Blood and Bone Marrow Transplant

Also known as Hematopoietic Stem Cell Transplant, Hematopoietic Cell Transplant, Autologous Transplant, Allogeneic Transplant
A blood or bone marrow transplant replaces abnormal blood-forming stem cells with healthy cells
Overview

When the healthy stem cells come from you, the procedure is called an autologous transplant. When the stem cells come from another person, called a donor, it is an allogeneic transplant. Blood or bone marrow transplants most commonly are used to treat blood cancers or other kinds of blood diseases that decrease the number of healthy blood cells in the body. These transplants also may be used to treat other disorders.

For allogeneic transplants, your doctor will try to find a donor whose blood cells are the best match for you. Your doctor will consider using cells from your close family members, from people who are not related to you and who have registered with the National Marrow Donor Program, or from publicly stored umbilical cord blood. Although it is best to find a donor who is an exact match to you, new transplant procedures are making it possible to use donors who are not an exact match.

Blood or bone marrow transplants are usually performed in a hospital. Often, you must stay in the hospital for one to two weeks before the transplant to prepare. During this time, you will have a narrow tube placed in one of your large veins. You may be given medicine to make you sleepy for this procedure. You also will receive special medicines and possibly radiation to destroy your abnormal stem cells and to weaken your immune system so that it won’t reject the donor cells after the transplant.

On the day of the transplant, you will be awake and may get medicine to relax you during the procedure. The stem cells will be given to you through the narrow tube in your vein. The stem cells will travel through your blood to your bone marrow, where they will begin making new healthy blood cells.

After the transplant, your doctor will check your blood counts every day to see if new blood cells have started to grow in your bone marrow. Depending on the type of transplant, you may be able to leave, but stay near the hospital, or you may need to remain in the hospital for weeks or months. The length of time will depend on how your immune system is recovering and whether or not the transplanted cells stay in your body. Before you leave the hospital, the doctors will give you detailed instructions that you must follow to prevent infection and other complications. Your doctor will keep monitoring your recovery, possibly for up to one year.

Although blood or bone marrow transplant is an effective treatment for some conditions, the procedure can cause early or late complications. The required medicines and radiation can cause nausea, vomiting, diarrhea, tiredness, mouth sores, skin rashes, hair loss, or liver damage. These treatments also can weaken your immune system and increase your risk for infection. Some people may experience a serious complication called graft-versus-host disease if the donated stem cells attack the body. Other people may reject the donor stem cells after the transplant, which can be an extremely serious complication.

Visit Blood-Forming Stem Cell Transplants for more information about this topic.

Participate in NHLBI Clinical Trials

The National Heart, Lung, and Blood Institute (NHLBI) leads or sponsors many studies aimed at preventing, diagnosing, and treating heart, lung, blood, and sleep disorders.

Trials at the NIH Clinical Center

Blood and bone marrow transplant donors

This study is testing ways to reduce complications of blood and bone marrow transplants, which are used to treat some people who have serious blood disorders. Donors receive doses of a growth factor to increase the number of stem cells in their blood. Then, the donor has an apheresis procedure for removing the stem cells. The researchers are testing different processing steps after the donation to see how the stem cells and other cell types are affected. To participate, you must be between the ages of 18 and 60, and you need to meet certain health requirements for donors. This study is located in Bethesda, Maryland.

Bone marrow transplant procedures for severe anemia

This study aims to improve bone marrow transplant (BMT) procedures for older patients by using a low dose of radiation and two immunosuppressive drugs instead of chemotherapy. This type of BMT procedure is described as nonmyeloablative because it does not destroy bone marrow. Participants in this study must be between 2 and 65 years old; have a severe congenital anemia, such as sickle cell disease or beta thalassemia; and have a sibling who is a well-matched stem cell donor. This study is located in Bethesda, Maryland.

Stem cell transplant procedure with a partial match

This study is testing new ways to improve a stem cell transplant procedure that involves a donor who is not a complete match, called a partial match. To participate in this study, you must be at least 18 years old and have both severe sickle cell disease and a donor who is a partial match. This study is located in Bethesda, Maryland.

