NCCN Guidelines for Patients
Waldenström’s Macroglobulinemia, Version 1.2017
Stem cell transplant
Hematopoietic stem cells are cells that develop
into mature blood cells. Hematopoietic stem cells
and mature blood cells are made in bone marrow.
Cancer or its treatment can damage or destroy the
cells in bone marrow. A stem cell transplant replaces
damaged or destroyed stem cells with healthy stem
cells, which form new marrow and blood cells.
There are two types of stem cell transplant:
Autologous stem cell transplant uses your own
healthy stem cells to repair bone marrow after
high doses of chemotherapy. This treatment is
also called HDT/ASCR (
Healthy stem cells will be collected from
you when imaging tests show that cancer
treatment is working. You will then receive
intense chemotherapy and maybe radiation
to destroy any remaining cancer cells.
This intense treatment will also destroy bone
marrow, so your healthy stem cells will be
put back into your body to “rescue” your
Autologous stem cell transplant is more
commonly used for WM.
Allogeneic stem cell transplant uses healthy
stem cells that come from a donor. HLA (
ntigen) typing is the test used to
check if the donor and your tissue type are a
Chemotherapy will be given to destroy
cancer cells and suppress your immune
system from attacking the donor cells.
The transplanted stem cells will form new
marrow and attack remaining cancer cells.
This attack is known as the GVT (
There is a serious risk of GVHD (
isease). GVHD is when the
donated cells see the cells in your body as
foreign and attack them.
A stem cell transplant is not used as a first
treatment for WM. Your doctor might recommend an
autologous stem cell transplant if other treatments
are not working well.
Collecting stem cells
The first step of an autologous stem cell transplant
is to collect, or harvest, the blood stem cells. Blood
stem cells are found in the bone marrow and in the
bloodstream. If stem cells are collected from blood, a
process called apheresis will be done.
1. Medicine is given to increase the number of
stem cells in blood.
2. Some blood will be removed from a large vein
most likely in your arm. It will flow through a
tube and into a machine that removes stem
3. The rest of the blood will be returned through
Apheresis typically takes 4 to 6 hours and does not
require anesthesia. It may take two or more sessions
to obtain enough stem cells. During the procedure,
you may have lightheadedness, chills, numbness
around the lips, and cramping in the hands.
Stem cell transplant