How Does a Bone Marrow Transplant Work?

A bone marrow transplant is a treatment for certain types of cancer and blood disorders — including leukemia, lymphoma, multiple myeloma, among others — that replaces your bone marrow with healthy cells. The replacement stem cells can either come from your own body or from a donor.

The source of stem cells for transplant is determined by the cancer or blood disorder being treated and the transplant team. Bone marrow transplant, stem cell transplant and hematopoietic stem cell transplant are all terms for the same process.

Who can donate bone marrow?

A bone marrow donor can be the patient or someone else.

When the patient is the donor, it is called an autologous bone marrow transplant. When the donor is someone other than the patient, it is called and allogenic bone marrow transplant. 

In an allogeneic bone marrow transplant, stem cells come from a genetically matched donor, often a brother or sister. Other donors for allogeneic bone marrow transplants may include a parent, child or an unrelated donor identified through national bone marrow registries. Allogenic bone marrow transplants may also come from an umbilical cord blood transplant.

If you are between the ages of 18-40 you can volunteer to be a stem cell donor at https://bethematch.org. Registering involves a simple cheek swab. Volunteer donors are extremely important and may save lives through bone marrow transplant. The need for diversity amongst donors is especially critical as minority ethnicities have very few donors available in the national registries.

Ochsner’s Stem Cell Transplant and Cellular Therapy Program is fully accredited by the Foundation for the Accreditation of Cellular Therapy (FACT) to perform autologous and allogeneic bone marrow and stem cell transplants. FACT is the only accrediting organization that addresses all quality aspects of stem cell and cellular therapy.

How does a bone marrow transplant work?

In both autologous and allogeneic transplants, a donor’s stem cells are removed by a special type of blood donation called apheresis (a-pher-esis). In this process, the donor is given medication to stimulate extra stem cell production in the bone marrow. The stem cells are then collected by blood donation through an IV line. It is extremely rare that a surgery, called a bone marrow harvest, is used to collect stem cells from a donor.

Once collected, the stem cells are either taken to the patient for their transplant procedure or stored until it’s needed. If frozen, the stem cells are thawed before they’re given to the patient.

The transplant recipient is given the stem cells through a vein, similar to a blood transfusion. The stem cells travel to the bone marrow, where they engraft or “take” and start to make blood cells. Signs of the new blood cells usually can be seen in the patient’s blood tests in 1-2 weeks.

Who is a candidate for a bone marrow transplant?

People who are physically healthy, people who are in the early stages of disease and people who have not already had a lot of treatment often do better with transplants. Major health problems — such as serious heart, lung, liver or kidney disease — might disqualify someone from being eligible for a bone marrow transplant.

Talk with your health care provider about your treatment options and whether you are a candidate for a bone marrow transplant.

How long does it take to recover from a bone marrow transplant?

Recovery from a bone marrow transplant begins after the stem cell infusion. During recovery, you are waiting for the stem cells from the transplant to engraft or “take.” They will eventually start to multiply and make new blood cells. This new production of blood will be evident in your lab tests.

The time it takes to start seeing a steady return to normal blood counts varies by patient, but it’s usually about 2 to 6 weeks. You should plan to be in the hospital or visit the transplant center daily for several weeks. Transplant patients need to plan to have one or more caregivers, usually friends and family, available to stay with them and assist with their recovery after the transplant.

During and after your transplant, your doctor might prescribe antibiotics to help you fight infections, as you will have low numbers of red and white blood cells and platelets. You will also need to receive all childhood and adult vaccinations again after the transplant.

You may experience side effects including stomach, heart, lung, liver or kidney problems. You might also feel distress, anxiety, depression, joy or anger. Adjusting emotionally after the transplant can be hard because of the length of time you feel ill and isolated from others. Support and encouragement from family, friends and the transplant team are important to help get you through this time.

At Ochsner, our experience and our cutting-edge research ensures highly specialized, comprehensive, innovative care in a patient-friendly, state-of-the-art facility. Our team of physicians and staff will work together, for you and with you, for the best possible outcome.