Blood and Marrow Transplantation

Although it is called a transplant, a blood and marrow transplantation (BMT) is not an operation. It is an infusion of adult stem cells through a small intravenous (IV) needle in your vein. Stem cells in your bone marrow, the soft, sponge-like material found inside your bones, reproduce into red and white blood cells and platelets. Once they mature, these cells leave the bone marrow and enter the bloodstream. A BMT is used to replace bone marrow that has been destroyed by disease, chemotherapy or radiation.

Definition of treatment

A BMT replaces defective or damaged cells in patients whose normal blood cells have been crowded out by cancers cells. Previously, BMT referred to a "bone" marrow transplant because stem cells were harvested or removed only from the bone marrow. While this procedure is still recommended for some people, most stem cells today are taken from circulating or peripheral blood in a procedure that is much gentler on the donor. Read more about this process called hematopoietic stem cell harvest apheresis.

Types of treatment

BMT is often preceded by high-dose chemotherapy and/or radiation, which destroys both your cancerous and healthy cells. You must be in the hospital to avoid exposure to infection.

There are two main types of transplants:

• Autologous: Stem cells are collected from the patient’s blood or bone marrow and stored until time of transplant; the patient is both donor and recipient
• Allogeneic: Stem cells are collected from the blood or bone marrow of a relative, or a non-related donor found through the National Marrow Donor Program Registry or other registries.

After your transplant, you will have to remain in the hospital for about three to four weeks.  In addition, you will need to adhere to a long-term drug therapy regimen and an intensive follow-up period.

UC San Diego Health System expertise

By participating in research and clinical trials, UC San Diego Health System is able to offer advanced therapies, such as: 

• Reduced Intensity (Mini Transplant): Uses lower dosages of chemotherapy and/or radiation 
• Cord Stem Cell: Uses stem cells harvested from umbilical cords and placentas
• Haploid Identical Transplant: Uses haplo-identical matches; donor is a parent, sibling or child with a genetic match that is at least ‘half’ identical to the recipient

Learn more about the Blood and Marrow Transplant Program.

FAQs

What types of cancer are treated with BMT?

• Lymphoma and Hodgkin’s disease
• Acute and chronic leukemia
• Multiple myeloma
• Myelodysplastic syndrome
• Sarcoma 
• Aplastic anemia

Are there any potential risks for BMT?

As only a small amount of bone marrow is removed, donating usually does not result in any major problems for the allogeneic donor. The most serious risk involves the use of anesthesia during the procedure. Additionally, a donor might feel fatigued and sore for a few days in the area where the bone marrow was removed. However, the donor’s blood marrow is replenished in about two to three weeks, and normal strength returns.