What happens during stem cell transplants?

Conditioning is the first step in stem cell transplant. You will receive chemotherapy or radiation therapy during this period to destroy and damage your bone marrow.

Stem cell transplant replaces bone marrow that has been damaged with healthy stem cells. Stem cell transplantation can be viewed as a transfusion, which involves the transfer of blood and immune cells, rather than a surgical procedure.

Your blood count would be affected if your bone marrow was not replenished following very high doses. Your blood count should return to normal within two to six weeks after a stem cell transplant.

What is chemotherapy?

Chemotherapy, which is a treatment that uses anti-cancer drugs to kill cancer cells, is also known as chemotherapy. The treatment’s goal is to eliminate as many cancer cells as possible.

Non-cancerous cells can also be affected by chemotherapy. Normal cells are bone marrow, hair, and reproductive system cells.

What is radiation therapy?

Radiation therapy uses high-energy beams or X-rays to kill cancer cells. Radiation therapy is often combined with chemotherapy.

What is total body radiation?

Total body radiation treatment is sometimes used to treat stem cell, transplant recipients. Total body radiation is not like radiation that only targets one area of the body. It treats the whole body with radiation to kill cancer cells and suppress the immune response.

What effects do radiation and chemotherapy have on my blood cells?

Cancer cells grow faster than any other cells in your body so chemotherapy can affect cells that grow rapidly more than those that grow slowly.

Some normal cells, such as blood cells, can grow at a rapid rate. One side effect of chemotherapy may be that it can kill young blood cells while they are still growing. Your blood cell count can fall to its lowest point in as little as three to ten working days.

Radiation is used to prepare for stem cell transplant. It targets cancer cells and suppresses your immune response.

To determine how many blood cells you have, your blood will be tested. This is known as having your “counts” tested. Your counts are monitored daily while you’re in the hospital. Your doctor or nurse will inform you when your blood count is expected to drop. Your nadir is the time at which your platelet and white blood cell counts are lowest.

Understanding how your counts affect your treatment, activity level, and infection exposure is crucial.

White blood cells

Fighting infection is done by white blood cells. Normal white blood cell counts range from 4,000 to 10,000.

There are three types of white blood cells, namely neutrophils (lymphocytes), monocytes (monocytes), and lymphocytes (neutrophils). The most important infected cells are neutrophils. They consist of both polys and bands. The absolute neutrophil count (ANC) is the sum of all polys and bands.

What happens if my counts drop?

Your risk of infection increases when your ANC falls below 500. This is known as neutropenia. To stimulate bone marrow production and speed up recovery, your doctor may recommend a colony-stimulating agent called G-CSF (or GM-CSF).

Your risk of infection decreases when your ANC is healthy, but there are still risks for viruses and fungi. Your immune system may not fully recover in as little as one to two more years.

Calculating your absolute neutrophil count (ANC)

Calculating your ANC is as easy as taking the total white blood cells and multiplying that number by the percentage of polys.

2,500 WBC count X .50 Poly count = 1,250 (no neutropenia)
1,250 WBC count X.20 Poly count = 250. (Neutropenia).

Red blood cells

Your body’s red blood cells carry oxygen throughout the body. The hemoglobin (Hgb), and the hematocrits (Hct) are two ways to measure red blood cells. Hemoglobin ranges from 14.0 to 18.0. The normal value of hematocrit ranges from 37 to 52.

Anemia is a condition where your red blood cells count is too low. You might feel tired and short of breath more often than normal. You may feel tired or short of breath more often than usual. This could be due to the treatment you are receiving.

Your care team might recommend a blood transfusion if your red blood cells count is low.


Your blood clots when you have a cut or bruise. Platelets are what help you stop bleeding. Normal platelet counts range from 150,000 to 400,000.

Your platelet count below 50,000 puts you at a greater risk of bleeding. However, the risk remains low until your count drops to 21,000.

Low platelet counts are known as thrombocytopenia. A low platelet count can lead to transfusions. This depends on the clinical situation.

Your platelet count will help you decide if physical therapy or exercise is necessary during each stage of the transplant process.

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