Autologous Bone Marrow Transplant (BMT) Process
- Our BMT Nurse Coordinator will meet with you to further discuss what will take place next and how to prepare yourself for the procedure.
- A series of baseline screening tests and evaluations (e.g.: blood tests, cardiac & lung assessment, dental assessment, fertility assessment, etc.) will be conducted to ensure the necessary treatment or preventive measures can be prepared where required.
Stem Cell Collection Procedure (Apheresis)
- An injection of growth factor, called Granulocyte Colony Stimulating Factor (GCSF), will be given to increase the number of circulating stem cells in your bloodstream on a daily basis for 4 days. This process is also known as stem cell mobilisation.
- Our haematologist will order a blood test on the day of stem cell collection to determine the sufficient number of circulating stem cells (or CD34+).
- Once the CD34+ count is adequate, you will be referred to our inhouse specialist doctor for a central line insertion procedure. A tube will be inserted into a large vein either near your collar bone, neck or the groin area under local anaesthesia. This line will be used for blood tests, drawing blood for stem cell collection, and administration of fluids or medications.
- For stem cell collection, a special machine (apheresis machine) will be connected to your central line. Blood is then drawn via this line and passed through the machine to separate and collect your stem cells. The remaining blood is then returned to the body.
- The stem cells collected will be in sterile bags, prepared and frozen in a specialised haematology lab. If insufficient stem cells are collected, an additional day of apheresis may be required.
- Frozen stem cells are kept according to specific lab requirements until they are required for the infusion (transplant). Frozen stem cells can be stored for many years.
- Once the catheter (CVC) is removed, you will be discharged home and continue with follow-ups as an outpatient. Your transplant team will schedule the date for the transplant.
- During conditioning, you will go through high-dose anti-cancer treatment. This process aims to kill, reduce and destroy any cancer that is left in your body.
- High-dose of chemotherapy will be administered over several days through your central line.
- Once completed, you are now ready for the stem cell infusion (transplant). During this time, you will be monitored in a special isolation room to prevent any infections until your immune cells recover.
Stem Cell Transplant
- Stem cell infusion will usually be done 1 to 2 days after going through conditioning treatment.
- You will be given pre-medication prior to the stem cell infusion (such as paracetamol, anti-histamine) to prevent any reaction.
- The time needed for the infusion will depend on the number of stem cell bags. The nurse in charge will monitor your status throughout the infusion.
- The day of your infusion will be referred to as day zero. Recovery time will be measured from this day.
Recovery – Engraftment
- After treatment and transplant is complete, the engraftment period follows. This is when your new stem cells start to grow and produce healthy blood cells.
- During this period, you will be in an immunosuppressed state and are required to stay in the hospital’s isolation room for 3 to 4 weeks for close monitoring and recovery. You may require transfusions and medications to help manage the symptoms.
- Once your immune cell counts begin to improve, our haematologist may allow you to go back home with medications and a follow up appointment.
- Although doctors have allowed you to go home, you are still at risk of infections and are advised to be extra cautious.
- You may also be advised to continue the same lifestyle as your hospitilisation period for the next 3-6 months after the transplant.
Our team of haematologists, BMT nurse coordinators, and multidisciplinary specialists will ensure that you and your family receive exceptional care throughout your whole bone marrow transplant journey.