What Is a Bone Marrow Transplant?

What Is a Bone Marrow Transplant?

Did you know there is more than one type of bone marrow transplant?

For example, there is an autologous transplant and an allogeneic bone marrow transplant. But what exactly are they?

We reached out to Preet M. Chaudhary, MD, PhD, of the USC Norris Comprehensive Cancer Center at Keck Medicine of USC to get insights into the procedures.

Bone marrow transplants are also known as stem cell transplants. Stem cells are taken from two primary sources: bone marrow or peripheral blood. It is possible to collect stem cells without going directly into the bone marrow, because stem cells mobilize their way into and are also within the peripheral blood.

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After stem cells are collected from one of these two sources, they are given back to the patient after they have undergone chemotherapy and sometimes additional radiation therapy for the treatment of their underlying disease.

There are two main types of bone marrow transplants:

  • Autologous transplants. This is when a patient utilizes their own bone marrow or peripheral blood stem cells for transplant.
  • Allogeneic transplants. This is when a donor donates bone marrow or peripheral blood stem cells to a patient.

When is a bone marrow transplant necessary?

A bone marrow transplant is used as a treatment for certain blood cancers, blood disorders (like aplastic anemia, thalassemia and sickle cell anemia) and, in rare cases, for certain solid tumors (germ cell tumors).

What is the purpose of a bone marrow transplant?

In situations where a patient is really sick and the standard chemotherapy treatment isn’t going to work for the patient, a more intense chemotherapy treatment is used. These are called myeloablative transplants. The problem with myeloablative transplants is that if the patient doesn’t have a bone marrow transplant done as well, they will die, since the bone marrow will never recover. The purpose of a bone marrow transplant is to make your blood function come back. This keeps the patient alive.

In severe cases, such as myeloablative transplants where patients are given very high doses of chemotherapy and radiation therapy, the original bone marrow function is wiped out. The bone marrow transplant is then used to supplement the lost bone marrow. In these situations, there is an immediate challenge, where the bone marrow hasn’t recovered. During that period of time, the patient can experience side effects, such as mucositis, nausea, vomiting, low counts, fever and risk of infection. Another frequent complication of bone marrow transplant, when a donor is used, is a condition called graft-versus-host disease.

Non-myeloablative transplants and reduced intensity transplants are forms of allogeneic transplants, where the intensity of chemotherapy and radiation therapy is less intense. In general, the acute complications of bone marrow transplant are less severe with these procedures.

The most important thing in either of these situations is the outcome — to rid the body of cancer.

What are the risks?

The major risk of any type of cancer treatment is the risk of relapse, where the disease comes back. The outcome of the procedure is determined by whether or not the patient stays in remission.

In allogeneic transplants, there is also risk of graft-versus-host disease and the risk of infection from the use of the immunosuppressant drugs.

The good news is that with chemotherapy and a bone marrow transplant, there is a chance to completely rid the body of cancer.

Why USC Norris Comprehensive Cancer Center?

1. Experience

Being in a racially diverse melting pot, like Los Angeles, gives the USC Norris team considerable experience within haploidentical (half-matched) transplants. That allows us to serve a niche within a niche in allogeneic bone marrow transplants.

2. Team approach

Bone marrow transplant is a team approach. Over the years, we have developed a strong team of physicians, pharmacists, nurses, coordinators, social workers and an entire team to make sure the process of a bone marrow transplant is as smooth as possible.

3. Academic medical center

Being an academic medical center means we are not only experts within bone marrow transplants but across all other disciplines. Bone marrow transplant patients often encounter other complications, such as liver or lung problems. At USC Norris, if any other complications do arise, our experts will take care of you.

4. Comprehensive cancer center

Being a comprehensive cancer center means we are not only experts in bone marrow transplant but have expertise in other areas of cancer, as well. That means if any other complications arise, we will be able to take care of you.

5. Center of Excellence

To get the Center of Excellence designation, we have to meet certain quality outcome measures. Due to a combination of all the factors above, we are a Center of Excellence for a large number of providers and insurance companies, which speaks to the quality of our program.

To learn more about our bone marrow transplant programs, visit https://cancer.keckmedicine.org/patients/cancer-programs/blood-diseases-center/.

To schedule an appointment, call (800) USC-CARE (800-872-2273) or visit https://cancer.keckmedicine.org/patients/request-an-appointment/.