Stem cell and bone marrow transplants

If your bone marrow has been damaged and can no longer produce healthy blood cells, a stem cell transplant may be recommended. This procedure can also be used to replace blood cells that have been destroyed or severely affected by intensive cancer treatment. ^{Footnote [1]}  

Initially, you’ll be evaluated and assessed to make sure you’re physically well enough for the transplant.

Next, the stem cells can be collected from you (an autologous transplant) or from a donor (an allogenic transplant). ^{Footnote [1]} A donor can be a matched sibling, unrelated donor or umbilical cord blood donor. Your blood or donor’s blood is taken through an IV line and circulated through a machine which separates out the stem cells. If your stem cells are being used, they are usually frozen after collection for later use.  If donor stem cells are being used, they are usually infused fresh or after short storage.

To prepare your bone marrow for the new stem cells you’ll then receive chemotherapy and/or radiotherapy, to condition your body over several days. This can be quite challenging and unpleasant, as you may suffer with side effects such as sickness, hair loss and tiredness. ^{Footnote [2]}  

Once conditioning is complete, the healthy stem cells will be infused into your bloodstream through a drip.

You’ll be awake during all parts of the procedure, and it’s generally painless. The new stem cells settle in your bone marrow and start making new blood cells over the next few weeks.  After the transplant, you will need to stay in hospital for a while – how long can vary depending on how your body responds to the transplant. ^{Footnote [2]}  

A bone marrow transplant uses stem cells taken from the bone marrow (an autologous transplant) or a donor’s bone marrow (an allogenic transplant).  The bone marrow is usually collected from an area of the hip bone by a surgical procedure under anaesthesia.  You’ll be evaluated and assessed to make sure you are physically well enough for the procedure. ^{Footnote [2]}  

Following collection, the stem cells are harvested and then the chemotherapy/radiotherapy conditioning treatment is given.  The stem cells from the bone marrow are then infused into the bloodstream.  Recovery from a bone marrow transplant takes longer than a stem cell transplant.

You may feel anxious about the risks and challenges of a transplant. However, if you are otherwise in good health apart from your underlying condition, the risks are usually moderate. Your medical team will explain these risks in detail before the procedure. The main risks include:

Graft-versus-Host Disease (GVHD)

This is when transplanted donor cells attack your body’s own cells. This doesn’t happen when your own stem cells are transplanted back into your body. ^{Footnote [3]}  

Acute GVHD

This usually appears within the first 100 days after transplant. Symptoms can include a skin rash, (redness, itching), liver jaundice, nausea, vomiting, abdominal pain, and diarrhoea. ^{Footnote [4]}  

Chronic GVHD

This usually appears after the first 100 days after transplant, most commonly within two years, and may persist for months or years. It can affect the skin, mouth, eyes, liver, lungs, joints, muscles, fascia and genitals. ^{Footnote [4]}  

Other risks

• Infection – this can happen because of your white blood cell count being low in the early days after the transplant.
• Anaemia – this can happen as your red blood cell count is lower after the transplant.
• Fertility can be affected by the high dose chemotherapy (with or without radiotherapy) used in conditioning, and some patients choose to freeze their eggs or sperm before the procedure. ^{Footnote [3]}  

While you’re in hospital the transplant team will be on the alert for any side effects and will be able to help you if you feel unwell. 

Some patients experience pain in different parts of the body which can slow down your initial recovery - your medical team will be able to advise you on pain relief or refer you to a pain specialist team.

Other side effects after the stem cell transplant can include abdominal pain, tiredness, sickness, bleeding, bruising, fever or headaches. ^{Footnote [5]}  

If you are diagnosed with a condition that may require a stem cell transplant, we can help you navigate what benefits your particular policy has access to. You can update us by calling directly to our claims team or using the MyAviva portal online. 

Once we’ve confirmed your claim meets the terms of your policy, we’ll pay any medical bills directly (subject to your policy terms and conditions). Just be sure to tell us if you need more tests or treatment, or if your hospital or specialist changes.

It’s good to have one less thing to worry about. It takes Aviva.