Autologous Transplant, Allogeneic Transplant, and CAR-T Cell Therapy

Autologous Transplant

Autologous stem cell transplant involves using your own stem cells after receiving high-dose chemotherapy to fight your cancer. The stem cells are collected by a process called Apheresis, which is performed in the Apheresis unit of the hospital. In most cases, stem cell collection is an outpatient procedure. After stem cells are collected, they are processed and you go home to rest for a week before your hospital admission to receive an autologous stem cell transplant. On the first day of your admission, you will begin a high dose chemotherapy regimen. Depending on the type of treatment prescribed for you, you will receive your transplant after the chemotherapy is completed.  Autologous stem cell transplant involves the infusion of cells, much like a blood transfusion. 

It is not a surgical procedure. Typically, most patients are in the hospital 7-12 days following their autologous stem cell transplant infusion. After receiving high-dose chemotherapy and the stem cell infusion, you are very vulnerable to infection. It’s important to take precautions to protect your immune system like limiting visitors and exposure to anyone with illness. At this point in time, the stem cells are regrowing in your body and strengthening your immune system. Your transplant physician will determine if your stem cells have regrown to a satisfactory level and if it is safe for you to leave the hospital.  You will continue to have close follow up in our clinic on 2E at MedStar Georgetown.

Allogeneic Transplant

Unlike autologous transplant, allogeneic transplant involves finding a suitable donor to collect stem cell from for your transplant. The donor may be a family member or someone from a national bone marrow registry. In any case, a search will be conducted to find the person who most closely matches your own DNA. This is usually done through blood testing and is called HLA typing.

Sibling/Family Member Donors

If blood testing reveals that your family member is the best match, then you will move forward with a family member allogeneic transplant. We call this type of stem cell transplant “matched related”. If your family member is agreeable, we will move forward with testing this person to ensure that they are suitable to donate stem cells. Your family member will be evaluated by a different physician at Georgetown and will undergo a physical exam and blood testing. They must be healthy enough to donate stem cells for you. Any abnormal results will be reported to your transplant physician and a decision will be made on whether or not to proceed forward. If no abnormal results are found, the allogeneic transplant will move ahead as planned. It’s important to note that your donor has to agree to donate stem cells or bone marrow for your transplant.

Registry Donors

If blood testing reveals that you do not have a suitable sibling or family member match, finding a donor from the bone marrow registry may be the best choice. We will conduct a thorough search to ensure that we find a donor that closely matches your DNA. Once the donor is found, they are evaluated through the registry to ensure that they are in good health and able to donate stem cells or bone marrow for your transplant.  The process is completely anonymous, and you will not be given any personal information about your donor.  You may be given the option to meet them at a later point in time after your transplant, if that is something that you would like to do. It’s important to note that the donor must agree to donate stem cells for you.

After the donor is selected, your transplant evaluation is scheduled. You will undergo blood testing and evaluation to ensure that you are well enough to receive an allogeneic transplant. Unlike autologous transplants, allogeneic transplants carry the potential risk of your body rejecting the donor stem cells. Throughout your life, you will continuously be monitored for signs and symptoms of this condition. This condition is called Graft vs. Host Disease.

You will be admitted to the hospital in preparation to receive your allogeneic transplant. You will receive high dose chemotherapy and may or may not receive irradiation before you receive your donor stem cells. The high dose chemotherapy and irradiation get rid of any residual disease and make room in the bone marrow for the new donor cells.

You may also receive other medications and antibiotics that are new to you. Some of the medications are designed to prevent your body from rejecting the new stem cells. Some of the medications are to protect your immune system while it is most vulnerable. An example of this is prophylactic antibiotics-they are given to prevent potential infections.

The donor cells take time to grow in the body. The period of stem cell regrowth is called “engraftment”. You will not be able to go home from the hospital until you have engrafted. The expected period of time you will be in the hospital is estimated to be 14-28 days.

After your allogeneic transplant, you will be seen in the 2E outpatient clinic at MedStar Georgetown. You will be monitored closely by the transplant physician and clinical team.

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 from chemotherapy. They can stay in the body for years and continue to circulate and kill cancer cells.

 Much like autologous stem cell transplant, patients collect their own T-cells through a process called Apheresis. The T-cells are removed and shipped to a processing lab for manufacturing. In the lab, a special tumor fighting antigen is attached to the T-cells. This manufacturing process can range from 14 days to one month.

In preparation for CAR-T, you will receive chemotherapy to make room in your body for the new T-cells. This chemotherapy may be given inpatient or outpatient.

After you have received chemotherapy, you will receive the CAR-T infusion. The infusion can be performed either inpatient or outpatient, dependent on your diagnosis and type of CAR-T therapy prescribed. The infusion takes about an hour and you’ll be closely monitored for several hours afterwards.

The biggest side effects of CAR-T include the development of Cytokine release syndrome (CRS) and neurotoxicities. CRS syndrome means that your body is setting up an immune response and substances called cytokines are released.  Signs of CRS include lowered blood pressure, fever, rash, chills and abnormal laboratory values. Some patients will require care in an intensive care unit (ICU).

