What is a stem cell or bone marrow transplant?

A transplant allows you to have high doses of chemotherapy and other treatments. The stem cells are collected from the bloodstream or the bone marrow.

What are stem cells?

Stem cells are very early cells made in the bone marrow. Bone marrow is a spongy material that fills the bones.

Diagram of bone marrow

These stem cells develop into red blood cells, white blood cells and platelets. 

Diagram of three different types of blood cell

Red blood cells contain haemoglobin which carries oxygen around the body. White blood cells are part of your immune system and help to fight infection. Platelets help to clot the blood to prevent bleeding. 

How transplants work

You have a stem cell transplant after very high doses of chemotherapy. You might have targeted drugs with the chemotherapy. You may also have radiotherapy to your whole body. This is called total body irradiation or TBI.

The radiotherapy and chemotherapy have a good chance of killing the cancer cells. But it also kills the stem cells in your bone marrow. 

So your team either collect:

  • your own stem cells before your high dose chemotherapy
  • or a donor's stem cells

After the treatment you have the stem cells into your bloodstream through a drip. The cells find their way back to your bone marrow where they start making blood cells again and your bone marrow slowly recovers.

To treat acute myeloid leukaemia (AML), you usually have a transplant using stem cells from a donor. Some people might have a transplant using their own stem cells, although this is not as common. 

Mini transplant

Some people who have a donor transplant might have a mini transplant. This is also called a reduced intensity conditioning (RIC) transplant. 

You have lower doses of chemotherapy than in a traditional stem cell transplant. You might have this treatment if you are older (usually over 50 years), or not fit or well enough for a traditional transplant.

Photograph showing a stem cell transplant

A stem cell or bone marrow transplant?

The main difference between a stem cell and bone marrow transplant is whether stem cells are collected from the bloodstream or bone marrow.

A stem cell transplant uses stem cells from your bloodstream, or a donor’s bloodstream. This is also called a peripheral blood stem cell transplant.

A bone marrow transplant uses stem cells from your bone marrow, or a donor’s bone marrow.

Stem cell transplants are the most common type of transplant. Bone marrow transplants are not used as much.  This is because:

  • it’s easier to collect stem cells from the bloodstream than bone marrow
  • your treatment team can usually collect more cells from the bloodstream
  • blood counts tend to recover quicker following a stem cell transplant

You might have a bone marrow transplant if collecting stem cells has been difficult in your situation.

Why you might have a transplant

The aim of a transplant is to put the cancer into remission. Remission means there is no sign of the cancer.

Your doctor might suggest a transplant if your disease:

  • is in remission but is likely to come back
  • has not responded to other treatments 

Types of transplant

We have more information about having a transplant using:

  • your own stem cells (autologous stem cell transplant)
  • or stem cells from another person (allogeneic stem cell transplant)
Last reviewed: 
11 May 2020
Next review due: 
11 May 2023
  • Guidelines for selection and HLA matching of related, adult unrelated donors, and umbilical cord units for haematopoietic progenitor cell transplantation
    British Society of Blood and Marrow Transplantation, 2012

  • Acute Myeloblastic Leukaemia in Adult Patients: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up
    M Fey and C Buske
    Annals of Oncology, 2013. Volume 24, Issue 6

  • Clinical Commissioning Policy: Haematopoietic Stem Cell Transplantation
    NHS Comissioning Board, 2013

  • Hematopoietic SCT in Europe: data and trends in 2011
    JR Passweg and others
    Bone Marrow Transplant, 2013. Volume 48, Issue 9

  • Using NHS Cord Blood Bank
    NHS blood and transplant. Accessed August 2015

  • UK Stem Cell Strategic Forum Report
    NHS Blood and Transplant, 2010

  • The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact patientinformation@cancer.org.uk with details of the particular issue you are interested in if you need additional references for this information.

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