The bone marrow transplants and stem cell transplant process involves the following for our patients:
- Collecting healthy stem cells from you or a donor
- Giving you chemotherapy and/or radiation therapy to treat diseased cells
- Infusing the healthy stem cells back into you. This way your body can create a new population of healthy blood-forming stem cells
We may often use the following terms to mean much the same thing. There are some differences though.
- ‘Bone Marrow Transplants’: we use stem cells we collect straight from bone marrow
- ‘Peripheral blood stem cell transplant’: we use blood stem cells only from the blood stream
The stem cells that we collect are the same, regardless of whether they are from bone marrow or from blood.
Contents
- Bone marrow and stem cells
- Bone marrow or stem cell transplant treatment?
- How a bone marrow or stem cell transplant works
- Types of bone marrow and stem cell transplants
- Resources
Bone marrow and stem cells
Bone marrow is the tissue that fills the cavities in your bones. It is where your body makes most of your blood cells.
We can find stem cells in your bone marrow. They are cells that have not yet decided what they will be. They could turn into red blood cells, white blood cells, or platelets. Because of this, these cells can divide and form distinct types of blood cells. Normal blood cells have a lifespan, and your body is always replacing them. Bone marrow tissue is active throughout your whole life as a result. Stem cells continue to divide to produce new blood components.
Bone marrow or stem cell transplant treatment?
We use stem cell transplants to treat:
- Some cases of haematalogical (blood) cancers
- A range of other blood disorders
You may not need a stem cell transplant even if you have blood cancer. You may need stem cell transplants if:
- The disease worsens during other treatment
- The disease is not all gone after other treatment
- We know that the disease type can reoccur after treatment
We can treat the following diseases with a stem cell transplant:
- Acute and chronic leukaemia
- Lymphomas
- Myeloma
- Aplastic anaemia
- Some immune system disorders
How a bone marrow or stem cell transplant works
There are a couple of cases where we need to replace your stem cells:
We treat blood cancers with high dose chemotherapy and radiotherapy. We do so to kill the disease. Unfortunately, we cannot target only the diseased cells with these treatments. As a result, the process can also kill the important stem cells in the bone marrow. Also, for other blood disorders that are not blood cancer, stem cells may be defective.
In such cases, we give you healthy stem cells through your veins (intravenous). This is much like a blood transfusion.
Your body will then use these transplanted cells. It rebuilds your body's blood and immune system with them.
Types of bone marrow and stem cell transplants
Your doctor will discuss with you the best type of stem cell transplant for you.
The options you have will depend on:
- The type of disease you have
- Your age and health
- The condition of your bone marrow
- Whether we can collect stem cells from you, or a donor collection is necessary and available
There are two different types of transplants:
- Autologous Transplants
- Allogeneic Transplants (allografts)
Autologous Transplants
In an autologous transplant we take your own stem cells in advance when your disease is in remission. We then return them to you after high dose chemotherapy or radiation therapy. Most people have one autologous transplant. Some patients might have two or more transplants. We call this 'staged autologous transplantation' and usually occurs over a few months. We take this approach to help reduce the chance of the disease relapsing.
We usually use Autologous stem cell collection in Day therapy's apheresis for outpatients. We may also collect stem cells from you when you are an in-patient with us (one or more nights). We perform Transplantation in the specialised Haematology ward on level 5.
Find out more about our myeloma and autologous stem cell transplantation service.
Allogeneic Transplants
We also refer to allogeneic transplants as allografts. With these, we first take the stem cells from a compatible donor.
Siblings of patients are the most common donors. We can also use the stem cells from another compatible family member. We can also use stem cells from a donor whose tissue type is a bit different from your own. We call this a mismatched transplant.
We may be unable to find a compatible family member. Or we may find one, yet it may turn out they cannot donate. The next choice is a volunteer unrelated donor (VUD) transplant. This donor may be outside of your family. They will have similar tissue though.
The choice of donor is made after using a blood test to ensure their cells are the best possible match to your own. Tissue type and blood type are not the same and a donor's tissue may be compatible even if their blood type is not.
We take donations for allogeneic transplants in Day Therapy as an outpatient procedure. We then perform transplants in the Royal Melbourne Hospital's specialised ward 7B. This is part of the Parkville Integrated Haematology Service.
Find out more about our allogeneic transplantation service.
We adopted this content from the Leukaemia Foundation's Guides for Patient and Families.
Bone marrow and stem cell transplants - resources
Links
- Allogeneic stem cell transplants - Leukaemia Foundation
- Autologous stem cell transplants - Leukaemia Foundation