Bone marrow and stem cell transplant for chronic lymphocytic leukaemia (CLL)

Men and women discussing chronic lymphocytic leukaemia

This page is about bone marrow and stem cell transplants for chronic lymphocytic leukaemia (CLL). There is information about

A quick guide to what's on this page
What a transplant is
When transplants are used for CLL
Mini transplants and transplant timing
More information about transplants

Bone marrow and stem cell transplant for chronic lymphocytic leukaemia (CLL)

A small number of people have intensive treatment with a bone marrow or stem cell transplant for CLL, but this is still experimental.

The aim of a bone marrow or stem cell transplant is to keep the CLL under control for as long as possible. This type of treatment involves having your bone marrow cells killed off with high dose chemotherapy. You may also have radiotherapy to your whole body (TBI). This destroys the leukaemia cells but also your bone marrow cells. After the intensive treatment you will have donor bone marrow or stem cells through a drip. The stem cells move into your bone marrow and start to make new blood cells again.

This treatment is called a transplant because bone marrow or stem cells are removed from a donor and then transplanted into you. Doctors don't use this type of treatment very often for chronic lymphocytic leukaemia.

Mini transplants

Mini transplants don't use quite such intensive chemotherapy treatment. So your bone marrow is not destroyed. The chemotherapy still suppresses your immune system and allows donor blood cells to grow.

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Transplant means killing off your bone marrow cells with high dose chemotherapy. You may also have radiotherapy to your whole body (TBI). This high dose treatment destroys the leukaemia cells but also your bone marrow cells. The bone marrow is the spongy substance inside your bones. It contains cells called stem cells, which make all your blood cells.

After the intensive treatment your bone marrow cells need to be replaced, because it is vital you have a working bone marrow to survive. You will have your donor cells through a drip (intravenous infusion). Having someone else's bone marrow or stem cells is called a donor or allogeneic transplant. The stem cells then move into your bone marrow and start to make new blood cells again. It can take a few days or weeks for the stem cells to start to make enough blood cells.

The aim of this intensive treatment is to try to cure your chronic lymphocytic leukaemia or control it for longer than is possible with other types of treatment. Doctors call this treatment a transplant because bone marrow or stem cells are removed from a donor and then you have them. So they are transplanted into you. If you are having a bone marrow transplant your donor will have surgery to remove their bone marrow.

Bone marrow or stem cell transplants are not commonly used for chronic lymphocytic leukaemia. It is still really an experimental treatment and you should have it as part of a clinical trial. The aim of the treatment is to keep the CLL under control for as long as possible.

Your doctor is most likely to suggest that you have a transplant if you are younger, fit and your leukaemia has come back quite quickly after your initial treatment. As transplants are not routine treatment, we have not gone into great detail here. There is more information about bone marrow and stem cell transplants in the cancer treatment section.

Doctors and researchers have been looking into mini transplant or reduced intensity conditioning (RIC) for CLL. Mini transplants don't use quite such intensive chemotherapy treatment. So your bone marrow is not destroyed. But the chemotherapy treatment used suppresses your immune system and allows donor blood cells to grow. There is more about mini transplant in the CLL research page.

You can find detailed information about bone marrow and stem cell transplants in our cancer treatment section. You can find out about current research into CLL on the CLL research page or by looking at our clinical trials database. Pick 'leukaemia: chronic leukaemia' from the dropdown list of cancer types.