Learning about Bone Marrow or Cord Blood Transplants

A bone marrow or cord blood transplant (also called a BMT) may be a treatment option for your disease. Bone marrow or cord blood transplants can be used to treat patients with life-threatening blood, immune system or genetic disorders. For a list of diseases that can be treated with a transplant, see Learning More about Your Disease.

The cells used for transplants

A bone marrow or cord blood transplant replaces your unhealthy blood-forming cells with healthy ones. The cells used in transplants can come from three sources:

• Bone marrow
• Peripheral (circulating) blood (also called peripheral blood stem cell or PBSC transplants)
• Blood collected from an umbilical cord after a baby is born — to learn more, see Cord Blood Transplants

If you need a transplant, your transplant doctor will choose the source of cells that is best for you.

Your doctor will also decide whether to use your own blood-forming cells or cells collected from someone else. This choice depends on your disease and other health factors. 

• A transplant using your own cells is called an autologous transplant. For an autologous transplant, cells will be collected from your bloodstream (or, less often, from your marrow) and stored for your transplant.
• A transplant using cells from a family member, unrelated donor or cord blood unit is called an allogeneic transplant.
• A transplant using cells from an identical twin is called a syngeneic transplant.

Finding a match

If you need an allogeneic transplant, your doctor will look for a donor or cord blood unit that matches your HLA tissue type. HLA stands for human leukocyte antigen, a marker your immune system uses to recognize which cells belong in your body and which do not. HLA tissue types are inherited, so your best chance of finding a match is with a brother or sister. However, 70% of patients do not have a suitable donor in their family.

If you do not have a donor in your family, your doctor can search the Be The Match Registry^SM , operated by the National Marrow Donor Program (NMDP), which provides access to more than 12 million volunteer donors on the global donor listing. This includes more than 7 million volunteer donors and nearly 90,000 cord blood units on the  Be The Match Registry as well as donors available through agreements with international cooperative registries. It can take as little as a few weeks to a few months or more to find a donor or cord blood unit. Not everyone finds a suitable match. If your doctor cannot find a suitable donor or cord blood unit for you, he or she will look at other treatment options. These options might include using a partly matched family member (haploidentical donor).

The transplant process

To prepare your body for a transplant, you may be given chemotherapy, sometimes along with radiation therapy. This is called a preparative regimen or a conditioning regimen. The standard transplant uses very strong treatment that destroys your diseased cells. It also destroys your immune system so it will not attack the donated cells. This treatment is too harsh for some patients who are older or have certain health problems. For these patients a reduced-intensity transplant, which uses a less harsh preparative regimen, may be an option.

After the preparative regimen, blood-forming cells are given to you (infused) through a tube or central line that goes into a vein in your chest. (One of the most common central lines is called a Hickman catheter.) The transplanted cells move into the spaces inside your bones where they create new marrow. They grow and make healthy new red blood cells, white blood cells and platelets.

• Red blood cells carry oxygen to all parts of your body.
• White blood cells help your body fight infection.
• Platelets help control bleeding.

When the transplanted cells begin to grow and make new blood cells, this is called engraftment. To learn more, see Waiting for Engraftment: Days 0-30.

Deciding whether to have a transplant

A transplant doctor can help you decide if a transplant is a good treatment for you. For more information that may help you think about transplant as a treatment option, see:

• Discussing Options with Your Doctor
• When to Consider Transplant
• Advances in Transplant: Helping More Patients
• Evaluating Your Health Before Transplant