Stem Cell Transplant and Cellular Immunotherapy Program Procedures
At the MedStar Georgetown we provide the full spectrum of care for our stem cell and cellular therapy patients. We want you to feel informed and prepared for your procedures. Our team will take the time to explain every step in detail and answer any questions you may have. We tailor your treatment plan for your needs, factoring in your age, general health and specific condition. Our team will discuss the process for your individualized treatment with you.
Bone Marrow or Stem Cell Transplantation Procedures
Preparation for Transplantation
Your overall health contributes greatly to the success of your transplant. We want to ensure that you are in the best health possible before your procedure. Our pre-transplant coordinators and support staff will help guide you through the preparation phase, helping you lower your risk of complications and increase your chances for a positive, long-term outcome. They may recommend some exams or tests prior to your transplant, to treat existing infections and plan for your postoperative care. These include:
- Dental exam: It’s important to treat any sources of infection. Your dentist may also recommend fluoride treatments to prevent decay.
- Gynecological exam: Women are required to undergo a gynecological exam before transplantation to treat any infections.
- Dietary changes: We will most likely place you on a special diet before your procedure. Our experienced dietitian will create a personalized food plan that meets your nutritional needs. In addition, achieving a close-to-normal weight can contribute to a better result. Our dietitian can work with you to help you gain or lose weight safely and effectively.
- Fertility planning: Chemotherapy and radiation can cause sterility (inability to have children). Talk to your doctor about banking sperm or ova if you wish to start or add to your family after the procedure. We can also make a referral for you to a fertility center.
- Baseline tests: We will run a number of tests before the procedure to establish baseline information. This gives us a detailed picture of your body’s current health and functioning so we can evaluate any changes that occur during or after the procedure. Tests include imaging scans, a hearing test and a heart evaluation.
We will then begin preparing you for the actual procedure.
Once we have completed the evaluation and determined that you are a stem cell transplant candidate, we will begin the first step: a harvesting procedure. We will collect the cells from you or from a donor, depending on the type of transplant procedure you are having allogeneic or autologous.
We harvest healthy cells from a family member or unrelated donor.
We harvest your own cells. We collect the cells from the bloodstream (or, occasionally, from the marrow) and store them for transplant.
Bone Marrow Harvesting
Bone marrow or peripheral blood stem cell harvesting is the first step in your bone marrow or stem cell transplant process. During harvesting, we obtain the stem cells we need for your transplant. We may harvest the cells from you, a relative, or an unrelated donor, or we may obtain cells from an umbilical cord.
At MedStar Georgetown University Hospital, we have unique expertise in this area. We are home to the National Marrow Donor Program, the largest marrow and blood stem cell harvesting site in the nation. This high volume gives our team a superior level of experience and expertise in cell collection.
The timing of the harvesting procedure depends on the type of transplant you are having:
- If the bone marrow is coming from a donor, we will harvest it from him/her on the day of the transplant procedure.
- If we are harvesting the bone marrow from you, we will harvest these cells before you receive chemotherapy conditioning for transplantation.
With either you or your donor under general or spinal anesthesia, your specialist will remove a small portion of bone marrow from your or the donor’s hips with a syringe. The amount of marrow taken depends on the patient’s weight and the specific condition to be treated. The body can replace marrow in about two weeks.
Stem Cell Harvesting
Blood stem cell harvesting is another way to obtain the stem cells needed for transplantation.
Your specialist will place a needle into a vein in each of your arms to collect blood into a leukapheresis machine, which removes the white blood cells and returns the other blood cells back to the patient. For some patients, a catheter will be placed into a vein to gain access to blood. This collection procedure has few side effects, and our experienced transplantation nurses will monitor you regularly and a physician will be onsite at all times.
You will be awake the entire time, and after the session, you may go home.
CAR-T Cell Therapy
CAR-T cell therapy is a new, innovative therapy that is used to directly target tumors. CAR-T cells are unique in that they can stay in the body for years and continue to circulate and kill cancer cells. Much like autologous stem cell transplantation, a patient's own cells are collected through a process called apheresis. MedStar Georgetown is an authorized Yescarta® treatment site.
Awards & Recognitions
MedStar Georgetown Awarded FACT Accreditation
Our program, home to the nation’s largest stem cell collection facility, is the region’s only adult, Foundation for the Accreditation of Cellular Therapy (FACT)-accredited program for autologous transplant, allogeneic transplant, and cellular immunotherapy.