Bone marrow transplant glossary
Medical terms to know
Absolute neutrophil count (ANC) — Neutrophils are a type of white blood cell that helps keep the body from getting an infection. Doctors look at neutrophils in blood to determine when a transplant is beginning to work or when a patient is healing from chemotherapy treatment. (See engraftment, neutrophil.)
Allogeneic transplant (al-o-je-n’ay-ik) — Also known as an allo transplant. Stem cells are taken from someone other than the patient. The other person (a donor) may be a family member or someone else who is found to be similar to the patient.
Anemia — Red blood cells carry oxygen throughout the body. Anemia is when red blood cell numbers are too low. This can make patients feel tired, short of breath and cold all the time.
Apheresis (af″ĕ-re´sis) — The procedure used to remove stem cells from the peripheral blood. Blood is moved from a vein, through a tube and into an apheresis machine. This machine filters out the stem cells and returns the rest of the blood to the body through another vein. The stem cells that were removed are saved for use later during a transplant.
Autologous transplant (aw-to’l-o-gus) — Also known as an auto transplant. In an autologous transplant, a patient's own stem cells are collected before chemotherapy and given back later. The patient is both the donor and recipient of the stem cells.
Benign — Not cancerous.
Bone marrow — The soft tissue inside of large bones where stem cells and blood cells are created. Stem cells in the bone marrow create white blood cells, red blood cells and platelets.
Bone marrow harvest — A surgical procedure used to collect bone marrow.
Bone marrow transplant (BMT) — A BMT is done to replace damaged cells from cancer with new healthy stem cells. A bone marrow transplant may be autologous or allogeneic. (Also see peripheral blood stem cell transplant.)
CAR T-cell therapy (chimeric antigen receptor T-lymphocyte cell therapy) — A promising treatment for recurring or resistant types of non-Hodgkin’s lymphoma such as diffuse B-cell lymphoma, primary mediastinal B-cell lymphoma, and transformed follicular lymphoma. The patient’s own immune system is used to recognize and eliminate cancer cells.
Chemotherapy — A drug that destroys cancer cells. Chemotherapy is used before a stem cell transplant. The kind of drugs used in chemotherapy depends on a patient's disease, age and health.
Central line catheter — The central line is a catheter, or thin plastic tube, that is put into a large vein that runs near a person's neck. Stem cells can be collected (apheresis) through this tube. The catheter will stay in place throughout a patient's transplant and will be taken out when a doctor decides he or she no longer needs it.
Collection — See apheresis.
Colony stimulating factors (CSFs) — Proteins that are made by the body to speed up the growth of blood cells. CSFs can be given by a shot to help the body make more blood cells in preparation for collection by apheresis.
Conditioning — The process of getting a patient ready to have a bone marrow or blood cell transplant is called conditioning. Chemotherapy with or without radiation therapy is often used. It is also known as a preparative regimen.
Discharge planning — Preparing to leave the hospital. Medical staff members determine what a patient will need at home and give him or her instructions. This plan also informs the patient on when to see his or her doctor.
Donor — A person who can give stem cells from their blood to be used for a transplant.
Engraftment — The point when the stem cells given to a patient during a transplant start to grow and make new blood cells.
Fatigue — The feeling of being tired and having little energy.
Filgrastim (G-CSF) — The man-made version of a normal human protein that increases the number of blood cells in the body. (See colony stimulating factors.)
Graft-versus-host-disease (GVHD) — This can develop after an allogeneic transplant if the immune cells from the donor see the recipient's tissues as foreign. GVHD can arise even when the transplant comes from a matched related donor. This does not happen when a patient uses his or her own cells in an autologous transplant.
Harvesting — Collecting/removing stem cells from the body. (See apheresis or bone marrow harvest.)
Hematopoietic cells — Blood stem cells found in the bone marrow and blood. These cells can grow into red blood cells, white blood cells or platelets. Also called blood-forming cells or progenitor cells.
Hemoglobin (Hgb) — The part of a red blood cell that carries oxygen.
HLA typing — HLA stands for human leukocyte antigens. These proteins are present on each cell and allow the immune system to recognize "self" from "foreign." HLA typing is used to match patients and donors for stem cell and organ transplants. It is also called HLA testing.
Immune system — The body’s system to fight against disease.
Induction phase — This part of a transplant is the regular chemotherapy a patient gets beforehand. Induction is done first in order to shrink the cancer or disease as much as possible before the transplant.
Infusion — An infusion is when fluid is introduced into a patient's blood through a vein. Red blood cells, platelets and stem cells are all given through infusion.
Low bacteria diet — See neutropenic diet.
Lymphocyte — A type of white blood cell. It is an important part of the body’s immune system.
Maintenance treatment — Continuing treatment after a transplant. Usually this is treatment in a smaller dose given for up to a year or more to help keep the transplant successful.
Malignant — Cancerous.
Mobilization — The treatment given to prepare a patient for a transplant. This is done to get the stem cells to move from the bone marrow into the blood stream where the cells can be collected.
Myeloablative transplant — A stem cell transplant that uses very high doses of chemotherapy and/or radiation prior to transplantation with autologous or allogeneic hematopoietic stem cells.
Neupogen® — The brand name for Filgrastim. (See Filgrastim.)
