NCCN Guidelines for Patients® | Multiple Myeloma - page 27

NCCN Guidelines for Patients™: Multiple Myeloma
Version 1.2012
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3.3 Stem cell transplant
Collecting the stem cells
The first step of a stem cell transplant is to collect, or harvest, the stem cells.
Stem cells are located in the bone marrow as well as in the bloodstream. Stem
cells can be collected from you or from another person, called a donor. Your
doctor will likely collect enough stem cells for two transplants.
One way to collect stem cells is to remove blood through a large vein in
the arm with a central venous catheter. The blood is then filtered through a
machine that removes the stem cells and returns the rest of the blood to you
(or the donor) through the catheter. This process is called apheresis. Next,
the harvested cells are combined with a preservative, frozen, and stored to
keep them alive until they are transplanted into you. This process is called
cryopreservation. Apheresis typically takes 4 to 6 hours and does not require
anesthesia. It usually causes little discomfort, such as lightheadedness, chills,
numbness around the lips, and cramping in the hands during the procedure.
Stem cells can also be collected from your bone marrow using bone marrow
aspirations. In this procedure, you will be given either regional or general
anesthesia. Next, a needle is inserted through your skin into your hip bone
or breastbone to drawn out the marrow. The needle must be inserted several
times into one or more spots in the bone to collect enough bone marrow.
The marrow is then processed to collect the stem cells. The stem cells are
then cryopreserved until the transplant. Collection of the bone marrow takes
about 1 hour, and side effects may include pain, bleeding, and side effects of
High-dose chemotherapy
After the stem cells have been harvested, high doses of chemotherapy are
given to destroy any remaining myeloma cells in the bone marrow. The high-
dose chemotherapy also destroys normal cells in the bone marrow, including
Active myeloma:
that is causing symptoms
Bone marrow:
The soft
tissue in the center of bones
Bone marrow aspiration:
The removal of liquid bone
marrow from the body
Central venous catheter:
A thin, flexible tube that is
inserted into a vein
General anesthesia:
A controlled loss of
wakefulness from drugs
Regional anesthesia:
controlled loss of feeling in
a part of the body from drugs
Side effect:
An unplanned
response to treatment
Stem cell:
An immature cell
from which other types of
cells develop
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