In recent years, the number of clinical trials associated with regenerative medicine and stem cell transplants have increased at a dramatic level. Doctors, therapists, and scientists all believe that stem cell technologies possess the capability of becoming the standard treatment for a wide assortment of injuries, illnesses, and diseases.
Regenerative biological studies have been found to successfully increase healing times and result in positive developments in functional-based recovery. As a result, stem cell transplants are now refining the art of rehabilitation on a clinical level.
In this guide, you will learn about the stem cell transplant procedure, the success rates associated with the procedure, and be provided with information on the recovery of those that have the procedure performed.
Stem Cell Transplant
A stem cell transplant – which is also often referred to as a “bone marrow transplant” – is a special medical procedure performed on patients that aid in delivering stem cells that are healthy in order to replace stem cells that are damaged or unhealthy.
In most instances, the defective cells have been directly affected by cancer; however, cancer is not always the underlying cause behind a damaged cell.
In some cases, a stem cell transplant may be provided to individuals that suffer from blood disorders and/or autoimmune diseases.
The Hematopoietic Stem Cells
When a stem cell transplant (SCT) is performed, hematopoietic stem cells are utilized. These are a type of immature cell that starts its life in the bone marrow of the patient and develops into a type of mature blood cell. The following outlines the cells in which hematopoietic stems cells develop:
- White Blood Cells – These types of cells work within the body in order to fight infection.
- Red Blood Cells – These types of cells aid in carrying oxygen to the tissues, organs, and other internal components of the body.
- Platelets – These cells aid in the process of blood clotting in the body.
The Importance of Stem Cells
Each of the bones in the body has a special area referred to as “bone marrow”. This is the area that is responsible for making the blood cells. The area is soft and resembles a sponge and is located directly inside of the bones. It always contains hematopoietic stem cells.
These will – eventually – mature and transition into the necessary blood cells that help keep us healthy.
There are certain types of injuries, illnesses, and diseases that can prevent these types of cells from going through the maturing process. When this happens, complications arise within the blood cells that are developed within the bone marrow and the person is not as healthy as they can be.
Stem cells that are replaced help in the creation of blood cells that are healthy and contribute to the overall health of an individual.
Stem Cell Transplant Procedure
The stem cell transplant procedure may prove to be long and daunting. It starts with determining whether or not you are eligible for the procedure.
While considered highly beneficial in treating a multitude of injuries, illnesses, and diseases, the procedure has the potential to be quite difficult on the body.
You will likely be interviewed and go through testing at length.
Examples of a few procedures that may be performed include HLA tissue typing and a bone marrow biopsy.
Once it has been established that you are able to handle the procedure both physiologically and psychologically, your care team will set you up for the conditioning treatment. This involves being provided with a high dose of radiation and/or chemotherapy. This is done over the course of a couple of weeks to properly prepare the body.
Immediately thereafter, you will be able to engage in a time of rest. Once the body has rested, you will be provided with the stem cells.
When given the stem cells, it will be similar to that of a blood transfusion. It could be in an IV or through a central venous catheter. There is no pain or discomfort when the body receives the stem cells. You will be awake during the procedure.
For many, it is considered to be a time of celebration. It is a very meaningful process that will provide you with a complete renewal of health. Many patients consider this to be their “second chance” – in terms of their health.
Stem Cell Transplant Success Rate
According to research, the success rate of stem cell transplants had increased at a significant level throughout the past few years.
For those with life-threatening conditions, the one-year survival rate increased from 48% to 63%.
For those with injuries, illnesses, and diseases that were not considered to be life-threatening, the success rates were even higher.
While still considered to be a relatively new procedure, stem cell transplants appear to be highly successful for all of those that receive them.
Stem Cell Transplant Side Effects
Stem cell transplant side effects are considered to be rare. If side effects do occur, they are typically considered to be mild. In most cases, the side effects are directly related to the preserving agent that was utilized to originally freeze the healthy stem cells.
Many patients report having a strong taste in their mouth. That same taste often results in a smell being put off by the body. This commonly only happens for a few days and then starts to rapidly fade.
There are some patients that may develop a fever and experience chills. The blood pressure may go low and shortness of breath may be experienced. Respiratory side effects could include tightness and/or pain in the chest and coughing. For some, there may be a decrease in the output of urine. For others, general weakness may occur.
Any side effects experienced may be quickly treated to ensure the comfort level of the patient. Again, all side effects are considered to be rare and they do not often result in complications.
