Getting rid of cancer cells in autologous transplants

For autologous transplants, some centers clean or “purge” the stem cells before they are given back to the patient. This is done to remove any cancer cells that might be mixed in with them. It’s unclear whether this helps, as it has not yet been proven to reduce the risk of cancer coming back (recurrence).

A possible downside is that some normal stem cells can be lost during this process. This may cause the patient to need more time to begin making normal blood cells and leave the patient without white blood cells or platelets for a longer time. This, in turn, might increase the risk of infection or bleeding problems.

One method that is popular now is to give the stem cells without treating them. Then, after transplant, the patient gets a medicine to get rid of cancer cells that may be in the body. This is called in vivo purging. Rituximab (Rituxan^®), a monoclonal antibody drug, may be used for this. Research is being done to look at the need to remove cancer cells from transplants and the best way to do it.