Editorial
‘We’re here to support patients for as long as they need us’
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WHAT IS A BONE MARROW OR STEM CELL TRANSPLANT? An allograft transplant is used to treat patients with a blood cancer or blood disorder — nearly two-thirds of all allogeneic transplants in the UK are used to treat leukaemias. The transplant involves replacing the bone marrow stem cells of a patient with stem cells from a tissue-type matched donor. The stem cells are harvested from blood, the bone marrow or umbilical cord blood. Before treatment the patient receives high dose chemotherapy, 12 JCN 2014, Vol 28, No 5
Bowel and bladder problems Liver and kidneys complications Respiratory, cardiac and vascular difficulties such as idiopathic pneumonia syndrome, arrhythmias and congestive heart failure Memory and other psychological changes such as depression and anxiety Immune system problems and late infections Secondary cancers.
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id you know that over 3,000 people in the UK had a bone marrow or stem cell transplant in 2012? Around 1,400 of these were allograft transplants, where the patient receives blood stem cells from a donor — this could be from a sibling or an anonymous donor. Anthony Nolan is a pioneering charity that saves the lives of people with blood cancer and blood disorders. Every day, we use our register to match individuals willing to donate their bone marrow or blood stem cells to people who desperately need lifesaving transplants. But, for the patient, their journey doesn’t end at the point of transplant — a transplant patient is a patient for life and at Anthony Nolan we’re here to support those patients for as long as they need us.
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Anneliese Levy, patient information manager at the charity Anthony Nolan
sometimes with total body irradiation. This destroys any malignant or abnormal cells, provides space for the donor stem cells by eradicating existing bone marrow tissue, and suppresses the patient’s immune system to minimise the risk of graft rejection. The transplant itself is given as an infusion. Once the donor stem cells are infused into the patient’s body, they make their way to the bone marrow. Once there, they will start to grow into normal blood cells — this is called engraftment.
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What are the ongoing effects of a stem cell or bone marrow transplant?
After the procedure, patients will have to spend time in protective isolation to minimise the risk of infection. This is the start of a long road to recovery.
WHAT ARE THE LONG-TERM EFFECTS OF TRANSPLANT? It has been said that a transplant patient is a patient for life due to the gruelling treatment that precedes the transplant and the potential long-term physical and psychological effects. The primary post-transplant illness is graft-versus-host disease (GvHD). This is where cells from the donor attack the patient’s body. Symptoms can range from mild skin, gut and joint problems, to life-threatening complications. Other common late effects include: Infertility, premature menopause, sexual dysfunction Joint, muscle and bone changes Ocular changes such as cataracts Oral difficulties, including dry mouth and increased tooth decay Endocrine disorders, such as hypothyroidism
WHAT CAN YOU DO? Community nurses can look out for any patients in their care presenting with late effects of stem cell transplant. They should still be followed-up by their transplant centre, but it’s important that they receive ongoing monitoring, screening and treatment. Encourage them to approach their GP or transplant centre, or direct them to us in the patient experience team at Anthony Nolan for further information. You can also get in touch with us if you have any questions.
HOW CAN ANTHONY NOLAN HELP? We have a range of free expert resources for your patients. You can direct them to the patient information section on our website (www. anthonynolan.org/patientinfo), or let them know about our transplant community (www.anthonynolan.org/ transplantcommunity). JCN The Patient Experience team at Anthony Nolan are here for patients and their families, every step of the way. They can call us on 0300 303 0303, or email
[email protected]
