HSCT México

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Treatment Timeline

The treatment is a 28-day long procedure which includes 2 rounds of non-radiational chemotherapy divided into four days, stem cell mobilization, harvesting and reintroduced into the body, and lastly, a rituximab infusion.

  • “The specific dosage information of the following medication will be provided during the treatment” (for dosage doubt email hsct@hsctmexico.com)

    - Rituximab,
    - Cyclophosphamide,
    - Filgrastim,
    - ItraconazoleAnti-FungalProphylaxis,
    - MESNA,
    - Dexamethasone,
    - Ondansetron,
    - Sulphametoxazol/TrimetopimAnti-InfectiveProphylaxis,
    - Pantroprazole,
    - Acyclovir
    - Aprepitant.

The treatment starts on day -13 (it is a countdown until the transplant day)

MEDICAL PRE-TESTING
DAY - 13

  • Extensive medical tests include review of patient
  • MRI’s (brain, plus cervical, thoracie & lumbar spine), chest X-ray, blood panel, electrocardiogram, spirometry.
  • Consultation with neurologist, cardiologist & hematologist.
  • Medical history.

CHEMOTHERAPY
DAY - 12 & DAY - 11

  • Two days of initial chemotherapy are administered to condition the immune system, eliminate autoreative cells responsible for autoimmunity and to begin to mobilize stem cells into the blood stream.

STEM CELL MOBILIZATION
DAY -10 & DAY -4

  • To further mobilize the stem cells from the bone marrow into the blood stream, subcutaneous filgrastim injections are given every 12 hours during a eight day period.
  • These will be administered by clinic nurses and medical staff.

STEM CELL
HARVEST DAY -3

  • Catheter placement, if necessary, takes place during an ambulatory procedure at the hospital. An apheresis stem cell collection procedure is conducted, whereby using an automated cell separator, stem cells required for
    the transplant are collected and stored at a controlled temperature.

CHEMO THERAPY
DAY - 2 & DAY - 1

  • Once sufficient stem cells have been harvested, two additional days of high-dose chemotherapy are administered to further reduce white blood cells and suppress the majority of the existing immune system responsible for autoimmunity.

STEM CELL
TRANSPLANT DAY 0

  • Day Zero. Stem cells are given back to the patient

NEUTROPENIC PERIOD
BEGINS DAY +1

  • After the transplant, patients enter a period of minimum immune Function called neutropenia. This varies from patient to patient, but
    usually appears between 48 and 72 hours after the transplant, and will last approximately seven to ten days
  • During this period, neutrophils, which are a type of white blood cell responsible for fighting infections are low. Diet and exposure are highly controlled, patients should follow the neutropenic recommendations provided.

HEMATOLOGY CONSULTATIONS UNTIL
RECOVERY DAY +2 - FWD

  • Periodic Hematology
  • consultations every 48 hours.
  • Blood samples and filgrastim injections will be performed until
    recovery.

RITUXIMAB INFUSION
APPROX DAY +11

  • Upon recovery, a rituximab infusion is given in order to deplete any remaining lymphocytes. At this point patient can return home.

MEDICAL PRE-TESTING
DAY - 13

  • Extensive medical tests include review of patient
  • MRI’s (brain, plus cervical, thoracie & lumbar spine), chest X-ray, blood panel, electrocardiogram, spirometry.
  • Consultation with neurologist, cardiologist & hematologist.
  • Medical history.

CHEMOTHERAPY
DAY - 12 & DAY - 11

  • Two days of initial chemotherapy are administered to condition the immune system, eliminate autoreative cells responsible for autoimmunity and to begin to mobilize stem cells into the blood stream.

STEM CELL MOBILIZATION
DAY -10 & DAY -4

  • To further mobilize the stem cells from the bone marrow into the blood stream, subcutaneous filgrastim injections are given every 12 hours during a eight day period.
  • These will be administered by clinic nurses and medical staff.

STEM CELL
HARVEST DAY -3

  • Catheter placement, if necessary, takes place during an ambulatory procedure at the hospital. An apheresis stem cell collection procedure is conducted, whereby using an automated cell separator, stem cells required for
    the transplant are collected and stored at a controlled temperature.

CHEMO THERAPY
DAY - 2 & DAY - 1

  • Once sufficient stem cells have been harvested, two additional days of high-dose chemotherapy are administered to further reduce white blood cells and suppress the majority of the existing immune system responsible for autoimmunity.

STEM CELL
TRANSPLANT DAY 0

  • Day Zero. Stem cells are given back to the patient

NEUTROPENIC PERIOD
BEGINS DAY +1

  • After the transplant, patients enter a period of minimum immune Function called neutropenia. This varies from patient to patient, but
    usually appears between 48 and 72 hours after the transplant, and will last approximately seven to ten days
  • During this period, neutrophils, which are a type of white blood cell responsible for fighting infections are low. Diet and exposure are highly controlled, patients should follow the neutropenic recommendations provided.

HEMATOLOGY CONSULTATIONS UNTIL
RECOVERY DAY +2 - FWD

  • Periodic Hematology
  • consultations every 48 hours.
  • Blood samples and filgrastim injections will be performed until
    recovery.

RITUXIMAB INFUSION
APPROX DAY +11

  • Upon recovery, a rituximab infusion is given in order to deplete any remaining lymphocytes. At this point patient can return home.
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