Bone Marrow Transplant

What Is It?

A bone marrow transplant is a procedure used to treat certain types of cancer and some other diseases. During a bone marrow transplant, a person's bone marrow cells are destroyed with radiation or chemotherapy. The cells are then replaced. Bone marrow cells are blood cells in the spongy center of bones.

Cells to replace your original cells can be taken from your blood or bone marrow before the procedure starts. Bone marrow cells also can be taken from a different person (a donor) whose cells are a good match for the person receiving the transplant (the recipient). A good match means certain chemical markers on the cells of both donor and recipient are as close as possible.

More than 15,000 bone marrow transplants are done every year in the United States.

What It's Used For

Bone marrow transplants are used most commonly to treat leukemias, Hodgkin's disease, multiple myeloma and lymphomas. The use of bone marrow transplants to treat other types of cancer, including breast cancer and kidney cancer, remains experimental. Bone marrow transplants also can be used to treat noncancerous conditions, including aplastic anemia, congenital deficiencies of the immune system and thalassemia major.

Preparation

Your doctor will discuss your treatment plan, the possible side effects of the procedure and possible complications. If you are a man and you are considering becoming a father, you may want to talk to your doctor about saving some of your sperm because chemotherapy and radiation can cause either temporary or permanent infertility. This is called sperm banking.

You should become totally familiar with all of the support services offered by the medical center where the transplant will be performed.

You will undergo pre-treatment evaluation and testing, including many blood tests and other tests, such as a chest X-ray and an echocardiogram.

The next step in a bone marrow transplant is to determine where the replacement cells will come from. There are two options. The cells can be taken from the person having the transplant before the main procedures. This is called an autologous transplant. The other option is for the cells to come from a donor. This is called an allogeneic transplant.

If your own cells will be used, these cells must be collected before your main radiation or chemotherapy begins. There are two ways this can be done.

• Bone marrow harvesting — The cells to be used for the transplant are taken from the patient's bone marrow. The procedure is done in an operating room under general anesthesia so you are not awake. A needle and syringe is inserted into the hipbone and is used to withdraw bone marrow.