GCSF injections may cause some pulsating pain in the bone as your bone marrow is being stimulated to form new stem cells. You may also develop mild symptoms of flu. You can take painkillers such as paracetamol to relieve these side effects.

However, if you feel severe pain in the stomach, shoulder tip, or chest, contact our doctor immediately for advice.

You will be given an appointment for the stem cell collection at the Haematology Ward in Mount Elizabeth Novena Hospital. It is vital that you attend your appointment on the correct date; otherwise, it will affect the entire process.

A sample of blood will be taken to check if there are enough stem cells circulating in your bloodstream. The results of this blood test are usually available after 2 hours. If your blood count is high enough, we can begin the stem cell collection procedure.

If your blood counts are too low, the stem cell collection cannot be performed on that day.

In this case, you may be given a dose of Plerixafor as an injection. Plerixafor can help to improve the effectiveness of GCSF by stimulating the entry of stem cells into the bloodstream from the bone marrow. Plerixafor injection will be given by nurses on the haematology ward at around 11 pm. You will be monitored after the injection to assess your response and check for the development of any adverse reactions. You will remain in hospital overnight and proceed to a second day of stem cell collection the next morning.

It should be noted that Plerixafor is approved for use only for patients with lymphoma or myeloma.

Most people do not develop any complications during stem cell collection. The process is not painful, though it may cause mild discomfort.

You may experience a few side effects like tingling around the mouth that occurs due to the low calcium level in your blood. This might occur due to the citric acid, which is mixed with your blood while it is being processed in the cell separator machine to inhibit its clotting.

Inform our nurse if you experience this as the symptoms can be easily be relieved by chewing calcium tablets. If the tingling does not reduce even after chewing calcium tablets, intravenous calcium would be given directly into your vein.

In rare cases, patients develop low blood pressure during the procedure. This symptom may occur in patients who are using medications for high blood pressure. We may ask you to omit these medications in the morning to avoid low blood pressure during stem cell collection.

If the veins in your arms are very narrow, there may be difficulties obtaining a good blood flow. In such cases, we may put a temporary catheter into a larger vein of your neck or chest. The catheter will remain in place only during the collection procedure. The line can be removed immediately after the collection of sufficient stem cells.

Please inform our Apheresis team if you are taking any other medications as you may have to stop using them for a few days before and after the procedure.

• You will be attached to the cell separator machine for several hours during the procedure. Hence, it is advisable to bring something that will keep you occupied like a magazine or book. You can also bring an electronic device as the hospital provides free WiFi.
• You can eat food and drink normally throughout the day.
• It should be noted that you will have to stay connected to the collection machine until the procedure is completed. Hence, if you need to visit a restroom during the procedure, our team will help you use a bottle or bedpan.
• You may feel tired after the procedure. Hence, it is advisable to avoid driving and arrange for someone to drive you home after the procedure.

The cells will be stored appropriately in a stem cell laboratory until you are ready for your stem cell transplant when your cells are given back to you in a way similar to blood transfusions.

Engraftment refers to transplanted stem cells settling into the bone marrow to begin creating new blood cells.

It typically takes between 10-14 days after the transplant for engraftment to occur.

There are a number of complications that can occur after a Stem Cell Transplant. These include both short term and long term complications.

Patients may experience short term complications such as mouth and throat pain, vomiting or nausea, infection, or graft-versus-host-disease (GVHD). Longer-term complications include disease relapse, GVHD, cardiac and hormonal changes, as well as secondary cancers.

Our transplant team will work closely with you through the different phases of your transplant to monitor, prevent and manage any such complications.

The first stage of recovery after a Bone Marrow Transplant typically takes 4 to 6 weeks. This is the period in which our transplant team will monitor you to see if engraftment has occurred.

Typically, patients remain in the hospital until their blood counts stabilise and the patient is fit and independent without any infective complications.

Full recovery after a Bone Marrow Transplant can take between 6 months to a year.

In order for doctors to determine if your bone marrow transplant is successful, your blood count levels need to return to normal along with your immune system. This can take between 6 to 12 months. Our transplant team will continue to monitor you during this period for any issues that may surface.

The cost of a Bone Marrow Transplantation depends on several factors, which include the type of transplant (autologous vs allogeneic), type of donor (related, vs unrelated, vs haploidentical) as well as the disease status of the patient and whether any potential complexities are expected for the procedure.

At CFCH, our team will work to establish the most appropriate treatment strategies for your condition. If a bone marrow transplantation is required, a detailed transparent breakdown of the costs will be provided upfront to you.

If you are concerned about the costs required for your bone marrow transplant, feel free to get in touch with us. We will be happy to help you understand the various fees involved.