You might have a stem cell or bone marrow transplant as part of your cancer treatment.
It is a treatment for some people with:
- lymphoma (cancer of the lymphatic system)
- leukaemia (cancer that develops in the white blood cells of the immune system)
- myeloma (cancer that develops in white blood cells called plasma cells)
It is also a treatment for other blood conditions.
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.
These stem cells develop into red blood cells, white blood cells and platelets.
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.
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.
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 your transplant will depend on your situation. Your doctor might explain that a transplant will try to cure your disease or control it for as long as possible.
With lymphoma, leukaemia and myeloma the aim 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
Depending on your situation, you might have a transplant using:
- your own stem cells (autologous stem cell transplant)
- or stem cells from another person (allogeneic stem cell transplant)