The Stem Cell Transplant Process

At the University of Chicago Medicine, our transplant team works side-by-side with the patient, family and referring physician before, during and after transplantation to ensure the best possible outcome. The transplant process differs from patient to patient, but generally includes:

• Evaluation and pre-transplant testing
• Identification of the appropriate type of transplantation — autologous (from the patient), syngeneic (from an identical twin), or allogeneic (from a related, unrelated or cord blood donor).
• Obtaining stem cells from the patient or a donor —

• Blood stem cells are taken through a painless process called apheresis. Blood is taken from a vein and circulated through a machine that removes the stem cells and returns remaining blood and plasma back to the patient.
• Bone marrow stem cells are harvested from the donor in an operating room. Stem cells are collected through a needle placed in the soft center — or marrow — of the bone. The donor may feel some pain after this procedure.

• Conditioning treatment — administration of chemotherapy and/or radiation to the patient in order to destroy all of the diseased cells in the body and to create space in the bone marrow for the transplanted stem cells to populate.
• Infusion of healthy stem cells into the patient — a painless process in which stem cells are transplanted into the patient through intravenous (IV) infusion. Side effects from this procedure are rare.
• Engraftment and recovery — transplanted stem cells begin to grow and reproduce healthy blood cells. For bone marrow or blood stem cell transplant, engraftment takes between two and three weeks; for cord blood transplant, the process takes three to five weeks. Most patients stay in the hospital during this period to be protected from infection and monitored for side effects, though select patients may be candidates for outpatient stem cell transplant.
• Post-transplant care — including regular examinations to monitor allogeneic transplant patients for signs of graft vs. host disease (GVHD) and to watch autologous and allogeneic patients for immune system recovery, complications related to chemotherapy or radiation and cancer recurrence (relapse).
• Coordination of continuing care with the patient's referring physician.

A Family-Centered Stem Cell Transplant Unit

Most patients undergoing stem cell transplantation are cared for in our dedicated unit for approximately one week before and two to three weeks after the procedure. Select patients may receive outpatient stem cell transplant care in specially designed treatment rooms within the unit. The same physicians and nurses who provide inpatient care provide outpatient care.

The stem cell transplant unit is located on the top floor of the Center for Care and Discovery and features state-of-the-art technology and thoughtful amenities:

• HEPA-filtered rooms, giving patients optimal protection against infection as well as freedom of movement.
• Patient rooms spacious enough to accommodate family members for extended stays. Features include foldout sofas, flat screen TVs and beautiful views of the Chicago skyline, Lake Michigan and the University of Chicago campus.
• Exercise rooms to help patients stay active and regain strength during hospitalization.

Clinical Trials

Our stem cell transplant physicians are members of the nationally renowned UChicago Medicine Comprehensive Cancer Center, one of only two National Cancer Institute (NCI)-designated Comprehensive Cancer Centers in Chicago. It is through the Cancer Center that we participate in clinical trials of emerging therapies. In addition, we are active participants in the Alliance for Clinical Trials in Oncology and the Blood and Marrow Transplant Clinical Trials Network. Involvement in these vital research organizations gives our patients access to the most novel and exciting treatments available.

State-of-the-Art Stem Cell Laboratory

Our stem cell transplant program laboratory is specially equipped to handle all of the blood and stem cell preparation necessary for transplant, including apheresis (separation and collection of stem cells from the blood) and cryopreservation (freezing of stem cells for future use).

Leading-edge technologies in the laboratory enable us to perform complex procedures that help improve transplant outcomes. These procedures include purging of cancerous cells and purifying donor stem cells to minimize graft-versus-host disease (a serious side effect related to the use of donor cells for transplant).