Infusion therapy

Infusion therapy in Denver

Infusions deliver critical medications, fluids and treatments directly to your bloodstream.

At Colorado Blood Cancer Institute, we understand that invasive cancer treatment can be stressful to both your body and mind. To ease these obstacles, we offer infusion therapy, which you receive awake and in our comfortable setting.

Comprehensive infusion care

Infusion therapy can be used in a variety of ways, so the type and severity of your condition will ultimately determine the form and manner in which you'll receive it.

Chemotherapy

Chemotherapy is a form of infusion therapy that works to stop cancer cells from multiplying, destroying them in the process.

We specialize in two types of initial induction chemotherapy. The first type is standard chemotherapy, which is usually administered at your referring oncologist’s office through an IV. If this proves effective, additional rounds of high-dose chemotherapy may potentially be used to eliminate any remaining cancer cells. However, it is important to know that if your body does not respond to standard chemotherapy, it is less likely to respond to high-dose chemotherapy, so other treatments will need to be explored.

The second type of chemotherapy we use is called mobilization chemotherapy, which is only used for those receiving what's known as an autologous stem cell transplant.

Conditions we typically treat with chemotherapy include:

• Acute lymphoblastic leukemia (ALL)
• Acute myeloid leukemia (AML)
• Amyloidosis
• Multiple myeloma
• Myelodysplastic syndromes (MDS)
• T-lymphoblastic lymphoma

After treatments for ALL and AML in particular, we may perform what is known as consolidation chemotherapy, which works to kill all remaining leukemic cells living at an undetectable level. By doing so, we can hopefully restore normal blood cell production and move your condition towards the complete remission phase.

Mobilization

Mobilization is the process of pushing stem cells out of your bone marrow and into your blood. This is done using certain drugs which increase the number of stem cells in the bloodstream prior to collection for an autologous stem cell transplant. Two common methods of mobilization are colony stimulating factors (CSFs) and chemotherapy.

With mobilization chemotherapy, we expect your blood counts to drop for several days afterwards, so we closely monitor your complete blood count (CBC) in the ensuing days. An oral antibiotic will often be prescribed as a layer of protection during this period where your blood count is low.

The current stage of your disease, as well as any past treatments, will ultimately help your physician determine the full scope of your mobilization treatment.

CSFs

CSFs are human proteins produced by the body to increase blood cell production. As the stem cells in the bone marrow begin producing more blood cells, more stem cells are also produced and released into the bloodstream. This is done to treat those with abnormally low amounts of blood cells, such as when you've completed chemotherapy treatments.

Stem cell collection

Stem cell collection is the first step in the process that leads to a transplant. Apheresis is the procedure we use to collect stem cells from your blood, and collection takes an average of one to two five-hour sessions.

Collection takes place in the infusion center at HCA HealthONE Presbyterian St. Luke's, and is performed by a specialized apheresis technologist. These trained technicians operate the apheresis machine, which withdraws blood from a central venous catheter (CVC) and circulates it through a centrifuge. This then separates out your stem cells and returns the remaining blood into your bloodstream. During the procedure, you may relax in your chair while reading or watching television.

For autologous transplants, your cells are cryopreserved and stored under special conditions until they are needed. Cryopreserved cells can be stored indefinitely.

For allogeneic transplants, stems cells from related donors are most often infused into you on the same day they are collected from the donor. This eliminates the need for cryopreservation. In the event all the stem cells are not needed, the excess cells will be cryopreserved for possible future use. Fresh stem cells are viable for 48 hours.

Bone marrow harvest

A bone marrow harvest is done to collect stem cells from your bone marrow. As opposed to the nonsurgical nature of apheresis, a bone marrow harvest is achieved using large needles to extract the stem cells. Depending on the state of your condition, a bone marrow harvest may be recommended instead of apheresis for stem cell collection.

Stem cell transplant

Similar to a blood transfusion, a stem cell or bone marrow transplant involves infusing healthy stem cells into your bloodstream, in order to replace damaged bone marrow. The procedure is performed using a CVC.

Before a transplant, we will typically perform a chemotherapy or radiation therapy conditioning regimen so your body can be prepared to receive new stem cells. When you have completed a conditioning regimen, your own or donated stem cells will be given to you. The timing for reinfusion of these stem cells varies from zero to three days after your conditioning regimen is completed.

We perform both allogenic and autologous stem cell transplants. Allogenic transplants involve receiving stem cells from a genetically-matched donor, while autologous transplants involve receiving stem cells collected from your own body.

Conditions typically treated with stem cell transplants include:

• ALL, depending on how the disease responds to initial chemotherapy sessions
• Amyloidosis
• Chronic myeloid leukemia (CML), particularly for more advanced forms of the disease when oral medications have proven ineffective
• Multiple myeloma
• MDS, particularly those with an intermediate or high risk and who also have an available matched donor
• Non-Hodgkin lymphoma (NHL)
  

Engraftment

Your stem cells are expected to grow and begin producing blood cells two to three weeks following your transplant, which is a process called engraftment. During engraftment, you may notice aching in your bones, especially in your pelvis, lower back and thighs. Your white blood cells are the first to engraft, followed by platelets, then red blood cells. If this process occurs, it means the transplant is working properly.