Neurotoxicity signs include dizziness, forgetfulness, and seizures. Some patients may experience difficulty in speaking or writing. Your doctor and clinical team will monitor you carefully for abnormal symptoms and signs of neurotoxicity.

Treatment does not end after CAR-T therapy. You will require monitoring over a period of years to ensure that your cancer does not come back. You may require more CAR-T cell infusions or additional chemotherapy.

To learn more or make an appointment with a specialist, please call our scheduling line. 

202-444-3736

 

Program Specialists


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.

FACT Gold Seal

Thank You for Registering

Thank you for registering for MedStar Georgetown's Shoulder Lecture
on Wednesday, May 22, 2019.

 

We look forward to seeing you!

Check-in begins at 6:30 p.m. Light refreshments will be served and parking will be validated.

If you have any questions, please call 202-295-0510.

Location

Bethesda Marriott
Grand Ballroom - Salons A-D
5151 Pooks Hill Rd.
Bethesda, MD 20814
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Parking

The Bethesda Marriott has an on-site parking lot adjacent to the hotel. Parking is free with validation.

Metro and Complimentary Shuttle Service

The Bethesda Marriott offers a complimentary shuttle service from the Medical Center Metro Station until 11 p.m. upon request by calling 301-897-9400. Shuttle service is offered to the Medical Center Metro Station from the hotel until 11 p.m. and offers continuous departures.

Thank You for Registering

Thank you for registering for our free Kidney Transplantation Lecture. Please see below for details.

 

Kidney Transplantation Lecture

Wednesday, March 13, 2019
7:00 - 8:30 p.m.

Location 

Westin Tysons Corner
7801 Leesburg Pike
Falls Church, VA 22043
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Featuring Topics

  • Transplantation: An Overview and Outcomes
  • Living Kidney Donor Transplant
  • How to Prepare for Transplantation
  • A Personal Experience With Living Donor Transplant (Hear from a donor and recipient)

 

If you have additional questions about this event, please contactLinden Spruill at [email protected] or 202-877-7247.

  

We look forward to seeing you there!

Thank You

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Thank you for requesting a consultation with a MedStar Health provider.

A representative will call you within one business day.

Thank You – GERD Lectures

Thank you for registering for MedStar Georgetown's GERD Lecture on Tuesday, May 14, 2019.

We look forward to seeing you! 

Check-in begins at 6:30 p.m. Light refreshments will be served and parking will be validated.
If you have any questions, please call 202-295-0510.

Location
Bethesda Marriott
Congressional Ballroom
5151 Pooks Hill Rd.
Bethesda, MD 20814

Parking
The Bethesda Marriott has an on-site parking lot adjacent to the hotel. Parking is free with validation.

Metro and Complimentary Shuttle Service
The Bethesda Marriott offers a complimentary shuttle service from the Medical Center Metro Station until 11 p.m. upon request by calling 301-897-9400. Shuttle service is offered to the Medical Center Metro Station from the hotel until 11 p.m. and offers continuous departures.

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Learn more about MedStar Orthopaedic Institute

MedStar Georgetown University Hospital, part of the MedStar Orthopaedic Institute, is recognized for excellence in orthopedics.  With one of the area’s most comprehensive teams of fellowship-trained orthopedic surgeons, we are a leader in the diagnosis and treatment of a wide range of musculoskeletal conditions, including disease and injuries to the bones, muscles, tendons, or ligaments. In addition, MedStar Georgetown houses several of the few fellowship-trained orthopedic surgeons in the region who specialize in shoulder and foot and ankle conditions.

At MedStar Georgetown, our specialty care programs offer the most advanced diagnostic tests, surgical as well as nonsurgical and minimally invasive procedures, sophisticated pain control, long-term rehabilitation and support throughout the entire process.  No matter how simple or complex the orthopedic condition, we have the expertise and compassion to help.

Our areas of expertise at MedStar Georgetown include foot and ankle, hand and wrist, shoulder and elbow, spine, total joint replacement, pediatric orthopedics as well as sports medicine.

Thank You – GI Community Lectures

Thank you for registering for MedStar Georgetown's Barrett’s Esophagus and Esophageal Cancer Lecture on Tuesday, May 7, 2019.

We look forward to seeing you! 

Check-in begins at 6:30 p.m. Light refreshments will be served and parking will be validated.
If you have any questions, please call 202-295-0510.

Location
Bethesda Marriott
Congressional Ballroom
5151 Pooks Hill Rd.
Bethesda, MD 20814

Parking
The Bethesda Marriott has an on-site parking lot adjacent to the hotel. Parking is free with validation.

Metro and Complimentary Shuttle Service
The Bethesda Marriott offers a complimentary shuttle service from the Medical Center Metro Station until 11 p.m. upon request by calling 301-897-9400. Shuttle service is offered to the Medical Center Metro Station from the hotel until 11 p.m. and offers continuous departures.

Thank You – LAUNCH Parent Group

Thank you for your request.

Thank you for requesting a spot in the MedStar Georgetown University Hospital LAUNCH parent group. 

A representative will be contacting you to confirm your spot in the program.