What is an Allogeneic Transplant?
For patients in need of a bone marrow or stem cell transplant, an allogeneic transplant in Orlando may be the best solution. During an allogenic transplant procedure, your doctor will use bone marrow or cells that are donated by a brother or sister or a matching donor located through a national registry. As you can imagine, a bone marrow transplant is a very complex procedure and each case is different. If you are need of an allogenic transplant, your cancer care team at the Florida Hospital Cancer Institute (FHCI) will develop a plan that is just for you. To learn more about an allogenic transplant in Orlando, please call (407) 303-1700 between 8 a.m. and 4 p.m. (Eastern Time) Monday through Friday. Or use our online assistance form and one of our coordinators will get back to you within one business day.
Though a plan will be individualized, here are some of the things you can expect during an allogeneic transplant:Back to Top
Before you can participate in treatment protocols, you’ll need to undergo a series of tests to make sure that you are a strong candidate for an allogenic transplant. Following are some of the tests that may be conducted:
MUGA Scan or Echocardiogram (ECHO): These tests will measure how well your heart can pump blood through the body. During a MUGA scan a special dye is administered through your veins so pictures of your heart can be taken. The test takes about an hour. In an ECHO text, diagnostic experts use an instrument to transmit high-frequency sound waves through your heart. These waves are converted to create a moving picture of your heart.
Electrocardiogram (EKG): This non-invasive test involves putting electrodes on your arms, legs and chest. While you lie still, your physician can analyze the electrical activity in your heart. The entire test takes about 10 minutes.
Skeletal Survey: Depending on your condition, your care team may elect to perform a skeletal survey. This test uses a series of comprehensive x-rays to assess the skeletal system. The test can take up to an hour and while there may be some discomfort due to the positions you must assume for imaging purposes, the test itself is painless.
CT Scan/Pet Scan: These tests can help your doctor confirm the presence, location and characteristics of any abnormalities. Because the images are digital, very small tumor masses can be detected and analyzed.
Pulmonary Function Test (PFT): This test checks the function of each breath you take, how much air is inhaled and exhaled as well as the speed. The goal of this test is to make sure there are no abnormalities in your lungs prior to your bone marrow or stem cell transplant.
Chest X-ray: X-rays are used to check for abnormalities in your lungs. It is a painless procedure and all you have to do is take a breath and hold it for a few seconds while the image is captured.
Blood tests and serological labs: Blood samples will be drawn to determine the level of function of your kidneys and liver, which are responsible for removing harmful materials from your body as they accumulate.
Bone marrow aspirate and biopsy: Prior to your transplant your care team will aspirate your bone marrow and perform a biopsy to evaluate the cells for signs of disease. This procedure involves numbing the hip area with lidocaine, then inserting a needle into your hip to retrieve a sample.
Creatinine clearance: Your kidney function is important to eliminating the medications you will be given during chemotherapy. This test involves collecting urine for a 24-hour period in a special container so it can be analzyed.
Dental exam: You will be asked to have your dentist examine your mouth for signs of infection or abscesses before your transplant and sign a release form.Back to Top
Harvesting Bone Marrow
Bone marrow will be drawn from the donor’s hipbone using a special syringe and needle. This procedure is conducted in an operating room and the donor is usually under general anesthesia so no pain is felt. The puncture site may be tender for a day or two after the donation and the donor is released the next day. Less than 5% of the bone marrow is removed and the donor’s body will replenish the supply over time.
If stem cells are harvested, the cells will be stimulated using a “growth factor” (such as Neupogen) which will cause the cells to multiply in number. Once the cells have been sufficiently primed, the care team will use an apheresis machine to remove cells from circulation. This procedure takes about six hours, the stem cells being filtered and collected from the blood. The rest of the blood components are returned to the donor.Back to Top
Before Your Transplant
Once your baseline testing is complete and it’s determined that you are a good candidate for an allogenic transplant, you will have a central venous catheter placed in your chest. This catheter is used throughout your transplantation. The catheter is similar to a tube used for intravenous feeding. It is inserted through a small incision in the upper chest and threaded into a large vein that empties into the heart. Once it is in the vein, it is tunneled under the kin to the lower chest where it exits. You’ll be asleep during the procedure but you may feel a bit of discomfort for a day or two after its insertion. Typically the catheter remains in place for several weeks, even months following your transplant. You and your caregiver will receive detailed instructions for keeping the catheter clean and preventing infections.
You will need to undergo a conditioning regimen before your transplant. The exact treatment plan varies according to your disease and condition. Conditioning involves the use of chemotherapy and/or radiation therapy. Chemotherapy is used to eliminate the cancer cells in your body and may require higher dosages than you may have had before in any cancer treatment. As such, you may experience some side effects of the therapy, including loss of hair, mouth or throat sores, nausea and vomiting, diarrhea and changes in the color of your skin.
Radiation therapy may also be used to prepare you for a transplant. Radiation therapy can include irradiation of the entire body, known as total body irradiation or TBIm or irradiation of the major lymph node chains, which is known as total lymphoid irradiation (TLI). The radiation prevents the cancer cells from growing and multiplying in the body.Back to Top
The Allogenic Transplant Process
Every transplant is different. The actual process is based on your unique situation and follows a plan that has been formulated just for you by your physician and the bone marrow transplant coordinator.
As noted, the first step is chemotherapy and/or radiation therapy, after which you’ll have a couple days of rest. Chemotherapy is an important step in the process and will consist of one or more different types of medications. To eliminate the cancer cells in your marrow, we use the highest doses possible.
Transplant day is considered Day 0 (zero), with successive days being referred to as +1, +2, etc. The actual transplant is similar to a blood transfusion. The marrow or stem cells are delivered to your room and either your physician or nurse will administer them through a central catheter. The whole process takes one to four hours.
You may notice some side effects from DMSO, a preservative that protects the cells if they were frozen. Medication should minimize these effects, but you may experience a garlic-like taste in your mouth for two or three days and your urine may be red colored for 24 hours after the transplant. Other possible side effects include shortness of breath, wheezing and stomach pains, but these are rare and your nurse and physician will be monitoring your condition closely during and after the transplantation.
For care after your transplant and discharge, visit the Patient Information section of this site.Back to Top
Schedule an Appointment
Contact one of our Cancer Care Coordinators to schedule an appointment at FHCI. You can call a coordinator at (407) 303-1700 between 8 a.m. and 4 p.m. (Eastern Time) Monday through Friday. Or fill out our online assistance form and one of our coordinators will get back to you within one business day.Back to Top