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Overview

Bone Marrow Transplant Overview

A bone marrow transplant is a treatment that infuses healthy blood-forming stem cells into the bloodstream after treatment has damaged or destroyed existing bone marrow. The new cells travel to the bone marrow and begin producing blood cells, including red blood cells, white blood cells, and platelets. Unlike an organ transplant, this procedure does not replace a solid organ; it restores the body’s blood-forming system with stem cells from the patient or a donor.

Which Conditions It Treats

Which Conditions a Bone Marrow Transplant Treats

Stem cell bone marrow transplants may be considered for certain blood cancers, bone marrow failure disorders, and inherited or immune-system conditions. Examples include some leukemias, lymphomas, multiple myeloma, myelodysplastic syndromes, and aplastic anemia. Eligibility depends on the disease, its status, available treatment options, and the person’s overall health.

  • Certain leukemias, lymphomas, and other blood cancers may require replacement of diseased or treatment-damaged marrow.
  • Multiple myeloma and myelodysplastic syndromes may be treated with high-dose therapy followed by restoration of blood-forming cells.
  • Bone marrow failure disorders such as aplastic anemia may be treated by restoring blood-forming cell production.
  • Some inherited blood or immune disorders may be treated with healthy donor stem cells through an allogeneic transplant.
  • The transplant team determines whether the expected benefits outweigh risks for the individual patient.

Planning may include disease testing, heart, lung, kidney, and liver assessments, donor or cell-source evaluation, and discussions about clinical trials or alternative treatments. A transplant specialist also considers how well a donor’s tissue type matches the patient and whether the person can safely tolerate the treatment.

During the Procedure / What to Expect

During a Bone Marrow Transplant: What to Expect

Conditioning Treatment and Preparation

Before the infusion, chemotherapy, with or without radiation, may be used to treat the disease and make space in the marrow for the transplanted cells. The conditioning plan varies according to the diagnosis, transplant type, treatment goals, and the patient’s health. It can lower blood counts and weaken the immune system, so careful monitoring begins before the cells are infused.

Stem Cell Infusion and Early Engraftment

Collected stem cells are usually infused through an intravenous line, similar to a blood transfusion. Afterward, the cells travel through the bloodstream to the bone marrow, where they begin to settle and make new blood cells; this process is called engraftment. The transplant team closely monitors blood counts, symptoms, infections, and organ function during this early period.

  • Frequent blood tests track blood counts, organ function, infection, and engraftment.
  • Transfusions, preventive medicines, and infection precautions may be needed.
  • Hospitalization or frequent outpatient visits depend on the transplant plan and recovery.
  • Caregiver support may be needed for transportation, medicines, communication with the care team, and daily activities.

Side Effects & Risks

Side Effects and Risks

  • Low blood counts can increase the risk of infection, bleeding, and anemia.
  • Conditioning treatment may cause nausea, vomiting, diarrhea, mouth sores, hair loss, and severe fatigue.
  • Infections can occur while the immune system is recovering and may require urgent treatment.
  • Graft-versus-host disease can occur after an allogeneic transplant when donor immune cells attack the recipient’s tissues.
  • Treatment may affect fertility or cause short- and long-term organ complications.
  • The original disease may return despite transplantation.

IMPORTANT

Risks are individual

Risk varies with the disease, transplant type, conditioning intensity, donor match, age, and overall health. The transplant team should explain the patient-specific risks, expected monitoring, and ways complications may be prevented or treated.

Recovery

Recovery After a Bone Marrow Transplant

Recovery begins when the transplanted cells engraft and produce new blood cells, but the immune system may take substantially longer to recover. Many people need ongoing monitoring and gradual changes to daily activities while blood counts, immunity, strength, and overall health improve. Recovery after a stem cell transplant can continue for months or longer and differs widely from person to person.

  • Attend frequent appointments and blood tests to monitor engraftment, infections, organ function, and disease status.
  • Take prescribed medicines and follow food, hygiene, activity, and exposure precautions.
  • Receive vaccinations again when the transplant team determines that it is safe.
  • Use caregiver, emotional, nutritional, rehabilitation, and social support during recovery.
  • Ask the transplant team when work, school, exercise, travel, and close contact with others can resume.

When to Call a Doctor

When to Call a Doctor

CALL PROMPTLY

Use your transplant center’s emergency plan

Use the transplant center’s emergency instructions and contact the care team immediately for fever or any symptom you were told to report. Do not wait for the next scheduled visit, particularly while the immune system is recovering.

  • Call immediately for a fever or chills, especially when the transplant team has provided a specific temperature threshold.
  • Report shortness of breath, chest pain, fainting, confusion, or sudden weakness.
  • Contact the care team for uncontrolled bleeding, black stools, blood in the urine, or new widespread bruising.
  • Report persistent vomiting, severe diarrhea, inability to drink, or rapidly worsening abdominal pain.
  • Tell the team about a new rash, yellowing skin or eyes, or other possible signs of graft-versus-host disease.

Diseases & Conditions

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