Neutropenia — A condition that occurs when a patient's white blood cell count is very low. White blood cells work to fight off infections. When a patient is neutropenic, he or she is at risk for getting very sick with infection.
Neutropenic diet — A special diet for patients who have a low number of white blood cells. Following a neutropenic diet can help protect a patient from bacteria and other harmful organisms found in some food and drinks. Patients cannot eat fresh, uncooked vegetables on this diet. Patients can eat fresh fruit, but only if they have thick skin, like bananas, and only if they have been washed on the outside. Fruit with thin skin, like apples or grapes, must be cooked before eating. Patients cannot eat deli meats and cheeses on this diet.
Neutrophil — Neutrophils are a type of white blood cell that helps protect the body from infection. Doctors determine how many neutrophils are in a patient's blood to check whether he or she is engrafting after a transplant or healing after chemotherapy.
Non-myeloablative transplant — Also known as a “mini,” “low-intensity” or “reduced-intensity” transplant. This type of transplant uses smaller doses of chemotherapy and/or radiation therapy.
Peripheral blood stem cells (PBSCs) — While most stem cells are found in a person's bone marrow, peripheral blood stem cells are found circulating in the blood stream. PBSCs are easier to collect than those found in the bone marrow.
Peripheral blood stem cell transplant (PBSC) — Stem cells found in the blood are collected through a procedure called apheresis. The stem cells are then frozen and stored. Next, a patient will receive treatment such as chemotherapy or radiation therapy. After treatment, the collected peripheral blood stem cells are given back to the patient. (Also see bone marrow transplant.)
Plasma — The liquid part of blood.
Platelet — A type of blood cell that helps stop bleeding by forming clots.
Prophylaxis — A measure taken to maintain health and prevent disease. A patient will be given prophylactic treatment as part of the transplant procedure. Medications, such as anti-viral and anti-bacterial, will be given in order to help stop an infection before one occurs.
Radiation therapy — Treatment with high-energy rays to destroy or shrink cancer cells.
Recipient — The person receiving the infusion of stem cells is known as the recipient.
Red blood cell — A type of blood cell that carries oxygen to all parts of the body.
Re-infusion — The process of putting stem cells back into a patient's blood after treatment for a disease or cancer.
Recovery — The process of healing after a stem cell transplant.
Relapse — When signs and symptoms of a disease return.
Remission — When signs and symptoms of disease are not present.
Stem cells — Unspecialized cells that are able to produce many different types of cells. These master cells are able to divide throughout their life and create new cells. These new cells can become highly specialized and will take the place of old cells that die or are lost. Stem cells contribute to the body's ability to renew and repair its tissues. There are many different types of stem cells, including embryonic, ocular and hematopoietic.
Stem cell transplant — Stem cell transplant can refer to the use of blood or bone marrow stem cells as a treatment for cancer or other diseases.
T cell — A type of white blood cell that plays an important part in the immune system.
Tissue — Materials from a body, including skin, hair, nails, blood and urine.
Total body irradiation (TBI) — Radiation treatment that is given to the entire body with high-energy rays to destroy or shrink cancer cells.
Tumor — Any strange growth of cells. Tumors can be caused by cancer cells (malignant) or non-cancer cells (benign).
White blood cell — A blood cell that helps fight infection and is part of the immune system.
Insurance terms to know
Appeal — To ask the insurance company to go back over a decision to not pay for a treatment or service.
Approval — An insurance company agreeing to pay for a treatment or service.
Co-insurance — The part or percentage of the cost of a medical service or procedure that the insured person will need to pay. For example, if the co-insurance is 70/30, the health plan pays 70 percent and the insured person pays 30 percent of a medical bill.
Co-payment (co-pay) — A set amount that is owed by the insured person for each medical visit, procedure or prescription. This could be a set dollar amount or a percentage. For example, an insured person may have a $20 co-payment for an office visit. This means he or she will have to pay $20 for a basic doctor office visit. The health plan would pay the rest. Every health plan is different. It is important that patients review their health plans and coverage.
Deductible — The amount the insured person must pay for a treatment or service before the health plan coverage begins. Not all treatments or services may require a deductible.
Denial — An insurance company’s refusal to pay for a medical service or procedure. The opposite of approval.
Drug formulary — A list of drugs that are paid by a health plan.
Exclusion — Treatments or services that are not paid for by a health plan. For example: elective cosmetic surgery.
Explanation of benefits (EOB) — A written statement showing what a health plan will pay, what the insured person needs to pay and/or any action that still needs to be taken. This is not a bill.
Out-of-pocket costs — Health care costs that an insured person must pay on their own because they are not paid by his or her insurance plan. Examples: co-payments, deductibles and co-insurance.
Network provider/participating provider — A doctor, hospital or other health care provider who has an agreement with a health insurance plan to provide services to its members for specific rates. These rates are usually lower than those of providers outside of the network. Out-of-network providers may be available at a higher out-of-pocket cost to the insured, or none of their charges may be paid by the health insurance plan.
Pre-certification/prior authorization — Approval given by a health plan before an insured person starts treatment. The patient must notify the health plan before admission to the hospital to give the health plan time to decide if the treatment or procedure is necessary.