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Myeloma ASCT Stem Cell Collection?
An Autologous Stem Cell Transplant (ASCT) is part of the FDA standard-of-care therapy plan. Myeloma patients undergo stem cell collection prior to an ASCT.
Many newly diagnosed MM patients who are on the fence about having high dose aka aggressive treatment aka an ASCT, go through the stem cell collection process soon after they complete induction therapy “just in case.”
The idea of collecting your stem cells right after your induction therapy is that this is when the MM in your bone marrow is at its lowest and the stem cells therefore, are the cleanest.
Are there any downsides, any risks, to collecting stem cells? If so, what are they?
Stem Cell Collection
What are the risks of collecting stem cells in anticipation of an autologous stem cell transplant?
1. Collection-Related Risks
- Infections and Bleeding: Stem cells are often collected through a process called apheresis, where blood is drawn and stem cells are separated out. In some cases, a central venous catheter is used, which can increase the risk of infection or bleeding at the insertion site.
- Low Blood Counts: Medications that stimulate stem cell production, like granulocyte colony-stimulating factors (G-CSF), can cause low blood counts, leading to temporary anemia, fatigue, and a higher risk of infections.
- Side Effects from Growth Factor Use: Growth factors may cause side effects such as bone pain, headaches, and flu-like symptoms. More rarely, these drugs can lead to spleen enlargement or, in very rare cases, splenic rupture.
- Circulatory Issues: Apheresis itself can lead to blood pressure fluctuations, electrolyte imbalances, and lightheadedness, though these effects are usually temporary.
2. Storage-Related Risks
- Cell Viability and Quality: Over time, frozen stem cells can degrade in quality, which could affect their efficacy upon thawing for the transplant. Poor storage conditions or issues with the freezing process may also impact cell survival.
- Cryoprotectant Toxicity: Stem cells are often frozen with agents like dimethyl sulfoxide (DMSO), which can be toxic if not completely removed before infusion. During transplant, leftover DMSO can cause nausea, vomiting, or even, rarely, more serious reactions.
3. Timing and Transplant Risks
- Possible Delay of Treatment: Collecting stem cells requires planning and can sometimes delay other treatments. This is typically only an issue if rapid disease progression is a concern.
- Risk of Not Using the Cells: If the patient’s condition changes, an autologous transplant may no longer be a suitable option, which could mean that the collected cells go unused.
4. Disease Contamination Risk
- Possible Presence of Malignant Cells: For people with blood cancers (like multiple myeloma or certain leukemias), there’s a risk that the collected stem cells may contain cancerous cells. Techniques like “purging” can reduce this risk, but it’s not always fully effective.
When I had my ASCT, my onc. told me nothing about the risks of an ASCT. And believe me, there are documented short, long-term and late stage side effects of an ASCT. A large and growing number of studies document no long-term benefit of ASCT over novel therapies.
Email me at David.PeopleBeatingCancer@gmail.com if you have any questions about stem cell collection or the ASCT procedure itself.
Good luck,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Autologous Peripheral Blood Stem Cell Harvesting
Peripheral blood stem cell harvesting is a procedure to harvest (collect) some of the stem cells in your blood. Stem cells are immature cells that make all the blood cells in your body. This includes:
- White blood cells that help your body fight infections and other diseases.
- Red blood cells that carry oxygen from your lungs to the rest of your body.
- Platelets that stop you from bleeding and help your wounds heal.
Autologous (aw-TAH-luh-gus) means your own stem cells will be harvested, stored, and put back (transplanted) into your body in a peripheral blood stem cell transplant. Your stem cells will grow and mature into new blood cells that will replace your cells that were killed during treatment. Peripheral blood is the blood that circulates (flows) in your blood vessels…
What to expect
You’ll lie on a bed or sit in a recliner chair during each harvesting session. A nurse will connect you to a machine. They’ll connect you either by an intravenous (IV) line (thin, flexible tube) that’s put into a vein in each of your arms or by your tunneled catheter.
The machine will draw blood from one of your IV lines or tunneled catheter access ports. The blood will pass through the machine and the machine will separate out and collect your stem cells. The machine will return the rest of your blood to you through your other IV line or tunneled catheter access port.
You can watch TV, read, or use your smartphone or tablet during your procedure. If you feel cold, you can ask for blankets to keep you warm.
As your stem cells are harvested, you may have muscle cramps, twitching, or feel tingling (a slight stinging or poking feeling) around your lips and fingertips. These are signs your blood calcium level is low. If you have any of these things, tell a nurse. They’ll give you Tums®, which are a quick and easy source of calcium. They may also give you a medication that has calcium through your IV line or tunneled catheter…
When to Call Your Healthcare Provider
Call your healthcare provider if you have any of the following:
- A fever of 100.4 °F (38 °C) or higher
- Flu-like symptoms
- Any redness, bleeding, drainage, swelling, or pain around your tunneled catheter site or at the IV sites
- Numbness or tingling in your lips, hands, or feet
- A lot of pain on the left side of your body
- A bad headache and any neurological (nerve) changes, such as:
- Changes in vision
- Changes in short-term or long-term memory
- Changes in mobility (your ability to move)
- A hard time speaking
- Any other concerning symptoms…”
Hyperbaric Oxygen Increases Stem Cell Proliferation, Angiogenesis and Wound-Healing Ability of WJ-MSCs in Diabetic Mice
Moreover, several studies have proposed that HBOT mobilizes stem cells by improving homing and subsequent engraftment in injured tissues, which would explain, in part, the therapeutic effects of HBOT (Zádori et al., 2011; van Neck et al., 2017).
Despite all of the evidence of HBOT’s positive effects, its clinical value is still yet under discussion (see Dulai et al., 2014; An et al., 2015; Fox et al., 2015; Goldfarb et al., 2016; Chong and Rice, 2016; Borab et al., 2017).
Myeloma ASCT stem cell collection Myeloma ASCT stem cell collection