Stem Cell Transplant Recovery
Immediately after the infusion of the stem cells, the recovery process starts. At this time, the healthy cells that were placed within the body start to engage in a multiplication process and create brand new, healthy cells in the body.
The blood counts may not start to normalize until a period of as little as two weeks or as long as six weeks.
In some instances, the patient may remain hospitalized during this time. In other instances, the patient may be required to visit the center where the transplant was performed on a daily basis.
The red and white blood cells and the platelets within the body will remain low; however, an antibiotic will be provided to ward off any potential infections that may occur. Many patients may be provided with medications that combat viruses, bacteria, and fungus.
Once the white blood cells reach a target level, these medications will be stopped.
It is common for blood transfusions that include platelets and red blood cells to be provided. This is simply to help the body until the blood marrow is successfully working on its own and producing new, healthy cells.
What to Expect After a Stem Cell Transplant
In addition to the medical-related situations that may occur after a stem cell transplant, it is important for patients to understand that they may experience many emotional effects of the procedure.
First, isolation may occur. The change in daily routines may be very challenging – especially combined with all of the treatments that may have to be provided after the stem cell transplant.
It is absolutely vital for a patient to have a solid support team. This will aid in the recovery process and any potential treatments and/or complications that may be experienced afterward.
What Has to Happen Before Returning Home
There are general guidelines that transplant centers utilize in order to determine when it is best for a patient to return home. The following outlines the most basic criteria:
- First, the patient should have gone at least 48 hours without having a fever.
- Any side effects such as nausea, vomiting, and gastrointestinal upset must be successfully controlled either with or without medicine for a total of 48 hours.
- The patient must be able to keep any medications in them for a total of 48 hours or more.
- The platelet count in the body must be – at the minimum – 15,000 mm.
- The neutrophil count of the body must be no lower than 500 mm.
- The hematocrit percentage of the body must be no lower than 25%.
- The patient must have someone that will be with them at home and available to help them once they are discharged from the hospital or transplant center.
Stem Cell Transplant Rehabilitation
The stem cell transplant procedure does not simply “end” when a patient returns home. Most patients will experience fatigue, will find that they have mental health issues, or may even experience physical complications.
This stage initiates the rehabilitation period. During this time, many medications may be being taken. A caregiving team must be in place to help those who have had the procedure performed. The patient is followed closely by a medical team to ensure no complications arise. During this period, antibiotics and transfusions may be necessary.
The purpose of rehabilitation is to ensure that the patient’s immune system gains strength and they are able to successfully recover from the injury or illness which was initially treated.
There are several milestones that indicate that a stem cell transplant has been successful. The following outlines information on the two most important indicators:
- Blood Counts at Safe Levels – A blood count includes the red blood cells, the white blood cells, and the platelets that are found within the blood. For the first couple of weeks following the procedure, these levels are low. While it is true that treatments may be ordered during this time to increase blood levels, they are designed to contribute to the overall effectiveness of the procedure.
- Cures the Injury and/or Illness – The second milestone that indicates that the stem cell transplant procedure is a success is that it actually cures the original injury and/or illness. The transplant is done for the purpose and intent of curing. If cancer is the issue being treated, going into remission counts as a success.
100 Days After Stem Cell Transplant
The “100th day” milestone is – perhaps – one of the most significant to those that have a stem cell transplant performed. It is often revered to as the “turning point” – in terms of the recovery process.
This is because the highest risk for complications is officially gone and the healthy cells infused within the body have officially gone through the engrafting process and started to create healthy cells.
Families are often contacted as a result of the survivorship of the patient that has made it to the 100th day milestone.
At this point, more education is provided to the patient and they are provided with a multitude of resources that will help them be as healthy as possible.
According to numerous studies, physical therapists play a critical role in post stem cell transplant recover. Each patient will be provided with an individual type of treatment that helps their body recover from injuries, illnesses, and/or diseases that detrimentally impact their overall health.
The musculoskeletal presentation of the patient is critical in determining the best treatment for their individual needs. By helping a patient address their unique needs and engaging that patient in various physical therapy protocols, the success rate of the transplant is immediately heightened.
We here at Back to Motion Physical Therapy are dedicated to ensuring a high success rate after stem cell infusion. If you are on the road to recovery, you may contact us today to learn more about the services and programs that we offer to enhance your success rate.