In their worst cases, transplant-related side effects (such as infection and GvHD) can be fatal. Sepsis (overwhelming infection) or chronic infections that prevent the immune system from recovering will leave the patient vulnerable and unable to fight infection.
Despite improvements in therapy, approximately 5% of patients who undergo autologous stem cell transplantation (ASCT) experience early mortality (EM), death within 1 year of transplant (EM post-ASCT). Such patients tend to have few comorbidities suggesting their EM is owing to aggressive underlying disease.
For at least the first 6 weeks after transplant, until the new stem cells start making white blood cells (engraftment), you can easily get serious infections. Bacterial infections are most common during this time, but viral infections that were controlled by your immune system can become active again.
Infections, toxicity, and (after allogeneic HSCT only), graft-vs. -host disease (GVHD) are the main causes of death.
A stem cell transplant is very complex. It can take 6 to 12 months or longer for your blood counts to be back to normal and your immune system to work well. Side effects of a stem cell transplant can be very serious or even life-threatening. The healthcare team will watch you closely during this time.
Overall, the estimated survival of the study cohort was 80.4% (95% CI, 78.1% to 82.6%) at 20 years after transplantation. Survival beyond 5 years correlated inversely with age at transplantation (Fig 1).
You will feel very tired and run down after your transplant. This will be at its worst during the second and third weeks when your blood cell counts are at their lowest.
Life expectancy after a Bone Marrow Transplant
People have more probability of surviving for another 15 years after a bone marrow transplant, who's been able to survive for at least 5 years after hematopoietic cell transplant without any signs and symptoms of relapse of the original disease.
Day 100 is a milestone that several stem cell transplant receivers circle confidently on their datebooks as the turning point in their retrieval. 100 days after stem cell transplant is when the highest risk for critical side effects is past and when the stem cells have engrafted and instigated making new blood cells.
Bacterial infections are the most common. Viral, fungal and other infections can also occur. Some infections can develop later on, weeks to months after the transplant. Infections can cause extended hospital stay, prevent or delay engraftment, cause organ damage, and may be life threatening.
Your team will monitor your chimerism levels. This measures how well your donor's cells have engrafted, i.e. how many of your blood cells are being produced by your donor's stem cells. A large drop in your chimerism level could be a sign of graft failure and you may need to have a donor lymphocyte infusion (DLI).
The risks to research participants undergoing stem cell transplantation include tumour formation, inappropriate stem cell migration, immune rejection of transplanted stem cells, haemorrhage during neurosurgery and postoperative infection.
Leukemia or myelodysplastic syndrome (MDS) occasionally occurs in patients who were transplanted with their own stem cells (autologous transplant). The risk is highest among patients who: received certain types of chemotherapy before or during transplant, such as cytoxan or etoposide.
It can take 6 to 12 months, or even longer, for blood counts to get close to normal and your immune system to work well. During this time, your team will still be closely watching you. Some problems might show up as much as a year or more after the stem cells were infused.
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.
“Relapse after allogeneic HSCT occurs in up to 30% of patients with Ph+ ALL and long-term OS has been dismal,” he said. “In other hematologic malignancies, therapeutic advances resulted in significant improvement over time in survival of patients who relapsed after transplant.”
Recovery Summary
Avoid traction, heavy load or resistance, and NSAIDs the first four weeks of recovery. Ultrasound/STIM/TENS units are not suggested for therapy during this time.
Bone marrow transplantation has a long track record of success for treating certain cancers. While older age is no longer considered a barrier to receiving this treatment, making sure that it is right for you and that you're prepared for the transplant experience are vital parts of the decision-making process.
One of the reasons bone marrow transplants are often a last resort for patients with blood cancers is graft-versus-host disease (GVHD), a common occurrence where transplanted donor immune cells attack both malignant and healthy cells in the recipient.
The most common treatment for graft failure is another transplant. A second transplant may use cells from the same donor or from a different donor.
You won't feel pain during infusion of the stem cells. You may have some nausea. We have medicine to help. However, recovering from stem cell transplant can be difficult.
Here is information on three-year survival rates: Multiple myeloma: Data show 79% were alive three years after transplant. Hodgkin lymphoma: Studies show most people receive HSCT to treat Hodgkin lymphoma that came back after chemotherapy. Of those, 92% of those people were alive three years after the transplant.
More than 80% of people who had aplastic anemia are cured after allogeneic stem cell transplantation. More than half of all people who received allogeneic stem cell transplantations for acute leukemia in remission are cured.
The risks include infection and growth of specialised tissue in the wrong place (ectopic tissue formation). Unproven stem cell treatments may also involve significant financial costs, including treatment and follow-up costs, as well as the cost of emergency medical care in the event that something goes wrong.