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Stem Cell Transplantation at Dana-Farber/Brigham and Women's Cancer Center: A Photo Tour

  • Vincent Ho, MD, with stem cell transplant patient - larger
  • Every year, thousands of people are diagnosed with blood cancers and other diseases of the blood and bone marrow. For some of these patients, the best course of treatment is a stem cell or bone marrow transplant.

    If you or a loved one may need a stem cell transplant, this photo tour is designed for you. We hope it will give you a helpful overview of the transplant process, as well as some of the many resources available to you in the Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) Adult Stem Cell Transplantation Program.

    While we know that preparing for a stem cell transplant is a difficult experience for you and your loved ones, rest assured that we will be with you at every step of the way throughout your transplant journey. We consider you and your caregivers to be part of the care team, too, and encourage you to ask questions and share your thoughts with us at any time.

  • How stem cells are used to treat patients like you

    illustration of stem cells

    What are stem cells?

    Stem cells are the "building blocks" of bone marrow and blood formation. They form white blood cells (which fight infections), red blood cells (which carry oxygen throughout the body), and platelets (which allow blood to clot, helping wounds heal) – all of the components your immune system needs to function.

    Where in the body are stem cells located?

    Stem cells are found in bone marrow (the tissue inside the bones) and in peripheral blood (the blood that circulates throughout the body, carrying vital nutrients). They are also found in the umbilical cord blood of newborn babies.

    What are the main types of stem cell transplant?

    Transplants performed here at DF/BWCC are either autologous (using your own stem cells) or allogeneic (using another person’s stem cells:

    • Autologous Transplant: Your own stem cells/bone marrow will be harvested from your body.
    • Allogeneic Transplant: A donor — someone who is either related to you, or who is unrelated but has a type of cell protein called HLA that closely matches yours – will have their stem cells or bone marrow harvested for your transplant.

    Stem cell donor services, collection, and processing

    stem cell donor services

    Whether you are donating your own stem cells for your transplant, or are receiving cells from either a related or unrelated donor, we have all of the facilities and support services you need to make the process go smoothly.

    If I am not using my own stem cells for a transplant, how will I get the donor cells I need?

    If you are not using your own cells for an autologous transplant, your specially trained donor search coordinator can help find a donor for you. Dana-Farber is accredited by the National Marrow Donor Program (NMDP) to coordinate donor searches for patients. If you need an allogeneic transplant but do not have a related donor who is a match, your donor coordinator will help organize the search. The NMDP's Be The Match Registry® and all other appropriate unrelated donor registries and cord blood banks will be contacted to help find a suitable donor for you.

    What happens during the transplant process?

    During the actual stem cell transplant, your body is infused with healthy stem cells (either your own if you have an autologous transplant, or a donor’s if you have an allogeneic transplant). The infused stem cells then grow and produce all of the different parts of the blood that both your body and your immune system need.

    You will be closely monitored before and after your stem cell transplant. After you have received your new stem cells, your care team will check your blood counts every day to monitor for engraftment. Engraftment is when your transplanted stem cells begin to make new blood (red blood cells, platelets, and other components of the immune system) within your body. The time it takes to reach engraftment depends on several factors, including stem cell source, the type of transplant, and your pre-transplant therapies.

    Where are the stem cells used for transplant at DF/BWCC processed?

    Dana-Farber is home to the Connell and O’Reilly Families Cell Manipulation Core Facility, which is New England’s only state-of-the-art cell therapy facility at an academic medical center. Our facility processes all of the stem cells we use for transplant and other patient care purposes. How does DF/BWCC ensure the quality and safety of the stem cells used for transplant? DF/BWCC has an entire department dedicated to ensuring the highest standards of quality in the manufacturing and use of stem cells, as well as all other types of cellular products used for patients.

  • Before, during, and after your stem cell transplant, you will work with a number of dedicated physicians, nurses, and other specialists who will coordinate your care to bring you the best possible outcomes in a supportive, compassionate, and family-centered environment.

    Your team will be in communication with your local oncologist throughout your treatment and during your post-transplant care. Resource specialists will also help coordinate other important parts of your care, including housing arrangements, transportation, referral to community programs, and any other services you may need.

    Your transplant physician

    physician with a patient

    Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) has more than 30 expert stem cell transplant physicians on staff. You will meet your transplant physician during your first visit, and he or she will direct and oversee your medical care from this point forward. Your transplant physician will talk daily with the other members of your care team to keep them up to date on your treatment.

    Your transplant nurse

    nurse with a patient

    You may meet a number of different nursing professionals during your transplant journey, including transplant nurse practitioners, transplant nurses, and research nurses. You will likely have the most interaction with your transplant nurse. He or she will be your central point of contact for any medical issues you experience. In addition to helping you prepare for hospitalization, your transplant nurse may follow up on your care during the post-transplant phase and will be available as an educational resource for you and your family.

    Your transplant clinical coordinator

    stem cell transplant clinical coordinator

    This team member is an important resource. He or she will work with you before your transplant to create a schedule, helping make sure all of your pre-transplant tests are completed on time. You may call your coordinator with any non-medical questions you have. The coordinator will also serve as a liaison with other members of your care team.

    Your transplant physician assistant

    physician assistant with patient

    A physician assistant (PA) who specializes in stem cell transplant care will partner with your transplant physician to coordinate your daily medical care.

    In addition to these essential team members, you may also receive support from other specialists at DF/BWCC.

    Your transplant social worker

    social worker with patient

    A clinical social worker will be available to provide counseling and emotional support to you and your family throughout all phases of your transplant care. He or she may also offer group counseling sessions, make referrals to resources you can access in your community, and help you and your family cope with any concerns or issues that arise before, during, or after your transplant.

