Hematopoietic progenitor cell (HPC); autologous transplantation
CPT4 code
Name of the Procedure:
Hematopoietic Progenitor Cell (HPC) Autologous Transplantation
Summary
Hematopoietic progenitor cell (HPC) autologous transplantation involves collecting a patient's own stem cells, treating the patient with high-dose chemotherapy, and then reinfusing the stem cells to restore bone marrow function. This procedure is often used to treat certain hematologic cancers and disorders.
Purpose
HPC autologous transplantation is primarily used to treat:
- Hematologic cancers such as lymphoma and multiple myeloma.
- Certain autoimmune diseases and blood disorders.
The goal is to allow high-dose chemotherapy to eliminate cancer cells without permanently damaging the bone marrow. The procedure aims to restore normal blood cell production and improve patient survival rates.
Indications
- Patients with certain types of lymphoma or multiple myeloma.
- Patients who have not responded well to conventional chemotherapy.
- Those with recurrent or refractory disease.
- Selected cases of autoimmune diseases and blood disorders.
Preparation
- Complete physical examination and medical history review.
- Blood tests, heart and lung function tests.
- Potential central venous catheter placement.
- Pre-procedure chemotherapy schedule.
- Instructions about medications, including stopping certain drugs.
- Avoidance of food and drink starting the night before the procedure.
Procedure Description
- Stem Cell Collection:
- Administration of growth factors to stimulate stem cell production.
- Collection of stem cells from the blood using apheresis.
- High-Dose Chemotherapy:
- Administration of high-dose chemotherapy to kill cancer cells and suppress bone marrow.
- Stem Cell Infusion:
- Reinfusion of the patient's previously collected stem cells via a central venous catheter.
Duration
The entire process, from stem cell collection to reinfusion, can take several weeks. The stem cell infusion itself typically takes a few hours.
Setting
The procedure is performed in a specialized hospital setting, often in a dedicated transplant unit.
Personnel
- Hematologist/Oncologist
- Transplant Coordinator
- Apheresis Nurse
- Chemotherapy Nurses
- Support staff including nutritionists and social workers
Risks and Complications
- Infections due to immune suppression.
- Bleeding and anemia.
- Graft failure (failure of the transplanted cells to engraft).
- Organ damage from chemotherapy.
- Allergic reactions to the infused stem cells.
Benefits
- Increased chance of remission in certain cancers.
- Potential cure for selected autoimmune diseases.
- Restoration of normal blood cell production.
- Improved survival rates in appropriate cases.
Recovery
- Close monitoring in the hospital for several weeks.
- Regular blood tests to monitor engraftment and blood counts.
- Avoiding exposure to infections.
- Follow-up appointments for ongoing assessment and care.
Alternatives
- Conventional chemotherapy or radiation therapy.
- Allogeneic stem cell transplantation (using donor cells).
- Immunotherapy.
- Targeted therapy.
Pros and Cons:
- Autologous Transplantation: Lower risk of rejection but higher risk of cancer relapse.
- Allogeneic Transplantation: Potentially curative but higher risk of complications like graft-versus-host disease.
Patient Experience
Patients may experience:
- Fatigue and weakness from high-dose chemotherapy.
- Discomfort from central venous catheter placement.
- Emotional stress and anxiety.
- Potential side effects such as nausea and mouth sores. Pain management and comfort measures will be provided throughout the process to alleviate symptoms.