bone marrow (this is also called a bone marrow transplant)
bloodstream
umbilical cord blood after the cord is no longer attached to a newborn baby
A person who provides the stem cells is a donor. For some illnesses,
people can be their own donor. Their stem cells are taken out, frozen, and transplanted
back later. Other times, someone else donates the stem cells.
When stem cells come from another person, the stem cells must have similar genetic
makeup. Usually, a person's brother or sister is a good match. A parent or even an
unrelated person sometimes can be a match.
What Can Happen When a Donor Isn't a Good Match?
If the donor stem cells are not a good match (and sometimes even if they are):
The body's immune system can attack the donor stem cells. This is called rejection.
The transplanted cells can attack the body's cells. This is called graft-versus-host
disease.
How Are Stem Cell Transplants Done?
Before a stem cell transplant, doctors place a central line (or
central venous catheter). This type of IV (intravenous) line goes into the skin and
into a large vein near the heart. A central line can stay in the body longer than
a regular IV. It gives the medical team a way to give medicines and collect blood
for testing without doing a lot of needle sticks.
Stem cell transplants are done in the hospital. First, the person getting the donated
stem cells has high doses of chemotherapy
and/or radiation to:
kill the unhealthy cells causing the illness
weaken their immune system so it doesn't reject the donor stem cells
Then, the person gets the donor stem cells through an
line (IV).
What Happens After the Transplant?
After someone has a stem cell transplant, their body needs time to make new red
blood cells, white blood cells, and platelets. During this time, they're at a higher
risk for infections, bleeding, and other problems.
Most people stay in the hospital for 3–5 weeks after the transplant. Their medical
team will:
Do blood tests to see if the transplanted stem cells are making new blood cells.
Give medicines to help prevent rejection and graft-versus-host disease.
Give medicines to prevent infections.
Give transfusions of
red blood cells, white blood cells, and platelets.
Check that organs (such as the liver and kidneys) are working properly.
Treat any problems that happen, such as mouth sores, vomiting, diarrhea,
infections, bleeding, rejection, and graft-versus-host disease.
Make sure the patient is getting good nutrition.
Make sure that all visitors follow infection prevention rules, which include:
It takes the immune system about a year to recover after a stem cell transplant.
Until then, the person can get very sick from infections. Even a mild infection, like
a cold, can be serious. To help
you avoid infections:
You, family members, and visitors should wash their hands well and often with
antibacterial soap and/or hand sanitizer.
Stay away from anyone who is sick.
Bathe every day with a mild shampoo and soap.
Follow your medical team's instructions for:
when you can go to school or other public places
when you need to wear a mask
what foods are OK for you
if you can be around pets
What Else Should I Know?
Most teens who have had a stem cell transplant feel better over time after they
leave the hospital. Your health care team knows how tough recovery can be, and how
important it is to get emotional support. Your doctor, a hospital social worker, or
child life specialist can help you get through this difficult time, so be sure to
ask.
When Should I Call the Doctor?
You or your parent should call your doctor right away if you:
