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What is an Autologous Transplant?

In contrast to an allogeneic transplant, the autologous transplant uses your own bone marrow or stem cells rather than those from a donor from a registry or a relative. For patients that need a bone marrow or stem cell transplant, an autologous transplant in Orlando may be the right solution. Marrow and cells are harvested while you are in remission, allowing cancer-free marrow and cells to be reintroduced into your body when required. To learn more about an autologous 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.

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Are You a Candidate for an Autologous Transplant?

Your condition will determine if you are a candidate for an autologous or allogeneic transplant. Your care team will run a series of tests to determine your overall health, the state of your cancer and other factors before determining what the best route is for the transplant.

As you know, no two transplants are ever the same. Each course of treatment is dependent on your unique situation, but rest assured that the cancer care team at the Florida Hospital Cancer Institute will recommend the best course of treatment for you that has the greatest promise of success.

Before you can have a transplant, you’ll need to undergo a series of tests to assess your overall health, the type and stage of your cancer and your ability to successfully undergo a bone marrow or stem cell transplant.

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Baseline testing

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 analyzed.

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.

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Adding a Central Catheter to Aid Treatment

Once your baseline testing is complete and it’s determined that you are a good candidate for an autologous 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 skin 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 or months following your transplant. You and your caregiver will receive detailed instructions for keeping the catheter clean and preventing infections.

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Harvesting Bone Marrow

Bone marrow will be drawn from your hipbone using a special syringe and needle. This procedure is conducted in an operating room and you will be under general anesthesia so no pain is felt. The puncture site may be tender for a day or two after the donation and you will be released the next day. Less than 5% of the bone marrow is removed and your body will replenish the supply over time.

If stem cells are harvested, the cells will be stimulated using either a “growth factor” (such as Neupogen) or mobilization chemotherapy (Plerixafor or Cytoxan, for instance) 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 your blood components are returned to your body. This procedure will be repeated daily for one to three days until an adequate number of stem cells have been collected.

Following is an overview of the apheresis collection process:

  • You should plan to arrive at 7:30 a.m.
  • Labs will be drawn from your central line to check blood and stem cell count and chemistry.
  • As noted, the process takes about six hours. We will have a bedside urinal/commode in case you need it. You won’t be able to disconnect from the collection process once it begins.
  • At the beginning of the process you’ll receive calcium via IV as you will lose some of your own calcium during the collection. If you have any tingling in your lips, hands or feet during collection let your nurse know and she will see that you are given TUMS or additional calcium infusions.
  • Because you’re being given additional fluids, you may notice that you have increased weight and a feeling of tightness with your rings and shoes. This is normal and the extra fluid should be gone in the next few days. You may also feel a bit tired, but this too will go away a day or two after collection.
  • You can eat and drink during your collection. If you came by yourself make sure you bring along something for lunch and a few snacks.
  • When your collection is complete and your blood counts have been reviewed by your care team, you can go home.
  • When the final number of stem cells collected has been confirmed, we will let you know whether you need to return for an additional day of collection.
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Before Your Autologous Transplant

You will need to undergo a conditioning regimen before your autologous 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 be 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 TBI, 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 your body.

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The 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.

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 your 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.

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Schedule an Appointment

To learn more about an autologous transplant in Orlando, please 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.

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