Bone marrow/stem cell transplant
What is bone marrow/stem cell transplant?
Stem cell transplant is the replacement of damaged bone marrow cells with healthy cells (stem cells). Stem cells are immature cells produced in the bone marrow that make more stem cells, red blood cells, white blood cells and platelets. Stem cells can be taken from bone marrow, from the bloodstream or from umbilical cord blood.
Why it's done
Stem cell transplant is used to:
- Treat diseases that damage or destroy the bone marrow, such as lymphoma and leukemia
- Restore the bone marrow after it has been destroyed by high doses of radiation and chemotherapy (stem cells may be taken from the person's body before the radiation or chemotherapy treatment and then reinfused)
- Experiment for gene therapy and the treatment of other diseases, such as diabetes and sickle cell disease
Northwell Health Cancer Institute offers the largest bone marrow and stem cell transplant program on Long Island and Queens, performing both autologous and allogeneic transplants. Thanks to exceptional patient care, we are the only transplant program in Long Island, Queens and Brooklyn that is accredited by the Foundation for Accreditation in Cellular Therapy (FACT). The program, which has been collecting bone marrow for unrelated donors for over 20 years, has also been designated a National Marrow Donor Program (NMDP) Apheresis Collection Center.
We offer the most advanced, individualized transplant options available. Our multidisciplinary team of radiologists, pathologists, medical oncologists and radiology oncologists collaborate to ensure that every aspect of this extensive treatment is precisely coordinated. This includes ongoing peer review and chart rounds.
Research at Northwell
Advances in bone marrow and stem cell transplantation are continuously happening here. Through alliances with leading research organizations, including Cold Spring Harbor Laboratory, we participate in investigator-initiated trials to offer the most leading-edge therapies to patients.
Northwell Health Cancer Institute is recognized worldwide for its commitment to providing pioneering treatment for cancer patients. This commitment has contributed to significant advancements that are improving the quality of lives and increasing the number of cancer survivors.
The success of a stem cell transplant depends on the person's age and general health condition and whether the donated cells match the body cells.
Serious complications that can occur after a stem cell transplant include rejection of the new stem cells, destruction of other cells in the person's body by the new stem cells, and/or a severe, life-threatening, infection.
Types of stem cell transplants include:
Autologous bone marrow transplant—Stem cells are taken from the patient either by bone marrow harvest or apheresis (a process of collecting peripheral blood stem cells), frozen, and then given back to the patient after intensive treatment. Often the term rescue is used instead of transplant.
Allogeneic bone marrow transplant—Stem cells are taken either by bone marrow harvest or apheresis from a genetically matched donor, usually a brother or sister. Other donors may include:
- A parent. A haploid-identical match is when the donor is a parent and the genetic match is at least half identical to the recipient. These transplants are rare.
- Unrelated donor who is a genetic match. Unrelated donors are found through national bone marrow registries.
Umbilical cord transplant—Stem cells are taken from an umbilical cord immediately after delivery of an infant. These stem cells reproduce into mature, functioning blood cells quicker and more effectively than do stem cells taken from the bone marrow of another child or adult. The stem cells are tested, typed, counted and frozen until they are needed for a transplant.
What to expect
The stem cell transplant procedure has several stages. Parts of the treatment may be done in a hospital, and others may be done in an outpatient center. The length of time of your treatment depends on how you respond and any problems you may have from the treatment.
Testing—You will first have tests to make sure that your health is good enough for the chemotherapy and radiation that are part of the procedure. This may take a few days. You will also be asked to provide a complete medical history, and blood tests and other diagnostic tests will be performed. It is important to notify your healthcare provider about any sensitivities or allergies to medication, latex, tape, contrast dyes, iodine or anesthetic agents.
Deciding on treatment—After the tests, you and your doctor will discuss your results, the support you can expect from caregivers, and the physical and emotional challenges you will face. Based on these things, you might go ahead with the transplant, or you might choose a different treatment instead. If you go choose to proceed with the transplant, you'll need to decide which type makes the most sense for you.
Conditioning—You’ll have chemotherapy and radiation to kill all the cancer cells in your body. It can take one to two weeks. You may have side effects, such as mouth sores, nausea, hair loss and poor appetite. The side effects may last several months, but your doctor can give you medicine to help ease them.
Transplant—After the cancer cells are killed, the healthy stem cells are put into your bloodstream. This usually takes one to five hours. The stem cells travel to your bone marrow and will start to make new stem cells in one to four weeks. These cells will then take over the job of making new blood cells.
Avoiding infection—The chemo and radiation destroy your white blood cells, and without them, your body can’t fight infection. Your doctor may give you antibiotics. Your caregivers, family and other visitors may have to wear masks, gowns and gloves and follow other rules while you’re in the hospital. These steps will help protect you from getting an infection while your body is making new white blood cells.
You may spend up to four weeks or longer in the hospital after the transplant. The length of time depends on your disease, your overall health and any problems you have during the transplant.
Possible side effects
Side effects of a stem cell transplant can include:
- Mouth and throat pain
- Nausea and vomiting
- Lung inflammation
- Graft-versus-host disease (GVHD)
Your team of specialists are highly focused on preventing or managing side effects throughout and after your treatment.
Cancer is challenging, but you don’t have to go it alone. At Northwell Health Cancer Institute, a wide range of support groups are available to help you cope with diagnosis, treatment and post-treatment issues.