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Resource Guide for Bone Marrow/Stem Cell Transplant
The ABCs of BMT! BMT, PBSCT, HSCT, bone marrow transplant, stem cell transplant, peripheral blood stem cell transplant, blood cell transplant….so many words and letters it looks like alphabet soup….do they all mean the same thing? In the area of stem cell transplantation there has been a lack of worldwide scientific agreement on a single terminology. An understanding of the history of this treatment method offers some explanation about why so many different terms are used. Direct collection from the bone marrow was the first source of hematopoietic stem cells (the cells capable of producing red cells, white cells and platelets), hence the treatment was initially called a bone marrow transplant or BMT. The discovery of hematopoietic stem cells in the peripheral circulation similar to those harvested from the bone marrow led to the term “peripheral blood stem cell transplant” (or PBSCT). Currently, the peripheral blood is the major source of stem cells rather than bone marrow, and so a more general term of “hematopoietic stem cell transplant” (HSCT) has been adopted to include situations in which the stem cells may be collected from the peripheral blood, directly from the bone marrow, or even from the placenta (cord blood transplant).
For an autologous transplant, first the stem cells are collected from the patient; then the patient is given high dose chemotherapy. After the high dose chemotherapy, the patient is given back his/her own stem cells. However, the use of the term ‘transplant’ for this procedure has also led to confusion. An autologous transplant is not really a transplant; it is actually just a reinfusion of the person’s own stem cells.
When talking about a stem cell transplant one must consider both the source of the stem cells (from the patient, from a related donor, from an unrelated donor), and the way in which the cells are collected (from the peripheral blood, from the bone marrow space directly, or from the placenta after delivery). Using the latest research, the health care team will make a recommendation about which stem cell source and which method of collection is most appropriate to the medical needs of the patient.
Throughout this publication, we will be using the term “stem cell transplant” and its abbreviation SCT, which includes bone marrow, peripheral blood, and cord blood transplant, related or unrelated.
Physicians always caution against using the term “miracle” in connection with stem cell transplant. It is, as they remind us, a modern medical procedure involving some risk. It comes with no guarantee. However, few would deny that there has been tremendous progress in the field. Examples include:
Despite all these reassuring and remarkable strides, the idea of a stem cell transplant is still overwhelming and understandably provokes anxiety for patients and their family members. SCT is a life-altering experience that requires a long-term commitment and is recommended for life-threatening conditions.
What you’ll find in these pages will help you understand and deal with the challenges of stem cell transplant. We have also addressed other important issues, such as insurance, finances, and preparing your family for the transplant. Information has been compiled by health professionals, survivors, and dedicated volunteers. Many have been where you are right now, trying to make sense of what lies ahead. We feel that this booklet will make transplant an easier experience for you and your family. We hope that if you have a clear overview of what your transplant entails, you’ll feel more in control and, with advanced planning, less overwhelmed.
Medical science has made great progress in the field of stem cell transplant. The vast majority of transplants treat diseases such as leukemia, lymphoma, multiple myeloma, and some solid tumor cancers. Today, people with immune deficiency disorders, sickle cell, or aplastic anemia may also benefit from transplant. In some individual cases, autoimmune disorders, such as multiple sclerosis, systemic lupus, and scleroderma are also being treated through transplant. So, while this procedure is not a simple solution, it does offer promise.
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