructions

  • Have your child return to normal activities as told by your child’s health care provider. Ask the health care provider what activities are safe for your child.
  • Do not allow your child to drive while taking prescription pain medicine, if applicable.
  • Talk with your child’s health care provider about social services and therapies to help you and your child cope better with recovery.
  • Keep all follow-up visits as told by your child’s health care provider. This is important. Your child may need blood tests. Your child may also need therapy to help him or her:
    • Exercise muscles and keep joints moving (physical therapy).
    • With growth and development needs (occupational therapy).
    • Manage stress and provide your child with emotional support (psychological therapy).
    • Keep busy and expressive (art therapy orrecreational therapy).

Contact a health care provider if:

  • Your child has a fever.
  • Your child has a cough that does not go away.
  • Your child cannot eat or drink without vomiting.
  • Your child has diarrhea.
  • Your child bruises and bleeds easily.
  • Your child has pain that does not get better with treatment.
  • Your child has darker urine than normal.
  • Your child is extremely tired.
  • Your child develops a rash or hives.

Get help right away if:

  • Your child has severe pain, and medicines do not help.
  • Your child has problems breathing or shortness of breath.
  • Your child has trouble urinating.
  • Your child has a rash, burning, or redness on the palms and the bottoms of the feet (soles).
  • Your child has yellowing of the skin and the whites of the eyes (jaundice).
  • Your child is confused or has trouble speaking.

These symptoms may represent a serious problem that is an emergency. Do not wait to see if the symptoms will go away. Get medical help right away. Call your local emergency services (911 in the U.S.).

Summary

  • It may take 2–4 weeks for your child’s transplanted cells to move into his or her bone marrow, mature, and make new blood cells.
  • During your child’s recovery, he or she is at risk for infection, bleeding, and fatigue.
  • Your child may not be able to return home right after the procedure. Your child may need to stay in, or close to, the hospital for treatment and testing.
  • You and your child may need extra support to cope with recovery after your child’s procedure.
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