Bone Marrow Transplant

Question 1

Why would a Stem cell/ Bone Marrow Transplant be considered?

Answer 1

If your ALL:
- Has features that shows it is likely to come back (high risk)
- has come back (relapsed ALL)

Question 2

What is the difference between stem cell transplant and a bone marrow transplant?

Answer 2

• Stem cell transplant uses stem cells from the blood stream
• Bone marrow transplant uses stem cells directly from the bone marrow

Question 3

What is an allogenic transplant?

Answer 3

• stem cells are from someone else (donor)

Question 4

Where may you get stem cells from?

Answer 4

• A brother/ sister
• A person unrelated to you whose stem cells are similar to yours
• cord blood stem cells ( umbilical cord)

Question 5

What is conditioning treatment?

Answer 5

• Before the transplant you have treatment to prepare your body to receive the stem cells.

Question 6

What are the three types of conditioning treatment?

Answer 6

• Myeloablative conditioning
• Reduced Intensity conditioning
• Total Body Irradiation

Question 7

What is myeloablative conditioning?

Answer 7

• Very high doses of chemotherapy

Question 8

What is Reduced Intensity Conditioning?

Answer 8

• Lower doses of chemotherapy

Question 9

What are the long term side effects of TBI?

Answer 9

• Skin becomes sensitive
• Lung changes
• Clouding of the lens of the eye (cataracts)
• Fertility Problems (
• Underactive Thyroid
• A second cancer

Question 10

What is TBI?

Answer 10

• Radiotherapy to the whole body

Question 11

How does the conditioning treatment work?

Answer 11

• The treatment kills the leukaemia cells as well as the healthy cells
• This makes space in your bone marrow for the donor stem cells
• It dampens down your immune system so you don’t reject the donor cells
• After the conditioning treatment you have the stem cells in your bloodstream through a drip
• The cells are able to find their way back to your bone marrow
• Your body then starts making blood cells again and your bone marrow slowly recovers

Question 12

What is engraftment? How long does engraftment take?

Answer 12

• This is a process by which your bone marrow makes blood cells again and your blood counts come up
• This can take up to 2-3 weeks.

Question 13

What is done in the Recovery phase of your transplant?

Answer 13

• You stay in a hospital room by yourself with special air filters
• These filters trap the bacteria in the air that can cause infection
• Visitors and staff entering the room have to follow strict infection procedures
• Visitors are typically limited and if your visitors are unwell they can not see you

Question 14

What is done I’m the recovery phase of your treatment?

Answer 14

• You stay in your own isolated room with special air filters
• The air filters are able to trap the bacteria to prevent infections
• Visitors and staff entering the room need to keep strict infection protocols
• Visitors are limited
• Visitors are not allowed to visit if they are ill or if they have been in contact with someone who is ill
• You might have to follow a special diet including foods that are unlikely to give you an infection

Question 15

What are some of the symptoms of having a Transplant?

Answer 15

• Breathlessness and looking pale
• Bruising, bleeding gums/ nose bleeds
• Feeling/ being sick
• Tiredness and weakness
• Graft vs Host disease ( diarrhoea, weight loss, jaundice, skin rashes, SOB)
• Hair loss
• Sore mouth and Ulcers
• Loss of fertility

Question 16

Advice to a patient undergoing recovery?

Answer 16

• Get into a routine
• Sit out of bed at meal times
• Make use of the physiotherapist
• Take walks around your hospital room
• Do jigsaws/ puzzles/ read books/ creative hobbies