

Bone marrow is the spongy tissue found inside bones. It contains stem cells that produce the body’s blood cells. A bone marrow transplant, also called a stem cell transplant or blood and marrow transplant, replaces cancer cells or unhealthy stem cells that can no longer produce blood cells with healthy cells. Stem cells can be harvested for transplant from bone marrow, the umbilical cord blood or from peripheral blood (the blood that circulates throughout the body).

While commonly called a bone marrow transplant, the procedure can also be called a peripheral blood stem cell transplant or a cord blood transplant, depending on the source of the stem cells.

Allogeneic Bone Marrow Transplants

When you receive someone else’s stem cells (or bone marrow), it is an allogeneic transplant. Allogeneic transplants are used for acute and chronic leukemia, non-Hodgkin or Hodgkin lymphoma, aplastic anemia, multiple myeloma, myelodysplasia, and several other malignant and benign disorders.

The preferred donors for allogeneic transplant include a matched sibling donor or a volunteer matched unrelated donor. Our BMT and cellular therapy experts also specialize in alternative donor transplants (when a matched sibling or unrelated donor are not available) with a haploidentical (half matched) donor or transplantation using cord blood units (see below).

Autologous Bone Marrow Transplants

Autologous transplants are the most common and involve receiving your own stem cells. The procedure is used for multiple myeloma, lymphoma, amyloidosis, testicular cancer and several autoimmune diseases.

Based on your response to chemotherapy, your physician determines the best time to collect the stem cells. Prior to transplant, stem cells are mobilized, collected and frozen. Specifically, they are mobilized through growth factor called granulocyte colony-stimulating factor (G-CSF). Upon mobilization, the stem cells are collected using an apheresis machine, and then processed and cryopreserved until the patient is ready for the transplant procedure.

Tandem Transplants

For some diseases, like myeloma and testicular cancer, a multiple (or tandem) transplant approach may be preferable. Options include:

  • Autologous/Autologous Transplant — You have one transplant using your own cells, followed by another autologous transplant within three to six months following recovery from the first transplant. This is usually done in a clinical trial setting. 
  • Autologous/Allogeneic Transplant — An autologous transplant is followed several months later by an allogeneic transplant.

Cord Blood and Haploidentical Transplants

If a related or unrelated matched donor cannot be found, alternative transplant options may include a cord blood transplant using the stem cells from donated umbilical cords. This procedure is used more often with children. Another option is a haploidentical or "haplo" (half-matched) transplant using the stem cells of a donor — usually a sibling, parent or child — who is not a complete match for the patient. These procedures are usually part of a clinical trial.

Finding a Donor

Patients and families often have questions about finding a donor. The BMT and Cellular Therapy Program works with each patient’s family members to screen them for eligibility. If there is no match, a donor search coordinator will review the international Be The Match® registry  to identify any potential matches. The process of finding a donor takes about four to six weeks for a related donor, and an additional six weeks for an unrelated donor.

Preparing for a Transplant

Additionally, there are treatments patients may need to receive before a bone marrow transplant, including:

  • Myeloablative Therapy — High-dose chemotherapy and/or radiation therapy given prior to the blood or marrow transplant is given with the intent to wipe out the patient’s immune system and dysfunctional bone marrow.
  • Non-Myeloablative Therapy
    Reduced Intensity — Patients receive standard doses of chemotherapy, followed by a blood or marrow transplant. It provides patients with a new immune system, while delivering fewer chemotherapy side effects.

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