Dear OncoLink "Ask The Experts,"
My 40 yr old son has just been diagnosed with stage III recurrent Hodgkin's disease. His oncologist has suggested a stem cell transplant as part of his treatment. Can you please tell us what to expect as a result of this in regard to how sick he'll be, what he will need in the way of care for how long, etc., so that we can best work out how to care for him?
Selina M. Luger, MD, Director of the Leukemia Program and Assistant Professor of Medicine at the University of Pennsylvania, responds:
An autologous stem cell transplant is a treatment that involves the use of high doses of chemotherapy (and sometimes radiation). The chemotherapy doses and drugs make the blood counts drop very low and sometimes actually destroy the blood and bone marrow permanently. In order to make that safe and feasible, before the high doses of treatment are given, some of the patient's own stem cells are taken (from the blood and or bone marrow) and frozen away. Then after the patient gets the high doses of treatment, the cells are given back in order to allow the blood counts and bone marrow to recover. It usually takes about 8-14 days for the cells that are put back to start growing in the bone marrow and blood. During that period of time, the blood counts are very low and patients can develop infections, fevers, bleeding or other symptoms related to low blood counts. Patients often require antibiotics as well as blood and platelet transfusions for some period of time. Sometimes patients stay in the hospital for the entire time (3-4 weeks); sometimes patients go home after the chemotherapy and have close follow-up as an outpatient with a lot of outpatient treatments. This depends on the regimen chosen by the doctor as well as other factors. The recovery time, risk associated with the transplant, time in the hospital, care needed at home etc is also variable and should be discussed with the patient's doctors.