Q: When referring to types of transplants, what is the difference between bone marrow transplant and stem cell transplant?
A: A stem cell transplant can be referred to as a bone marrow transplant (BMT) or stem cell transplant (SCT), depending on the source of the cells that are transplanted. In other words, the only real distinction between a bone marrow transplant and a stem cell transplant is the method of collecting the stem cells.
Q: What is the difference between stem cells and bone marrow?
A: Stem cells are versatile cells with the ability to divide and develop into many other kinds of cells. Hematopoietic stem cells produce red blood cells, which deliver oxygen throughout the body; white blood cells, which help ward off infections; and platelets, which allow blood to clot and wounds to heal. Hematopoietic stem cells are found in the bone marrow – the spongy material inside the bones. Some of the hematopoietic stem cells circulate from the marrow into the bloodstream. When the cells are found there, they are called peripheral blood stem cells.
Q: What is the difference between an autologous transplant and an allogeneic transplant?
A: Patients receiving an autologous transplant receive stem cells from themselves, usually through a process called a stem cell harvest or stem cell apheresis. An allogeneic transplant means the cells are obtained from another individual who is genetically as close to the patient as possible.
Q: Can I still get a transplant if I don’t have a complete match?
A: Yes. The optimal donor is a donor whose stem cells match the patient’s human leukocyte antigens (HLA type). About one in four siblings are HLA-identical. In addition, about 70% of Caucasians and lower percentage of minorities find HLA-identical donors in registries. Patients who don’t have an exact match, may undergo a haplo-cord transplant. Through this process, patients receive stem cells from a single cord blood unit combined with stem cells from a donor who is partially HLA-identical to the patient. This procedure has been quite successful.
Q: Which type of transplant patient would undergo their transplant as an outpatient?
A: Depending on your disease and particular case, you may receive your conditioning chemotherapy regimen inpatient or outpatient. If you are an autologous transplant patient being admitted to start transplant chemotherapy, upon the discretion of the attending physician, you will be discharged from the hospital while waiting for your blood counts to recover. Patients who undergo all or part of their transplant as an outpatient must come frequently to the day hospital for evaluation; this ranges from every day during certain time points of the transplant to twice per week. You must be able to get to the day hospital that frequently to get the necessary medical treatments, and you need to be able to get there quickly and reliably. If you live outside of this parameter, our social workers can work with you to set up accommodations at the Helmsley Medical Tower or American Cancer Society Hope Lodge. A caregiver will be required to be with you 24/7 during this recovery process. You will be seen daily in the day hospital by a Nurse Practitioner (NP)/Physician Assistant (PA) and by one of the attending physicians. Blood work will be drawn and reviewed, and necessary medical treatments will be provided during your visit. Once your blood counts recover, you will be discharged from the day hospital program and follow-up will be organized with your primary transplant doctor.
Q: Do I need a dedicated caregiver throughout the entire transplant process?
A: Yes. Identifying a caregiver is extremely important and your physician and transplant team will require you have one. Your caregiver will be responsible for taking you to and from your appointments and will need to provide you with the right medications following your transplant. Their emotional support will be helpful to you as well.
Q: What support services are available through the hospital?
A: Social workers are available to assist you along the way, from transplant through recovery. We also provide orientation group meetings and support groups. If you would like to address your life events in a more spiritual manner, the hospital provides chaplain services, including pastoral counseling, prayer and reflection and any other areas upon your request.
Additional services include, a Kosher suite (located on 2N of Greenberg Pavilion), recreational therapy and Musicians (Tuesday evenings).
Q: What do I do if I don’t feel well after my transplant?
A: If you are experiencing a life-threatening emergency, we ask you to call 911, or go to the nearest emergency room. For all other concerns, we ask you to call your physician’s office. After clinic hours, there is always a covering physician on call. You will be triaged over the phone and instructed on what to do. You may be asked to come to the day hospital or emergency room to be assessed. Depending on the severity of your symptoms, you may be readmitted to the hospital.