About Transplantation

When you are diagnosed with a serious illness, it’s helpful to learn about the disease and treatment options. This can help you talk with your doctor and make a treatment plan together.

A bone marrow transplant or umbilical cord blood transplant (also called BMT) replaces diseased blood-forming cells (also called blood stem cells) with healthy cells.

• Diseases Treatable with a Bone Marrow Transplant or Cord Blood Transplant
• Types of Transplant and Cells Used
• Transplant Process
• When Your Doctor Recommends a Transplant
• Talking with Your Doctor

Diseases treatable with a bone marrow transplant or cord blood transplant

Diseases that may be treated with a bone marrow or cord blood transplant include:

• Leukemias and lymphomas
• Multiple myeloma and other plasma cell disorders
• Severe aplastic anemia and other marrow failure states
• Sickle cell disease and thalassemia
• Inherited immune system disorders, such as severe combined immunodeficiency (SCID) and Wiskott-Aldrich syndrome
• Inherited metabolic disorders, such as Hurler's syndrome and leukodystrophies
• Myelodysplastic syndromes

To learn about the symptoms, diagnosis, and treatment options for these and other diseases, see Learning About Your Disease.

Types of transplant and cells used

Your doctor will decide what type of transplant is best for you:

1. Autologous transplant uses cells collected from your body.
2. Allogeneic transplant uses cells donated from a family member, an unrelated donor or an umbilical cord blood unit.

For an autologous transplant, the healthy cells for a transplant can come from 1 of 2 sources:

• Bone marrow
• Peripheral (circulating) blood stem cells (PBSC)

For an allogeneic transplant, the healthy cells for a transplant can come from 1 of 3 sources:

• Bone marrow
• Peripheral (circulating) blood stem cells (PBSC)
• Umbilical cord blood that is collected after a baby is born

If you need a transplant, your doctor will choose the best source of the cells for you. Your doctor makes this decision based on your disease, other treatments you have had, and your overall health.

Transplant process

A bone marrow or cord blood transplant is a long process with many steps.

1. The cells are collected

Autologous Transplant: Your own blood forming cells are collected from the circulating blood (peripheral blood stem cells) or marrow. Most patients use PBSC for an autologous transplant. But your doctor will decide which is best for you.

• PBSC collection: Blood-forming cells are collected from the bloodstream. This process is called apheresis. Before apheresis you receive shots to increase the number of blood-forming cells in your bloodstream. During apheresis, blood is removed from your vein through an intravenous (IV) line, passed through a machine, and put back into your vein. The machine takes out the blood-forming cells that will be used for your transplant.
• Marrow collection: Blood-forming cells are collected from the pelvic, or hip, bone through surgery. You receive anesthesia so you are comfortable during the process. A doctor uses a special needle to remove the blood-forming cells from your bone marrow.

Allogeneic Transplant: Your doctor will look for a marrow donor or cord blood unit that matches your HLA type. HLA stands for human leukocyte antigen. This is a marker your body uses to know which cells belong in your body and which don’t.

If you don’t have a donor in your family, your doctor will search for an unrelated donor or cord blood unit through the registry of the C.W. Bill Young Cell Transplantation Program, also called the NMDP Registry^SM. The registry is a listing of potential marrow donors and donated cord blood units.

NMDP^SM has agreements with its global partners to provide access to more than 41 million potential marrow donors and more than 803,000 cord blood units within its search system.*

*Updated as of March 4, 2024. Current numbers can be found at the World Marrow Donor Association.  

2. Your body is prepared for a transplant

Before your body can receive the new cells, you get chemotherapy, with or without radiation. The treatment is called a preparative, or conditioning, regimen. The preparative regimen destroys the diseased cells and makes space in your body for the new cells to go.

3. You get the cells (transplant day)

On transplant day, the cells are put into your body through an intravenous (IV) catheter. The cells move into the spaces inside your bones where they grow and make new blood cells. They make healthy new red blood cells, white blood cells, and platelets.

4. Recovery

Recovery after transplant can last weeks to months. You may need to stay in the hospital or near the transplant center for the first 100 days after transplant. Then you may need more time for recovery at home. Throughout your recovery, doctors, nurses and social workers closely care for you to prevent and treat any side effects or complications.

For more information about chemotherapy and radiation, see Treatment Before Transplant.

For more about the search process, HLA matching, and steps of a transplant, such as evaluating your health before transplant, the preparative regimen, receiving your new cells, and recovery, see Find a Donor.

When your doctor recommends a transplant

Your doctor recommends your treatment based on several factors, including the status of your disease and your health. Different treatments are better at different times for each disease.

Your doctor also looks at your overall health and risk factors. These things can change over time too.

Your doctor will consider both your disease status and your current health when deciding on a treatment method. In general, transplant works better when:

• The disease is in the early stages or in remission
• The disease gets better after chemotherapy
• You are as healthy as can be expected and your organs work well

Talking with your doctor

If you have a disease that may be treated with a bone marrow or cord blood transplant, talk to your doctor. Ask questions about your disease, your risk factors, and treatment options. Every question you have is important.

Some questions you may want to ask your doctor about treatment options are:

• What treatment do you recommend and why?
• Is the goal to cure my disease, stop the disease progression, or control symptoms?
• What are other possible treatments?
• Will a bone marrow or cord blood transplant be an option at some point in my treatment?

Questions specific to a bone marrow or cord blood transplant might include:

• When do you recommend a transplant?
• When do you begin searching for a marrow donor or cord blood unit?
• What are the risks of waiting or trying other treatments first?
• What do you think the chances are that my transplant will be successful?

For more questions and topics to discuss with your doctor, see:

• Questions to Ask Your Doctor
• Treatment Decisions