Improving bone marrow transplants

This study is exploring how to improve bone marrow transplant procedures so the body better accepts donor stem cells. To participate in this study, you must be at least 4 years old, have sickle cell disease, and have a stem cell donor. This study is located in Bethesda, Maryland.

Healthy blood and bone marrow donors

This study is screening healthy participants who are willing to donate blood samples or who have apheresis procedures. Eligible donors may be asked to provide blood products for studies of blood disorders or to donate stem cells for people who are having a bone marrow transplant. To participate, you must be at least 18 years old and meet certain health requirements for donors. This study is located in Bethesda, Maryland.

To learn more about clinical trials at the NIH Clinical Center or to talk to someone about a study that might fit your needs, call the Office of Patient Recruitment 800-411-1222.

Are you considering a blood stem cell transplant?

This study is investigating a new method for collecting blood stem cells from donors to see if it reduces transplant complications, such as rejection, in patients who have blood diseases. To participate in this study, you must have a well-matched donor; you and your donor must be between 4 and 80 years old; and you must not be a candidate for immunosuppressive therapy. This study is located in Bethesda, Maryland.

Are you prone to bleeding because of low platelets or a bone marrow disorder?

This study aims to evaluate the effectiveness of tranexamic acid in preventing bleeding in patients who have thrombocytopenia, or low platelets, due to primary bone marrow disorders or chemotherapy, or blood or bone marrow transplants. To participate in this study, you must be at least 18 years old, have a bone marrow disorder, have low platelets, and be going through chemotherapy, immunotherapy, or a stem cell transplant. The study is located in Chapel Hill, North Carolina; Pittsburg, Pennsylvania; and Seattle, Washington.

Are you or your child interested in donating a sample of bone marrow for research?

This study will collect samples of bone marrow from patients who have sickle cell disease or β-thalassemia to help develop genetic therapies. Participants in this study must be at least 2 years old and have sickle cell disease or β-thalassemia. You may continue regular treatments while participating in the study. This study is located in Memphis, Tennessee.
View more information about Bone Marrow for Hemoglobinopathy Research.

Are you 15 to 40 years old and have severe sickle cell disease?

This study is comparing long-term outcomes for patients who receive blood and bone marrow transplants and those who receive standard treatment with medicines. Participants also have an option of contributing blood samples to be stored for future research. Participants must be 15 to 40 years old and have severe sickle cell disease. This study is located in Madison, Wisconsin.

Do you or your child have severe sickle cell disease and also know a half-matched bone marrow donor?

This study is seeking to improve bone marrow transplantation success from half-matched donors by testing a different conditioning procedure that uses a variety of medicines to prepare for the transplant. To participate in this study, you must be 15 to 45 years old and have severe sickle cell disease or have a child 5 to 14 years old who has had a stroke. This study is located in many sites across the United States, including Miami, Florida, and St. Louis, Missouri.

Have you received a stem cell transplant?

This study aims to monitor the long-term health of patients who have received a donor stem cell transplant from the NIH Clinical Center. To participate in this study, you must be between 10 and 80 years old and had your transplant more than 3 years ago. This study is located in Bethesda, Maryland.

Do you lack a well-matched donor for a blood and bone marrow transplant?

This study aims to determine whether a transplant of umbilical cord blood from an unrelated donor or a blood and bone marrow transplant from a partial match donor are suitable alternatives for people who do not have a well-matched donor. To participate in this study, you must be younger than 75, have severe aplastic anemia, have tried immunosuppressants without success, and not have a well-matched donor. This study is located in 28 cities across the United States.

Are you scheduled for a stem cell transplant with cord blood?

This study will assess the safety and effectiveness of certain cord blood transplants. The study will help researchers learn the best methods for collecting, storing, and using cord blood in transplants. To participate in this study, you must have a disorder that compromises your body’s ability to make blood cells. This study is located in Bethesda, Maryland.

Do you or your child need a stem cell transplant?

This study is exploring the use of treatment with certain medicines in combination with radiation for a successful stem cell transplant. To participate in this study, you must be younger than 49 years old and have a severe disease treatable by a stem cell transplant. This study is located in several sites across the United States, including Aurora, Colorado; Seattle, Washington; and Milwaukee, Wisconsin.

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