Stem cell transplant for chronic lymphocytic leukemia

A stem cell transplant replaces stem cells. It uses chemotherapy to kill all of the cells in the bone marrow. This includes both healthy cells and cancer cells. Sometimes whole body radiation therapy is also used. After chemotherapy, healthy stem cells are given to replace the ones in the bone marrow that were killed.

Stem cells are found in bone marrow, blood and umbilical cords. They are basic cells that develop into different types of cells that have different jobs. For example, all our blood cells develop from blood stem cells.

This treatment is used to replace stem cells when stem cells or bone marrow or both are damaged. A stem cell transplant is very risky and complex, and it must be done in a special transplant centre or hospital.

Your healthcare team will carefully weigh the risks of a transplant against the risk of the disease before they offer a transplant as treatment. A stem cell transplant is sometimes used to treat chronic lymphocytic leukemia (CLL) that has come back after treatment (relapsed) or that did not respond to treatment (refractory). The criteria to be eligible to have a stem cell transplant will be set by your treatment centre.

There are different types of stem cell transplant. The type used for CLL is an allogeneic stem cell transplant. In an allogeneic stem cell transplant, the stem cells are taken from one person (the donor) and given to another person (the recipient). The donor and recipient may or may not be related. The donor and recipient are matched through a process called human leukocyte antigen (HLA) typing.

An allogeneic transplant can cause severe complications and side effects.

Side effects of stem cell transplant will depend mainly on the type of chemotherapy or drug combination given, the type of transplant and your overall health. Tell your healthcare team if you have side effects that you think are from a stem cell transplant. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Side effects of stem cell transplant include:

• low blood cell counts, which can cause infection, bleeding and anemia
• graft-versus-host disease (GVHD)
• veno-occlusive disease (VOD)
• digestive system problems, including sore mouth and throat, loss of appetite and diarrhea
• skin problems
• pain

Find out more about a stem cell transplant and side effects of a stem cell transplant. To make the decisions that are right for you, ask your healthcare team questions about a stem cell transplant.