Bone Marrow Transplant Q&A
The following questions and answers were provided by Seattle Cancer Care Alliance.
What is a bone marrow transplant?
A bone marrow transplant (sometimes called a hematopoietic stem cell transplantation) is a life-saving procedure in which stem cells are transplanted from a donor to a patient. The source of the stem cells can either be bone marrow or blood.
What diseases are treated with a bone marrow transplant?
Bone marrow transplants are most often used for people with blood diseases who would not benefit from more conventional treatment, such as chemotherapy. Diseases that are commonly treated with bone marrow transplants include leukemia, multiple myeloma, lymphoma and myelodysplastic syndrome. Also pediatric patients with inborn defects such as congenital neutropenia and severe combined immunodeficiency (SCID) are treated with a bone marrow transplant.
Are there different kinds of transplants?
- In autologous transplants, patients receive their own stem cells.
- In syngeneic transplants, patients receive stem cells from their identical twin.
- In allogeneic transplants, patients receive stem cells from someone other than the patient or an identical twin. The patient's brother, sister, or parent may serve as the donor, or an unrelated donor may be used.
Can anyone be a transplant donor?
Yes, but for an allogeneic transplant to work, the genetics of the donor and patient need to meet a certain "match" criteria. Donors for allogeneic transplants are most often either family members or have been found through a registry, such as the one sponsored by the National Marrow Donor Program.
What's the process for getting a bone marrow transplant?
A bone marrow transplant is a lengthy process that can take up to six months. First, a compatible donor is needed (unless it's a autologous transplant). Afterwards, the patient goes through "conditioning" where the patient's immune system and unhealthy bone marrow/stem cells are killed through chemotherapy and/or total body irradiation. Meanwhile, donor stem cells are collected. Following conditioning, donor cells are infused into the patient's body through a central line, or central intravenous catheter. Next, it's a matter of waiting for the transplanted cells to "engraft" and the patient's immune system to recover.
How does a donor give stem cells?
Donor stem cells are generally collected two ways. If the donor is giving bone marrow, the marrow is drawn surgically from the donor's pelvic bones using a special needle. If donor is making a peripheral blood cell donation, blood is drawn through a needle into a special machine that separates out stem cells. The remaining blood is then returned to the donor.
How long have doctors been performing bone marrow transplants?
Transplant research began in the 1950s at the now-Fred Hutchinson Cancer Research Center. In 1990, the head of the Hutchinson Center, Dr. Edward Donnall (Don) Thomas, won the Nobel Prize for successfully transplanting bone marrow cells to cure severe inherited disorders such as thalassemia and immune system disorders, as well as leukemia and aplastic anemia. Today, researchers at the Hutchinson Center continue to develop new techniques for treating cancer. Seattle Cancer Care Alliance, the treatment arm of the Hutchinson Center, performs hundreds of transplants every year for patients from all over the world.