Bone Marrow or Stem Cell Transplant

What is a bone marrow transplant or stem cell transplant??

Bone marrow transplant or stem cell transplant may be done to treat certain types of cancer such as leukemia and lymphoma and some inherited diseases, such as Wiskott-Aldrich syndrome and sickle cell anemia.

A bone marrow or stem cell transplant is a procedure in which diseased marrow is replaced by a healthier one. Bone marrow is the spongy tissue inside large bones which makes blood cells, including red and white blood cells and platelets.

Many large hospitals have cancer centers that specialize in these transplantation procedures.

How is bone marrow transplant or stem cell transplant done?

First, the doctor collects stem cells to be used later to replace the destroyed or treated marrow. Stem cells are highly specialized cells that can renew the body's cells. Transplanted stem cells can restore the bone marrow's ability to make blood. For this procedure, stem cells are collected from the bone marrow or from circulating blood, also called peripheral blood stem cell or PBSC transplants.

What is the difference between a bone marrow transplant and a stem cell transplant?

If the stem cells are taken from bone marrow, the procedure is called a bone marrow transplant. If the stem cells are taken from blood samples from the patient or a donor, it's called a stem cell transplant. The choice of which to use depends on many factors, including the illness and the health of the person's own marrow.

Which kind of stem cells will I use?

The decision depends on your disease and other health factors. Your doctor will determine whether to use your own blood-forming cells or cells collected from someone else.

• A transplant using your own cells is called an autologous transplant.
• A transplant using cells from a family member or unrelated donor is called an allogeneic transplant.
• A transplant using cells from an identical twin is called a syngeneic transplant.

How is bone marrow or stem cell transplant performed?

Before the transplant, the person is given high doses of chemotherapy or radiation to destroy the diseased cells. Then, the healthy stem cells (or immature blood cells) are injected through a central line, a tube that goes into a vein in your chest. The procedure is much like a blood transfusion. The stem cells find their way to the marrow space. There they are expected to mature into normal functioning marrow cells. If the procedure is successful, the new marrow starts making blood within several weeks.

How long does the recovery take?

Following the transplant, your doctors will watch you carefully as you recover. The first 100 days are very important. Any type of infection can cause severe problems.

You will likely spend many weeks in the hospital for the entire process. Also, problems with bleeding and infection are fairly common, and will add more hospital days.

What are the risks?

There are many risks.

• While the new blood cells are maturing, the body can't fight infection. That increases the risk for pneumonia and other infections.
• It can be difficult to get a good bone marrow match.
• If the tissue of the person receiving the bone marrow reacts to the donated cells, a serious condition known as graft-versus-host disease may develop.

Having a bone marrow or stem cell transplantation is a major decision, so make sure you talk with your family about it.

Sources:

American Cancer Society

National Cancer Institute

National Institutes of Health (NIH)

National Marrow Donor Program

This article was reviewed and updated June 2007.