Stem cell transplants are risky procedures, in particular allogeneic transplants (using donor cells) because of the risk of graft-versus-host disease (GVHD). Both allogeneic and autologous transplants (using the patient's own cells) carry risks such as infections, bleeding and possible long-term complications, such as secondary cancers and infertility. Stem cell or bone marrow transplants are complex treatments that carry a significant risk of serious complications. If you receive a transplant that uses donor stem cells (allogeneic transplant), you may be at risk of developing graft disease against host (EICH).
This condition occurs when the donor stem cells that make up the new immune system see the body's tissues and organs as something foreign and attack them. Being a stem cell transplant patient increases the risk of developing a secondary cancer in the future. This is due to chemotherapy, radiation therapy, and other treatments you may have needed. The biggest risk is that you will undergo the procedure and that the transplanted stem cells will not be able to delay or eliminate the disease. The cancer can come back (come back) after a stem cell transplant.
However, it's less likely to happen over time. The biggest risks of allogeneic stem cell transplants are infections and GVHD. Stem cell transplants can be used to treat cancers that affect the blood and lymphatic systems, inherited blood disorders, and autoimmune diseases. If you receive a stem cell transplant, your provider may use your own healthy stem cells or donated stem cells.
It takes a while for stem cells to reach the bone marrow and start making new blood cells (called a graft). Sometimes, healthcare providers collect them to return to you after chemotherapy (autologous stem cell transplant). Short-term (acute) side effects usually occur within the first 100 days after a stem cell transplant. Whether you receive donated stem cells or your own stem cells, the process is a lot like receiving medication through a central venous catheter.
Host disease is a side effect of treatment that sometimes occurs in patients with leukemia, lymphoma, or other types of cancer of blood or lymphatic origin who have undergone an allogeneic stem cell transplant. If you're a biologically female, you may experience an early menopause after undergoing a stem cell transplant. A stem cell transplant involves destroying any unhealthy blood cells and replacing them with stem cells taken from the blood or bone marrow. Radiation treatments given before a stem cell transplant, chronic GVHD, infection, or the recurrence of cancer can damage brain tissue. Healthy stem cells from the donor (the person who donates the stem cells) attack the cells of the recipient (the person who receives the stem cells).
To kill cancer cells and help make room for new stem cells, patients receive chemotherapy before the transplant. Stem cell transplants use healthy, immature cells to replace those that don't work properly in a person's bone marrow or that have been destroyed by high-dose chemotherapy. These hematopoietic stem cells need to be replaced after chemotherapy ends so that the body can continue to produce blood. The immature, underdeveloped cells that live in the bone marrow, where blood is produced, are called hematopoietic stem cells.
