An overview of stem cell transplant as a treatment for cancer.

T National Cancer Institute estimates that 10.1 million Americans have a history of cancer, and that three of every four American families will have at least one family member diagnosed with the disease (National Cancer Institute, 2006). Stem cell transplantation (SCT) has been used for over 50 years (Kolb, Gidwani, & Grupp, 2006) to treat a multitude of cancers and non-myelodysplastic diseases after patients have completed standard treatment regimes. SCT usually is used to treat hematologic and lymphoid cancers, such as acute lymphocytic leukemia, acute myelogenous leukemia, chronic myelogenous leukemia, Hodgkin’s disease, multiple myeloma, and non-Hodgkin’s lymphoma (Copelan, 2006). Transplantation early in the course of the disease is critical in patients with hematologic cancers (Copelan, 2006). Every year thousands of patients undergo SCT to “rescue” them from highdose chemotherapy, which ablates the bone marrow (Ball, 2003). Other disease entities that are now being treated with SCT include genetic diseases, acquired anemias, germ cell tumors, primary amyloidosis, myelodysplastic diseases, neuroectodermal tumors and ependymoma, ovarian cancer and germ cell tumors arising in the ovaries, solid tumors of childhood, and other diseases classified as rare diseases (Copelan, 2006; Kolb et al., 2006). Additionally, SCT is still considered investigational for numerous nonmalignant autoimmune diseases such as lupus, but may offer a cure or a better quality of life (Burt et al., 2006; Petri & Brodsky, 2006). Because many medical-surgical nurses will come in contact with SCT patients before and after the actual transplants (and perhaps due to staffing shortages within specialized transplant units), stem cell use in combating malignancy and the nurse’s role in the process will be described. Nursing care and the complexity of this care continue to change, and nurses must respond to and reassess the need for practice changes constantly to provide high-quality care. CNE Objectives and Evaluation Form appear on page 190.