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What is a stem cell or bone marrow transplant?

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.

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.

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 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)
Last reviewed: 
21 Jan 2019
  • The European Blood and Marrow Transplantation Textbook for Nurses. Under the Auspices of EBMT
    M Kenyon and A. Babic 
    Springer Open, 2018

  • Clinical Commissioning Policy: Haematopoietic Stem Cell Transplantation. Reference: NHSCB/B04/P/a
    NHS Commissioning Board, 2013

  • British Society of Blood and Marrow Transplantation Indications for BMT
    British Society of Blood and Marrow Transplantation, 2013

  • Indications for HSCT in Children- UK Paediatric BMT Group 2015
    British Society of Blood and Marrow Transplantation, 2015

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

  • 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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