How a Bone Marrow Transplant Is Performed
Blood and bone marrow transplant procedures are often used as a treatment for a wide range of blood diseases and disorders, such as leukemia and lymphoma. At Moffitt Cancer Center, these transplants may also be performed to restore stem cells that have been damaged by cancer treatment, specifically high-dose chemotherapy and/or radiation therapy.
The transplant process begins when we receive a referral from a patient’s primary care physician or specialist, or when one of our own oncologists recommends the treatment for an existing patient. Our team will then evaluate information about the patient’s specific diagnosis and overall health to determine if a transplant is the best possible option.
How do you prepare for a bone marrow transplant?
If a transplant is determined to be a suitable treatment, a number of things must happen before the transplant can be performed. At Moffitt, our transplant team will work closely with the patient’s referring physician to prepare the patient for the procedure. The first step is to determine if we must find a donor whose stem cells match the patient’s.
There are two main types of bone marrow transplant procedures, allogeneic and autologous. If a patient requires an allogeneic transplant, the transplanted cells will come from a donor, so a suitable match must be found. A person is a "match" if the proteins on the donor's white blood cells, called HLA (human leukocyte antigens) are compatible with the patient's. At Moffitt, preferred stem cell sources for an allogeneic transplant are:
- A sibling, parent or other relative
- An unrelated donor
Finding an appropriate match for an allogeneic blood and bone marrow transplant can take several months. Until a donor is identified, the patient will continue with other forms of treatment for the underlying disease. In the case of an autologous transplant, the cells will be extracted from the patient, eliminating the need to find a donor. These cells will be frozen until it is time for the transplant to be performed.
Leading up to either type of transplant, patients must undergo a series of medical tests to identify medical conditions that could complicate the transplant. After these tests are successfully completed, the patient must undergo what is called conditioning to prepare his or her body for the transplant process. During conditioning, the patient is given chemotherapy (with or without radiation therapy) to prepare his or her immune system to accept the transplanted stem cells.
What you can expect during your bone marrow transplant
After the conditioning process is complete, the bone marrow transplant procedure can be performed. The transplant is a painless process and the recipient remains awake throughout the procedure. The donor stem cells are infused into the patient’s body through a central line, and then travel to the bone marrow where they may begin to produce new blood cells.
If the patient receives stem cells that have been frozen and thawed, medications will be administered before the transplant to help combat the effects of the preservative that was used to protect the frozen stem cells. Additionally, IV fluids will be given before and after the transplant to flush the preservative out of the patient’s body.
What can you expect after your bone marrow transplant
After the transplant is complete, the patient's treatment team will carefully monitor his or her red blood cell and platelet counts, as it typically takes two to three weeks before blood counts start to improve. As a result, the patient may have a higher risk of infection, bleeding, anemia and other complications during that time. Blood tests and other tests will be conducted frequently to monitor the patient’s condition. Consistent monitoring can help the treatment team identify any potential problems and make a prompt diagnosis, should they occur. If complications arise, the patient may need to remain in the hospital. The length of the patient’s hospital stay will depend on individual factors such as the risk of complications and the type of transplant performed.
Medically reviewed by Hany Elmariah, MD, MS