Reinfusion of your stem cells in autologous stem cell transplant
Your stem cells are reinfused (given back) one to two days after you finish your high dose chemotherapy treatment. This gives your body time to flush out the chemotherapy drug(s) before your stem cells enter your blood. The process is a lot like having a simple blood transfusion.
The day of your autologous stem cell transplant is called “Day Zero”. From Day Zero onward, your health care team will count each day as “Day One”, “Day Two”, “Day Three” and so on.
Your stem cell reinfusion day
If you were already admitted to the C7 Inpatient Unit for your high dose chemotherapy before your stem cell transplant, the stem cells will be brought to your hospital room on your Day Zero.
If you had your high dose chemotherapy as an outpatient but are having your stem cell transplant as an inpatient, you will be admitted to the C7 Inpatient Unit. Come directly to the Inpatient Unit for 9:00 a.m.
- You do not need to check in at the Admitting Department.
- You will be seen by the nurse who will check how you are doing, measure your weight and blood pressure, check your medical history and medication lists, and use your central line for blood work.
- You will get medications to reduce any side effects before you get your stem cells back.
- Your cryopreserved (frozen) stem cells will be thawed (unfrozen) in a warm water bath outside your room.
- When your stem cells are thawed, the bag will be hooked up to your central line and given back to you like a transfusion.
- It will take 10 - 15 minutes per bag to reinfuse (give you back) the stem cells. There can be anywhere from two to eight bags on average.
A nurse will be by your side during the infusion of your stem cells to monitor and help you if needed. A doctor or nurse practitioner will be close by during the transplant.
If you are having an outpatient transplant
Come directly to the C7 Day Hospital for 7:30 a.m. You do not need to check in at the Admitting Department.
- You will be seen by the nurse who will check how you are doing, measure your weight and blood pressure, check your medical history and medication lists, and take your blood tests from the central line.
- You will get medications to reduce any side effects before you get your stem cells back.
- Your cryopreserved (frozen) stem cells will be thawed (unfrozen) in a warm water bath outside your room.
- When your stem cells are thawed, the bag will be hooked up to your central line and given back to you like a transfusion.
- It will take 10 - 15 minutes per bag to reinfuse (give you back) the stem cells. There can be anywhere from two to eight bags on average.
- A nurse will be by your side during the infusion of your stem cells to monitor and help you if needed. A doctor or Nurse Practitioner will be close by during the transplant.
- You will have to stay for at least two hours after your infusion has finished to make sure you are ok to be released home with your caregiver
- Depending on how you react to your infusion, you may need to be admitted. This means that you would not go home with your caregiver and need to stay to be cared for on the C7 inpatient unit.
While your stem cells are being given to you (during your transplant):
You may:
- Feel nauseated (feeling like you have to throw up).
- Have some discomfort (feeling dizzy, nervous).
- A cold feeling in your chest because the thawed stem cells are cooler than your body temperature.
- Have an odd taste or smell like canned corn or garlic. This is due to the preservative called dimethylsulfoxide (DMSO). DMSO is added to the stem cell bag to protect your stem cells when they are frozen. If needed, you can suck on a hard candy that we will give you during the transplant to help get rid of this taste.
After your stem cells have been given back (after the transplant):
- Your urine may be red for a few hours after the transplant and should stop after 24 hours.
- The canned corn taste and smell from the DMSO will stay in your breath and sweat for 24 to 48 hours after the transplant.
- We will monitor your temperature, blood pressure and other vital signs for a few hours.
Family members or friends are welcome during the reinfusion.
It will take about 60-90 minutes in total for the reinfusion. During this time, you can rest, read, listen to music, watch television, or visit with your family and friends.
Recovering from your transplant
Your white blood cells, red blood cells and platelets will be very low for seven to ten days after the start of chemotherapy. You are at the greatest risk for an infection and bleeding during this time. Once your stem cells are put back into your blood stream, they begin to move back into your bone marrow where they will grow and start to make new blood cells. The new stem cells will help replace the bone marrow destroyed by the chemotherapy.
During your transplant recovery, you will need to wait for your transplanted stem cells in your bone marrow to start replacing the blood cells that were destroyed by the high dose chemotherapy. This may take 12 to 14 days but can sometimes be longer.
Daily things that will happen during your transplant:
- During your transplant recovery, you will be assessed by a physician and/or NP daily. This assessment will occur in the C7 Day Hospital (for outpatients) or your hospital room on the C7 inpatient unit (for inpatients).
- You will likely get blood work daily every morning between 3:00 a.m. and 5:00 a.m. or at your C7 Day Hospital daily appointments.
- Your temperature, blood pressure, heart and breathing rate will be taken regularly.
- We will weigh you or ask you to weigh yourself with the scale in your room and write it down on a piece of paper.
- We will check your body for signs of bleeding, bruising or infections.
Let the nurse know if you:
- See any bruising or little red spots on your body
- Have blood in your stool or urine
- Have a nosebleed
- Have a fever, chills or a cough
- Have skin redness, tenderness and/or swelling around your central line
Depending on your test results and how you are feeling, you may need:
- A transfusion of red blood cells or platelets if your counts are low
- Antibiotics (medication to fight infection) through the central line
- Extra intravenous fluids to help you stay hydrated.
- Nutrition support either by mouth or through the central line
- Other tests, such as chest x-ray, ultrasound, urine tests, CT scans. Often these are done to look for sources of infection.
What should you eat and drink during your hospital stay?
Eating
You can order foods from our menu. We also have a small kitchen where staff can get you other foods such as toast, broth, popsicles, ice cream, cookies, cheese and crackers. If you need assistance with making food choices, ask to meet with our dietetic assistant.
We recommend choosing high protein or high calorie foods if you are not eating very much. If you are having a hard time keeping up your calorie intake, we also have meal replacement drinks.
If your mouth is dry, you will find drier foods, such as bread, bagels and muffins, hard to eat unless you use butter or margarine.
If you have nausea that is made worse by smells, you should choose cold menu items as hot ones often have a stronger smell.
If you family wishes to bring in food for you, it must be brought freshly prepared and eaten the same day. We do not have a place to store food that needs to be refrigerated. If food needs to be heated, please use the microwaves in the cafeteria.
Drinking
Try to drink at least 1 to 1.5L (4 to 6 cups) of fluid every day. Water, juice, soups, and even Jello or popsicles are all good fluids. Some patients find it hard to drink this much fluid, but most patients can manage it by drinking small amounts throughout the whole day. Acidic juices (like orange) may bother your stomach, and caffeinated drinks (tea, coffee, cola) should not be taken in large amounts.
We have milk, juice, Powerade and ginger ale at the hospital. If you like other drinks you can bring them in and we can get you ice.
Visitors during your stay
Children under 12 are not permitted to visit during your stay.
Children may be contagious even if they do not have any signs or symptoms of being sick. Your infection fighting ability will be low and you are at high risk of getting an infection. Even a common cold can be serious.
No visitors are allowed to sleep overnight in the room.
If there is a medical emergency, sleeping visitors may delay us in giving you emergency medical care. As well, we want your caregivers to be able to rest while you are in hospital. They will need to help care for you when you are discharged home.
Mobility
It is important to keep active during your hospital stay. Keeping active will help you prepare for discharge home and recover after the transplant.
It is safe for you to leave your room and walk around the oncology inpatient unit. If you need mobility aids such as a cane or walker, we can provide you with these resources while you are in the hospital.
