Question

M.J. is a 65-year-old woman who has been diagnosed with acute myeloid leukemia (AML). After undergoing chemotherapy treatment with cytarabine and daunorubicin, she is prepared for an autologous stem cell transplant.

• What are the advantages of an autologous versus an allogenic stem cell transplant?
• What are three complications with s/s that can occur with stem cell infusions?
• What are some prophylactic interventions that can be done for complications?

Two days later M.J. vital signs are T 100.5F, HR 100, RR 28, B/P 90/50. SpO2 94% RA

CBC results:

WBC: 12,000

RBC: 2.9 million/mcl

Hemoglobin: 8.6 g/dL

Hematocrit: 27.2%

MCV: 78

Platelets: 55,000 cells/mcL

*Give two specific complications that are possibly occurring with M.J.

Answer 1

1

Autologous Transplants

• Stem cells are harvested prior to high dose chemo/radiation treatments.
• Stem cells are removed from either the blood or bone marrow then frozen
• No risk of immune system rejection of the transplant.
• Used mainly for leukemia,lymphoma and multiple myeloma
• Useful in non-cancer conditions such as multiple sclerosis and Chrons disease.

Allogenic Transplant

• Stem cells come from a donor whose tissue type closely matches the patient.
• The donor is usually a sister,brother or other family.
• Matched unrelated donors can be found through the national registry.

2 Cncer relapse,Infections,Lung problems,kidney ,liver or heart problems,slowed growth and development and a change in view of life.

3

• Labs must be checked daily to ensure our client is therapeutic
• BP,Heart rate and oxygen saturation must be closely monitored.
• Monitor skin closely.
• Maintain sterile environment,gowns,gloves ,masks if necessary
• Hb <8.5 activity is contraindicated
• <8 blood transfusion

4 M.J maybe at high risk for infection ,,may have a higher risk of bleeding.