Types of Bone Marrow Transplants
• Germ Cell (Testicular) Cancer• Lymphomas
• Multiple myeloma, and related diseases. Occasionally, this type of transplant is used for treatment of leukemia.
• Leukemias and bone marrow or immune system failure diseases.
• Reduced intensity or "mini"-transplant refers to a type of allogeneic transplant in which the pre-transplant
chemotherapy and/or radiation (called conditioning, see below) is less than maximally intensive. This type of transplant depends heavily on the anti-tumor effect of the donor cells for its therapeutic effect, so it generally requires that the disease either be in remission or very slow growing at the time of transplant. The immediate side effects of a reduced intensity transplant are less than those associated with a standard transplant, making it possible to offer transplant to a wider variety of people, including those who might otherwise not be transplant candidates because of age or other illnesses.
What the Donor Experiences
If stem cells are collected by bone marrow harvest (much less likely), the donor will go to the operating room and while asleep under anesthesia, a needle will be inserted into either the hip or the breastbone to take out some bone marrow. After awakening, he/she may feel some pain where the needle was inserted.
Autologous (self-transplant): This is the simplest form of transplant, and involves collection of the patient's own cells, which are counted, analyzed, and then frozen for later use. This type of transplant is most commonly performed for
• Hodgkin Disease
Bloodless Transfusions: For patients requiring a bloodless stem cell transplantation, our transplant center specializes in doing what is known as Bloodless Autologous transplants where patients do not receive any allogenic blood or blood products after the stem cell reinfusion. The period of cytopenias is managed with growth factors & other drugs to prevent bleeding.
Syngeneic (identical twin transplant): An identical twin is an ideal donor because of the genetic identity between the donor and recipient. It is like using one's own cells, except that the cells are not damaged from prior exposure to chemotherapy, and the risk to tumor cell contamination is eliminated.
Allogeneic (donor transplant): For this form of transplant, the stem cells are collected from a relative (usually a sibling), or other donor (volunteer unrelated donor or umbilical cord blood), whose tissue type matches closely with that of the patient. The chances of a brother or sister being a suitable match are about 1 in 4. The chances of any other family member being a match are much less, so we usually do not recommend extended family typing. Allogeneic transplants are most commonly done for
In most cases, a donation is made using circulating stem cells (PBSC) collected by apheresis. First, the donor receives injections for a few days of a medication that causes stem cells to move out of the bone marrow and into the blood. For the stem cell collection, the donor is connected to a machine by a needle inserted in the vein (like for blood donation). Blood is taken from the vein, filtered by the machine to collect the stem cells, then returned back to the donor through a needle in the other arm. There is almost no need for a recovery time with this procedure.
A bone marrow transplant is a difficult procedure to go through. Usually the person receives high doses of chemotherapy and/or radiation to eliminate whatever bone marrow he/she has left to make room for the new marrow transplant. Once this is done, the new stem cells are put into the person intravenously, similar to a blood transfusion. The stem cells then find their way to the bone and start to grow and produce more cells (called engraftment).
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