    Your financial counselor

    financial counselor

    A financial counselor will team with you to provide support and guidance in handling the costs of your transplant care. The counselor’s role is to make the financial side of your transplant as stress-free as possible.

    Your dietitian

    dietitian

    You will see a dietitian once you are admitted to the hospital for your transplant. The dietitian and his or her assistants will monitor the food you eat and provide supplements if you need them. The dietitian will typically visit with you once a week while you are in the hospital, but may come more often if needed. The dietitian will also meet with you and your caregiver before you are discharged to review the dietary restrictions you should follow and answer any questions you have.

  • In addition to the world-class cancer care you will receive from the expert team at Dana-Farber Cancer Institute, you will also have access to caring and collaborative medical specialists in many different disciplines at Brigham and Women's Hospital (BWH). Working together, the two hospitals will make sure you have everything you need to ensure your overall health and well-being.

    Oral Medicine and Dentistry

    dentist with a patient

    One example of an important specialty care area is Oral Medicine and Dentistry. You will need to see a dentist as soon as possible before your admission to the hospital, and to have any oral health needs taken care of before you have your stem cell transplant. This includes having your teeth cleaned and any fillings (or in some cases root canals and extractions) taken care of by your current dentist. Even if you wear dentures, you will still need to be examined by a dentist before transplant.

    A BWH Oral Medicine specialist will review your dental evaluation records and the X-rays sent by your local dentist, and then communicate with your dentist to make sure you have the right dental treatment plan in place.

    Chemotherapy

    patient receiving chemotherapy

    You will receive your chemotherapy treatments in your room, either by intravenous (IV) infusion or taken orally as a pill. If you have chemotherapy by infusion, the medication is delivered by an infusion “pump,” entering your bloodstream through a needle in your vein, a port, or a catheter. If you are taking oral chemotherapy, your doctor and nurse will check in regularly with you to see if you have any side effects.

    Your Inpatient Room

    patient and caretakers in an inpatient room

    While you are hospitalized for your transplant, you will be in a private room on a specialized oncology floor. Rooms for stem cell transplant patients are located in both Dana-Farber's Inpatient Hospital and Brigham and Women's Hospital. Following your transplant, it is extremely important to protect your immune system and make sure your living space is not contaminated. Your room will be specially equipped with a HEPA filter or a laminar airflow with a special air-lock entrance. This ensures the air in your room will remain germ-free as your immune system starts to recover. Each room is also equipped with a TV, DVD player, phone, closet, and private bathroom.

  • Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) provides a wide range of educational, emotional, practical, and spiritual sources of support for all patients and their families. Learn more about our Patient and Family Support Services.

    Stem Cell Transplantation: An Information Guide for Patients and Caregivers

    Stem Cell Transplantation: An Information Guide for Patients and Caregivers

    At the beginning of your transplant experience, you will receive a comprehensive guidebook that defines each step involved before, during, and after transplant. Your program nurse will review the guidebook with you and will be happy to answer your questions or provide additional information at any time. The guide also comes with a companion version for your caregiver(s).

    Private Online Support Community

    support community user

    Hosted by Dana-Farber Cancer Institute, the Stem Cell Transplant Online Community is a safe, private, and welcoming space for all DF/BWCC stem cell transplant patients and their caregivers. By taking part in the community, you will find — and be able to offer others — emotional support, helpful resource materials, and practical suggestions about life before, during, and after stem cell transplantation.

    Patient and Family Education

    patient and family education services

    Dana-Farber/Brigham and Women's Cancer Center (DF/BWCC) offers a comprehensive education program for stem cell transplant patients and their caregivers, including blended learning tools. You and your family can also take part in the many different events, seminars, and workshops held at Dana-Farber.

    Services for Bone Marrow/Stem Cell Donors

    services for donors

    Dana-Farber's Bone Marrow/Stem Cell Donor Services program is accredited by the National Marrow Donor Program (NMDP) and provides several services for both related and unrelated bone marrow/stem cell donors. These services include education and advocacy, stem cell and bone marrow collection coordination, and long-term support and follow-up care.

    Pharmacy Support

    pharmacist with patient

    A pharmacy resource specialist will be available to assist you and your caregiver prior to transplant, during your inpatient stay, and after your transplant to help identify the medications and supplies you need and to offer additional pharmacy assistance.

    Financial and Housing Assistance

    patient receiving financial assistance

    Our transplant financial counselors are experienced in helping plan for payment of transplant and other related services. We can help you sort through the details and steps needed to make your financial arrangements go smoothly.

    As you prepare for your stem cell transplant, you may also need to plan accommodations for your family and/or caregivers who will stay in Boston during your admission. Our resource specialists are here to help you learn about available housing options.

    Follow-Up Visits

    patient at a follow-up visit

    Your stem cell transplant care team will continue to be available for support during your recovery. After leaving the hospital, you will have scheduled follow-up visits (usually weekly for the first few months) at Dana-Farber on an outpatient basis. These visits will usually include a physical exam, blood count checks, and the opportunity to speak with your transplant doctor, nurse practitioner, physician assistant, and nurse about any questions or concerns you may have.

    Returning Home and Living Well Beyond Cancer

    patient with a nurse

    Dana-Farber's Adult Survivorship Program helps cancer survivors manage their long-term care. Working with the program, you will receive a comprehensive survivorship assessment from a nurse practitioner who is experienced in follow-up care. The staff of the Adult Survivorship Program collaborates closely with the stem cell transplant team to ensure you receive the right care for you, at each stage of your recovery from transplant and in the days, months, and years beyond.