NCCN Guidelines for Patients
Waldenström’s Macroglobulinemia, Version 1.2017
Bone marrow aspiration is used to remove bone
marrow. For this procedure, either regional
anesthesia or general anesthesia will be given. Next,
a needle will be
inserted through the skin into the
hip bone to draw out the bone marrow. The needle
must be inserted many times into one or more spots
to collect enough marrow. The marrow will then be
processed to collect the stem cells.
Collection of the bone marrow takes about 1 hour.
The entire hospital stay will likely be 6 to 8 hours,
which includes recovery time. The aspiration will
likely cause some pain and soreness for a few days.
Anesthesia may cause nausea, headache, and
tiredness. You may need a blood transfusion after the
After apheresis or aspiration, the harvested cells
will be combined with a preservative. Then, they will
be frozen and stored to keep them alive until the
transplant. This process is called cryopreservation.
Before the autologous transplant, you will likely
receive high doses of chemotherapy. High doses are
given to kill any cancer cells that may remain after
prior treatment. Chemotherapy is often received for
several days. The transplant will occur 1 or 2 days
later to allow the chemotherapy to clear from your
body. Otherwise, the chemotherapy could damage
the healthy stem cells.
Transplanting stem cells
After chemotherapy, you will receive your healthy
stem cells through a transfusion. A transfusion is a
slow injection of blood products through a central
line into a large vein. A central line (or central venous
catheter) is a thin tube. The tube will be inserted into
your skin through one cut and into your vein through
a second cut. Local anesthesia will be used. This
process can take several hours to complete.
The transplanted stem cells will travel to your bone
marrow and grow. New, healthy blood cells will form.
This is called engraftment. It usually takes about 2
Until then, you will have little or no immune defense.
You may need to stay in the hospital. You may be
given an antibiotic to prevent or treat infection. You
may also be given a blood platelet transfusion to
prevent bleeding and blood transfusion to treat low
red blood counts (anemia). While waiting for the cells
to engraft, you will likely feel tired and weak.
A clinical trial is a type of research study that people
chose to take part in. Clinical trials help learn how to
prevent, diagnose, and treat a disease like cancer.
Because of clinical trials, doctors find safe and
helpful ways to improve your cancer care. This guide
has many of those tests and treatments that were
found to help people with cancer.
Clinical trials go through levels or phases of testing.
These phases help move the research along to find
out what works best for people with cancer.
Phase I looks at how much and how to give the
Phase II tests for side effects and how it works
on the cancer type.
Phase III compares the new treatment (or new
use of treatment) to what is commonly used.
Phase IV follows late side effects and if the
treatment still works after a long period of time.