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Rebuilding your body's healthy blood cells
Your bone marrow is a spongy tissue inside your bones. The tissue contains stem cells, which turn into red blood cells, white blood cells and platelets.
When the stem cells in your bone marrow become damaged, they cannot make the blood cells your body needs to function. These blood cells are very important. Each one has a different job:
Platelets form clots to stop bleeding.
Red blood cells carry oxygen throughout your body. They also take carbon dioxide to your lungs to be removed.
White blood cells fight infection.
A bone marrow transplant — also called a stem cell transplant — replaces your damaged bone marrow stem cells with healthy stem cells. The new cells let your body make the red and white blood cells and platelets it needs. There are many different kinds of stem cells that can rebuild different organs in our body. We are describing stem cells that can rebuild a bone marrow.
Your doctor may offer a bone marrow transplant as a treatment option. A transplant can control or cure serious blood, immune system or genetic conditions, including cancer. You may need a bone marrow transplant if your body does not respond to chemotherapy or if your condition returns after chemotherapy treatment.
What is a bone marrow transplant?
In blood or marrow transplant, the patient is given chemotherapy followed by the infusion of donated stem cells. In allogeneic transplant, total body irradiation (TBI) is sometimes given, in addition to the chemotherapy. The chemotherapy and TBI are called the transplant conditioning regimen. The conditioning regimen is given for several reasons, one of which is to control disease and prepare the body for transplant. It is followed by an infusion of stem cells.
In allogeneic transplant, the stem cells are collected from a family member, unrelated donor or donated umbilical cords. In autologous transplant, the stem cells are collected from the patient who will be having the transplant.
The goal of the transplant process can be to control disease or it can be curative. Your transplant doctor will discuss the benefits of a transplant for the treatment of your specific disease.
Stem cell sources
The stem cells can be collected from three different sources:
A doctor uses a needle to take the stem cells directly from the bone marrow of your donor’s hip bone. This procedure is called a "harvest."
Your donor receives medication to stimulate release of stem cells into the blood stream so they can be easily collected. A special machine collects the stem cells from the blood.
Umbilical cord blood
You receive donated stem cells collected from donated umbilical cord(s) of healthy babies.
An autologous transplant uses your own stem cells. Your doctor collects your stem cells and freezes them for storage.
Whether you are undergoing an autologous or allogeneic transplant, you will receive the stem cells through an IV infusion. No surgery is required. The transplant takes place after you receive chemotherapy and sometimes radiation. These treatments prepare your body to accept the healthy stem cells. If the transplant is from a donor, you will receive additional medicine to prevent your body from “rejecting” the stem cells.
Will a bone marrow transplant improve your health?
You could benefit from a bone marrow transplant if your cancer or condition cannot be cured after chemotherapy treatment. Cancers, genetic disorders and other conditions of the blood and immune system can be treated, controlled or cured with a bone marrow transplant.
You might need a bone marrow transplant if:
Your cancer can be controlled best by high dose chemotherapy. Stem cells are required to help you recover from that chemotherapy.
Cancer and cancer treatment damaged your stem cells.
Your bone marrow stem cells cannot make blood cells.
Your stem cells carry a genetic alteration which makes them grow abnormally.
What conditions does a bone marrow transplant treat?
Before your cancer care team recommends a bone marrow transplant, they evaluate your health and talk with you and your family about your treatment options.
Bone marrow transplants can treat:
Blood cancers like leukemia, multiple myeloma or lymphoma
Bone marrow diseases like aplastic anemia
Other immune system or genetic diseases
If you and your care team decide that a stem cell transplant is the best treatment, your doctor will recommend the best stem cell source for you. The decision to use allogeneic, autologous or umbilical cord blood stem cells depends on your health and condition.
How a bone marrow transplant works
Once your doctor decides on which type of stem cells will be used, you begin preparations for your transplant.
You receive a transplant conditioning regimen that could include:
Total body irradiation (usually only for a transplant using a donor)
These treatments control your condition and get your body ready to receive the healthy stem cells.
You will receive your new stem cells one or two days after the chemotherapy and radiation are finished. The stem cells are transplanted through an IV infusion. During the infusion, the stem cells:
Enter your blood through the IV
Move through your bloodstream
Rapidly enter the bone marrow space
The transplant takes between 15 and 30 minutes if using your own stem cells and about 1 hour for donated stem cells.
What to expect after your infusion
As you wait for your new stem cells to begin their work, our transplant team will help you handle expected side effects and help you avoid infections and bleeding. You might:
Remain in the hospital until your blood counts recover
Have a sore mouth, poor appetite and feel tired
Be encouraged to drink, eat and exercise, get dressed and shower
Take medicines to boost stem cell growth and prevent infections
Possibly need blood transfusions before your stem cells begin to produce mature cells
Over time, the stem cells settle into your bone marrow. They start to grow and make red and white blood cells and platelets. This takes two to three weeks.
You can go home once your blood counts rise and you can drink, eat and take medicines by mouth.
Recovering at home
After you leave the hospital, you will need help from a caregiver or family member for a variable amount of time, but at least several weeks. Your immune system will be weak. You should wear a mask when you go out in public.
Be sure to contact your doctor if you show signs of:
Nausea and vomiting that persist
For the first 100 days after your transplant you will be closely followed by your nurse practitioner or doctor. You will get blood tests and may have other procedures during those visits. Your doctor or nurse practitioner will tell you how often to return to clinic after this time. If you develop complications, you may need to be readmitted to the hospital.
For allogeneic transplants, a serious side effect called graft versus host disease (GVHD) can occur and will warrant close monitoring and treatment. GVHD is caused by the donated cells reacting against a patient’s body and is a common side effect of an allogeneic transplant.
Meet our team
Experts in bone marrow transplants
The oncology team at the UW Health | Carbone Cancer Center includes experts in bone marrow/stem cell transplants.
The UW Bone Marrow Transplant program is accredited by the Foundation for Accreditation of Cellular Therapy (FACT). FACT accreditation ensures patients, medical professionals, health insurance companies and the government that our program exceeds standards in patient care and laboratory practices. We were among the first transplant centers world wide to achieve accreditation in 2001.
We have been rated as a high-performing transplant center in unrelated donor transplantation by the National Marrow Donor Program.
Our program is consistently awarded Center of Excellence designation by major transplant networks based on our facilities, performance and patient outcomes.
Bone marrow transplant locations
UW Health | Carbone Cancer Center
The experts at the UW Health | Carbone Cancer Center intimately understand every type of cancer. We will get to know you and design a treatment plan that works for you and your family.