A bone marrow transplant or stem cell transplant is a treatment for some types of cancer and bone marrow problems. Marrow is the soft, fatty tissue inside the hard bone. The marrow is where blood cells are formed.
White blood cells help fight infection.
Red blood cells carry oxygen and nutrients to your body.
Platelets help your blood clot.
Stem cells are young blood cells that can become red blood cells, white blood cells, or platelets. Most stem cells are in the bone marrow, but some are in the bloodstream. Blood in the human newborn umbilical cord also contains stem cells. Stem cells from any of these sources can be used for transplants.
When is it used?
A bone marrow or stem cell transplant may be done to:
Help your body make more blood cells
Help your body fight disease
Replace diseased or destroyed bone marrow with normal bone marrow
Stem cell transplants may be used to treat:
Immune deficiency diseases
Researchers are studying stem cell transplants to see if they will help with other diseases.
How do I prepare for this procedure?
Plan for your care and find someone to give you a ride home after the procedure.
If you need to take a medicine before donating stem cells, take the medicine exactly as prescribed.
Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
Follow all of the instructions provided by your healthcare provider.
Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do.
What happens during the procedure?
The bone marrow or stem cells are collected from a donor or from your own blood before you have chemotherapy or radiation therapy.
Before stem cells are collected from your blood, you will be given medicine for a few days to help your body make more blood forming cells. Stem cells will be taken from a large vein in your arm or through a tube placed in a vein in your neck, chest, or groin. The blood goes through a machine that separates the stem cells from the rest of your blood. The remaining blood is returned to you through another vein. Collecting stem cells from your blood takes about 4 to 6 hours. It can be done at an outpatient clinic. Stem cells can be frozen and stored until they are needed.
Bone marrow is usually collected from both hipbones with a needle. You will be given regional or general anesthesia to keep you from feeling pain during the procedure. Regional anesthesia numbs part of your body while you stay awake. General anesthesia relaxes your muscles and you will be asleep. The procedure to collect bone marrow takes about an hour.
When it is time for the transplant, the bone marrow or stem cells are given through a vein (IV), like a blood transfusion. The transplant takes 1 to 5 hours.
What happens after the procedure?
The medicine used to help your body make more blood forming cells may cause side effects such as fever, bone and muscle aches, headaches, tiredness, nausea, vomiting, and trouble sleeping. These side effects generally go away in 2 to 3 days after your last dose of the medicine.
After you donate bone marrow, the area where the marrow was taken out may feel stiff or sore for a few days, and you may feel tired. Within a few weeks, your body will replace the donated marrow. Some people are back to their usual routine within 2 or 3 days, but others may need 3 to 4 weeks to fully recover their strength.
When you are given a transplant, the stem cells start to make new, healthy blood cells in 2 to 4 weeks. During this time, you may be given medicine or blood transfusions to prevent problems.
After the transplant, you will have blood tests to see how well your bone marrow is making new blood cells. You may also have a test called bone marrow aspiration, which is the removal of a small sample of bone marrow through a needle for examination under a microscope. This helps your provider see how well your bone marrow is producing new cells and platelets.
Although your body will start making new blood cells in 2 to 4 weeks, it will take much longer for your immune system to completely recover. It could take up to several months if your own stem cells are used and 1 to 2 years if the stem cells were donated by someone else.
What are the risks of this procedure?
When you donate your own bone marrow, there are usually no serious risks other than the risks of the general or regional anesthesia used during the procedure. You should discuss the risks of anesthesia with your healthcare provider. When you receive your own stem cells in a transplant, there is no risk from anesthesia because anesthesia is not needed.
It may be harder for your body to fight infections.
You may have side effects from chemotherapy or radiation treatments that you had before you had the stem cell transplant.
If you use your own cells for the transplant after treatment for cancer, there may be cancer cells among the transplanted stem cells.
When you receive cells from another person:
The stem cells may die or be destroyed by your immune system before they can settle into your bone marrow, which is called rejection.
A complication known as graft-versus-host disease (GVHD) sometimes develops. GVHD occurs when white blood cells from the donor attack your cells. This can damage some parts of your body, such as the skin, liver, and intestines. It may happen within a few weeks of the transplant or much later. You may be given medicines that suppress your immune system to help prevent GVHD.
There is a small risk of infection from the donated cells.
You should ask your healthcare provider how these risks apply to you.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-10-08 Last reviewed: 2014-10-08
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.