Maisonneuve-Rosemont Hospital Université de Montréal

Autologous transplants

What is an autologous transplant?

Also referred to as autotransplantation, an autologous transplant involves collecting stem cells from patients and then, following intensive chemotherapy and/or radiotherapy designed to kill any remaining tumour cells that have resisted standard treatment, reintroducing those cells into their bodies.

The transplant basically includes three steps:

  1. collecting HSCs from the patient to make up the transplant, which will be cleansed, if necessary, of diseased cells and then frozen while awaiting the transplant;
  2. eradicating the tumour or diseased cells within the patient’s body through intensive chemotherapy and/or radiotherapy;
  3. infusing the transplant into the patient’s body, which will enable it to rebuild a healthy immune system and blood cells.

Autologous transplants are recommended in order to enable patients to receive intensive chemotherapy and/or radiotherapy treatment. In this case, prior removal of their stem cells protects them from the adverse effects of the chemotherapy and/or radiotherapy. Following this intensive treatment, the transplant will help the body recover and rebuild its immune and blood systems.

Since the body’s defence mechanisms are greatly undermined by such intensive therapies, patients must remain in isolation to protect them from any type of infection. They then depend upon blood transfusions to shore up their blood systems until the transplant has had time to take. Patients are also given antibiotics as a further precaution.

In an autologous transplant, therefore, the patient is both the donor and the recipient.

When an autologous transplant is indicated

Autologous transplants are recommended when patients are in remission or have minimal disease. It is used mainly in the case of such diseases as multiple myeloma, Hodgkin’s and non-Hodgkin’s lymphomas, certain solid tumour cancers and auto-immune diseases.

Advantages of an autologous transplant

Obviously, there is no risk of rejection with an autologous transplant, since patients receive their own cells. Their white blood cells, therefore, will not take the transplant for an intruder and go on the attack in order to eliminate it. This results in faster patient recoveries, and also means they do not have to take immunosuppressors or anti-rejection drugs.

Complications related to autologous transplants

Despite the enormous advantage represented by the impossibility of transplant rejection, autotransplantation is not without its risks.

The greatest of these risks are related to the pre-transplant chemotherapy and/or radiotherapy. Involving high-dose treatment designed to eliminate those tumour cells resistant to standard dosages, these pre-transplant treatments can also destroy the defence mechanisms of the body’s immune system. Patients therefore risk complications related to infections or the chemotherapy/radiotherapy’s toxicity. In addition, there is a danger that the initial disease could recur.

Mortality rate

In the best transplantation centres, the mortality rate for autologous transplants is less than 5%. The deaths that do occur following such transplants are mainly seen in older patients who have other health problems in addition to a blood-related disease.

Survival rate

The survival rate without disease recurrence depends upon the type of disease for which the transplant was performed.