Autologous Stem Cell Transplant

March 31, 2024 
This page was reviewed under our medical and editorial policy by Alex Herrera, M.D., hematologist-oncologist, City of Hope Los Angeles

An autologous stem cell transplant is one type of treatment option for blood cancers, also called hematologic malignancies. Approximately 12,000 autologous transplants were performed annually in the United States in recent years, according to the Center for International Blood and Marrow Transplant Research (CIBMTR). This guide to the autologous stem cell transplant process is designed to help patients and their families know what to expect from the procedure.

What Is Autologous Stem Cell Transplant?

An autologous stem cell transplant is a medical procedure during which the patient’s own stem cells are collected from the blood and then frozen. The patient is then treated with high doses of chemotherapy and/or radiation therapy, which assists in destroying cancer cells. The stem cells are then infused back into the body to help the patients’ blood counts recover so the body can heal faster, reducing the period that the patient experiences the side effects of high-dose chemotherapy.

This treatment type is mainly used for hematologic cancers, including:

• Certain lymphomas
• Multiple myeloma

It is also sometimes used for:

• Certain childhood cancers
• Neuroblastoma
• Testicular cancer
• Other diseases, such as Crohn’s disease or multiple sclerosis

Autologous Stem Cell Transplant Success Rate

The autologous bone marrow transplant success rate varies based on many factors, including:

• Type of cancer
• Patient’s age at the time of the bone marrow transplant
• Patient’s overall health
• Amount of time between the cancer diagnosis and the transplant

Patients should talk to the care team about their prognosis based on their specific cancer type, overall health and other factors.

Autologous vs. Allogeneic

An autologous transplant differs from an allogenic transplant. While an autologous transplant uses stem cells from the patient, an allogeneic transplant uses stem cells from someone other than the patient, known as a donor. The stem cell or bone marrow transplant donor needs to be a genetic match with the patient. This person may either be a close family member or someone from the national donor registry.

Stem Cell Collection

During the collection process, the patient’s own stem cells are harvested and stored via the following steps:

• Medication (a white blood cell growth factor, also known as G-CSF) is given four days before the procedure to increase stem cell production.
• A blood test is given the day after the course of medication to determine whether there are enough circulating stem cells.
• If enough cells are present, blood is taken from one arm, passed through a filter and returned to the other arm.
• The patient is awake for the procedure, which isn’t typically painful.
• The process takes up to four hours.
• The procedure is repeated the following day if more stem cells need to be removed.

Stem Cell Implantation

In this final part of the procedure, the new cells are transplanted into the body. Before the stem cell implantation, the patient undergoes high-dose chemotherapy and/or radiation therapy in a process known as conditioning. Also called pre-transplant treatment, conditioning:

• Destroys cancer cells in the body, therefore treating the cancer
• Makes room in the bone marrow for the new cells
• Assists in suppressing the immune system, which may help reduce the chances of the new cells being rejected by the body

After conditioning, the patient will have a few days to rest before the infusion process. During the infusion, or bone marrow transplant procedure:

• Stem cells are thawed and then returned to the body via a catheter, similar to a blood transfusion.
• Medication may be given to help reduce the risk of reaction to the substances used to preserve the cells when frozen.
• The patient is awake, and the infusion process isn’t typically painful.

Recovery from Autologous Stem Cell Transplantation

During the first few weeks after the procedure, the infused stem cells begin to multiply and make new, healthy cells. This process is called engraftment. The recovery process following an autologous transplant may be lengthy, requiring a hospital stay and recovery at home. This process may include these conditions:

• For the first two to three weeks after the infusion, patients stay near the hospital and visit the hospital every day.
• After discharge, patients visit their treatment center frequently so they may be closely monitored, usually for the first 100 days.
• During this time, patients still undergo regular exams and lab tests.

It may take six months or more for the patient’s immune system to optimize and for blood counts to return to somewhat normal levels following the transplant. While the process may be mentally and physically daunting, the patient’s care team is available to help. Having support from friends or family may also make recovery easier.

Side Effects of Autologous Stem Cell Transplant

Patients will experience side effects from their autologous stem cell transplant. They may occur immediately after the procedure and/or over a longer term. Patients will be closely monitored by their care team after their autologous transplant, but they should talk to their doctor if they experience any side effects.

Because the body’s immune system is weakened after the transplant, the risk of infection is high, especially in the first few weeks following the procedure. Because of the high risk, patients should take care to prevent infections. If bacterial infections do occur, they may be treated with antibiotics.

Other common side effects immediately following an autologous transplant may include:

• Fatigue
• Hair loss
• Low levels of red blood cells (anemia) and platelets
• Mouth sores
• Weight loss
• Nausea and vomiting
• Changes in taste
• Loss of appetite

Some side effects may not appear until months or years after the transplant. They may include:

• Thyroid problems
• Bone and lung damage
• Sexual health problems
• Infertility
• Cataracts
• Early menopause
• Another type of cancer may develop

Every person’s health and circumstances are unique, so individual patients may not experience any or all of these side effects based on various factors, such as the treatment they receive and their overall health.