Stem cell transplantation can be a life-saving treatment option for patients with blood cancers or disorders. The procedure, sometimes called bone marrow transplantation, replaces bone marrow that doesn’t work correctly or has been damaged by disease.
We spoke with Joseph Antin, MD, chief of the Stem Cell Transplantation Program at Dana-Farber/Brigham and Women’s Cancer Center, to learn more about this procedure:
Why might I need a stem cell transplant?
You might need a stem cell transplant if your bone marrow can’t make enough blood cells or if it produces abnormal blood cells, usually because it is damaged by disease. For example, acute myeloid leukemia (AML) is a cancer of the bone marrow. Typically there are too many white blood cells and those cells fail to mature and function properly. Conversely, patients with aplastic anemia can’t make enough blood cells. Depending on the source of the stem cells, this procedure may be called a peripheral blood stem cell transplant, a bone marrow transplant, or a cord blood transplant. All of these are stem cell transplants; the stem cells are collected differently in each of the three procedures.
What does a stem cell transplant do?
Stem cell transplantation refers to a procedure where healthy stem cells are taken from one individual and given to another (called an allogeneic transplant), or using an individual’s own stem cells (called an autologous transplant). Your physician will decide what type of transplant should be used for your treatment and the source of the transplanted stem cells.
An allogeneic transplantation replaces damaged bone marrow with blood-forming stem cells that develop into healthy bone marrow. This helps the body make enough blood cells and it lowers risk of anemia, bleeding, and infections. In autologous transplantation, collecting the stem cells before treatment and preserving them allows a much higher (and hopefully curative) dose of chemotherapy to be administered. The stem cells allow blood counts to recover after the high dose therapy.
Hematopoietic stem cells can grow into any of the cells found within the bloodstream. They make blood cells and the components that your immune system needs to function. During a transplant, your body is infused with healthy stem cells that then grow and produce all of the different parts of the blood that both your body and your immune system need.
Why would doctors choose a stem cell transplant?
Stem cell transplantation allows doctors to use much higher doses of chemotherapy and/or radiation than might otherwise be possible. These are more effective in destroying cancer cells, but they can also damage bone marrow. In allogeneic transplantation, the donor’s immune cells can also contribute to the anti-cancer effect of the procedure.
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What’s the link between bone marrow and stem cells?
Bone marrow is the spongy tissue inside large bones such as hip and thigh bones. It contains immature cells called hematopoietic, or blood-forming, stem cells that develop into three types of blood cells: red blood cells that carry oxygen through the body; white blood cells that are responsible for fighting infection; and platelets that help the blood clot. It is the stem cells that allow us to make trillions of blood cells over our lifetimes. Those stem cells can be collected directly from the pelvic bone (bone marrow harvest), or they can be released into circulation and collected by a procedure called apheresis (peripheral blood stem cell harvest). There are advantages and disadvantages to each approach that would be explained by the transplant physician.
Blood-forming stem cells are not the same as embryonic stem cells studied in cloning and other types of research.
What conditions are treated by stem cell transplantation?
Stem cell transplantations are a common treatment option for cancers such as multiple myeloma, certain types of lymphoma, and leukemia. They are also used to treat several types of blood disorders and immune system diseases, including: aplastic anemia, sickle cell anemia, disorders of immunity, myelodysplastic syndrome, Waldenström’s macroglobulinemia, and myeloproliferative disorders.
Do you have a question that is not answered here? You can visit the website for the Stem Cell Transplantation Program at Dana-Farber/Brigham and Women’s Cancer Center.
Celebrating 50 Years of Stem Cell Transplantation: Learn about the history, progress, and innovation in the adult stem cell transplantation program over the past 50 years.
I had a transplant at Brigham Women’s Hospital last November under the direction of Dr. Claudia PABA Prada, a great doctor and great person along with her right hand women RN Kathleen Finn. Wow, what a great team!!!!!!!!!
Dr Antin saved my life more than 19 yrs ago. I have a great life thanks to him and all the transplantation team. My wife and I have 2 wonderful daughters, the oldest Is looking at college. Thank you Joe for everything Rich
My grandson Benjamin Silveira is a bone marrow recipient at Boston children’s and is seen in Dana Faber his first transplant was at the age of 3 his second at the age of 6… His twin which was a 99.9 match donated marrow both times, my question why did the first transplant last only 3 years he had aplastic enemia and could he have to have a third transplant or should be be okay now…he’s going to be 9.Thank you Janet Moody
Dear Janet —
Thank you for connecting with us and for reading Insight. I’m sorry to hear about your grandson’s health trouble in the past. Unfortunately, we cannot give out medical advice over this blog or email. We would recommend bringing your question and any other concerns to your family’s pediatric oncologist or stem cell transplant physician.
Wishing you and your family all the best!
May i have my original complexion back after stem cell transplant.. allogenic transplant for cml ? Pls answer
Hi Roshan:
It’s best if you asked your doctor or nurse that specific question. They’ll know best about your particular situation and should be able to advise you. In general, though, here’s what our nursing team here said:
“Some patients have somewhat darkened (hyperpigmented) skin for several months s/p (post) transplant, and this usually fades back to baseline slowly over time. If you have had any GVHD related skin changes s/p transplant, this can cause more permanent changes, but these also tend to fade, at least somewhat, over time if the GVHD responds to treatment.”
I hope that’s helpful and wish you the best.
–Michael