Allogeneic Stem Cell Transplant

What is an allogeneic stem cell transplant?

An allogeneic (pronounced “a-loh-jeh-NAY-ik”) stem cell transplant replaces unhealthy stem cells in your bone marrow with donated healthy cells. About 40% of all stem cell transplants use donated stem cells. The donated cells may be blood stem cells or bone marrow stem cells.

Allogeneic stem cell transplants work by producing new healthy cells. These cells go on to make new blood cells.

This procedure is treatment for some types of blood cancer, blood disorders and immune system disorders. It may cure certain disorders. You may have an allogeneic stem cell transplant when other treatments aren’t effective or when a condition comes back.

What conditions do allogeneic stem cell transplants treat?

It’s treatment for several conditions, including:

• Acute lymphoblastic leukemia (ALL)
• Acute myeloid leukemia (AML)
• Aplastic anemia
• Lymphoma
• Myelodysplastic syndrome
• Myeloproliferative neoplasms (MPN)
• Sickle cell disease

How should I prepare for an allogeneic stem cell transplant?

Your transplant team will do several tests before the procedure. They do tests to confirm you’re able to manage side effects of pre-transplant conditioning. Tests may include:

• Complete blood count (CBC) to check your red blood cells, white blood cells and platelets
• Echocardiogram to see how well your heart pumps
• Electrocardiogram (EKG) to check your heart’s rhythm
• Liver function or kidney function tests

If you have cancer, your transplant team may do a bone marrow biopsy to remove a sample of your bone marrow. They may have done this kind of biopsy to confirm a blood cancer or blood disorder diagnosis. In this case, a medical pathologist will examine your bone marrow cells for signs of new changes. The biopsy results also help your team understand the risk that a condition could come back (recur) after transplant.

The next step is pre-transplant conditioning. This treatment uses chemotherapy and/or full-body radiation therapy. The treatment(s):

• Kills cancer cells in your body
• Makes room in your bone marrow for new blood stem cells to grow
• Suppresses your immune system to reduce the chance your body will reject the donated stem cells

You’ll stay in the hospital for conditioning. The process typically takes one to two weeks to complete.

What happens during allogeneic stem cell transplantation?

The actual procedure is painless. Your transplant care team will place a central venous catheter (CVC) in one of the large veins in your upper chest. The CVC is a tube that will deliver the new stem cells to your bone marrow.

The infusion process is like a blood transfusion: healthy stem cells flow from a bag through the CVC into your bone marrow. Infusion typically takes 30 minutes to an hour. Your transplant team will be with you throughout the infusion. They’ll check your vital signs. They’ll also watch for any symptoms of infusion side effects.

Side effects are rare and often mild. Some common potential side effects include:

• Chills
• Feeling short of breath
• Fever

Complications of allogeneic stem cell transplants

Allogeneic stem cell transplants can result in graft vs. host disease. This condition can happen if the donated stem cells attack other cells in your body.

What happens after an allogeneic stem cell transplant?

You’ll stay in or close to the hospital so your transplant care team can oversee your recovery and provide any treatment you may need. For example, you’ll continue to receive immunosuppressants so your body won’t reject the new stem cells. You may need blood transfusions while the new stem cells make new red blood cells and platelets.

It can take several weeks for the new stem cells to multiply and make new blood cells. You’ll see your transplant team for follow-up appointments so they can check your health and watch for issues like bacterial or viral infections.

What is the recovery time?

All told, it can take more than two years to completely recover from an allogeneic stem cell transplant. For example, it can take 10 days to two weeks for the new stem cells to start making new blood cells in your bone marrow. Your care team may call this process engraftment. And it may take up to a year for your immune system to recover from the transplant.

What’s the success rate of allogeneic stem cell transplant?

This procedure is treatment for many diseases. That makes it hard to give an overall success rate. But research shows long-term survival rates for specific diseases. For example, one study found the 10-year survival rate for people with acute lymphoblastic leukemia (ALL) was 81%, and 76% for people with acute myeloid leukemia (AML). These two diseases are among the most common conditions that providers treat with allogeneic stem cell transplant.

When should I see my healthcare provider?

You should contact your transplant care team right away if you notice the following symptoms. The symptoms could mean you have graft vs. host disease. These symptoms may include:

• Abdominal cramps
• Diarrhea
• Itchy skin rash
• Nausea and vomiting
• Your skin and/or eyes are turning yellow (jaundice)

And contact them if you have infection symptoms like:

• Chills
• Coughing, sneezing or runny nose
• Dizziness or feeling lightheaded
• Feeling short of breath
• Fever that’s 100.4 degrees Fahrenheit (38 degrees Celsius) or higher
• Frequent urination or painful urination (dysuria)

What’s the difference between allogeneic and autologous stem cell transplants?

An allogeneic stem cell transplant uses donated stem cells. An autologous stem cell transplant uses your own stem cells. The Center for International Blood and Marrow Transplant Research reports that 40% of stem cell transplants are allogeneic.