Home > Cancer and Treatments
Bone marrow and blood stem cell transplantation (BMT) is a treatment for many diseases in both children and adults.
Such as:
- Blood cancers like leukemia and lymphoma
- Solid tumors like breast or testicular cancer
- Blood diseases like aplastic anemia
- Immune and genetic diseases
BMT is provided at the U-M Cancer Center in our Blood and Marrow Transplantation Clinic.
Research on BMT and the cancers it often treats, is the focus of our Blood and Marrow Transplantation Program.
Bone marrow is the spongy tissue found inside
your large bones. It is responsible for making blood cells
All of these elements are very important; therefore, a change
in bone marrow function can be life-threatening.
It is also home to the immune system.
Blood cells grow in the same way as other human cells. They
are developed in the bone marrow from a parent cell known
as a “
stem cell.” These stem cells
begin to divide and mature until they are fully developed,
forming all the different types of blood cells: white blood
cells, platelets and red blood cells.
Stem cells usually are found inside the
bone marrow spaces of large bones, however, they can travel
from one bone to the other by way of the blood system. A very
small percentage of the white blood cells circulating through
your veins are stem cells.
Return to top of page
Bone marrow transplant is actually a transfusion of bone
marrow stem cells or blood stem cells (collected from
either a donor or the patient), which are used as a “rescue”
for the patient after high doses of chemotherapy. There are
several of forms bone
marrow transplantation. Each transplantation process is made
up of two parts:
The infusion or “transplant” is
done very much like a blood transfusion. If you are receiving
stem cells from a donor (an allogeneic
transplant), the infusion is given to you soon after the
stem cells are collected. The “transplant” is given
through your IV catheter much as other blood transfusions.
If you receive your own stem cells (an autologous
transplant), a blood bank technologist will bring the
frozen product to your room for thawing immediately before
infusion.
Return to top of page
Bone
marrow transplantation is a treatment for many diseases in both children
and adults. Among these are certain blood cancers such as leukemia and
lymphoma; some solid tumors; blood diseases such as aplastic anemia; some
immune diseases; and serious genetic disorders.
Bone marrow
stem cells are collected from either the patient
or a donor depending on the
type
of transplant being done. The process of collecting these
cells is called “
harvesting.” Stem
cells usually are found inside the bone marrow spaces of large
bones, however, they can travel from one bone to the other
by way of the blood system. Therefore, stem cells can be harvested
from either the bone marrow or the blood.
The procedure is performed in the operating room. The patient/donor
can be given general anesthesia so he or she is not awake
and won’t feel anything during the procedure. The patient/donor
may also select spinal anesthesia. Once in the operating room,
the patient/donor is positioned on his or her stomach. The
doctors place needles into the hip bone (pelvis) and pull
out the marrow with syringes. The needles are placed through
the skin three to five times over each hip bone. For each
puncture in the skin there are many punctures into the bone.
Once collected, the marrow is filtered and placed into blood
bags. If an autologous
transplant is to be done, the marrow is processed and
stored frozen until later. If the marrow is donated for an
allogeneic transplant,
it is brought to the patient for transfusion soon after the
harvesting is completed. When the marrow is donated from an
unrelated donor, it is collected where the donor lives and
brought by courier to the patient within hours of collection.
The entire harvesting procedure takes one to two hours. The
patient may receive a blood transfusion during the collection
to replace the blood removed with the bone marrow. Once completed,
the patient/ donor is taken to the recovery room with a large
bandage across the hips that remains in place for 24 hours.
Discharge from the hospital is generally the same day. There
is soreness from the harvesting, but pain medication is given
as needed. Soreness can vary from person to person, but normal
activity is usually resumed within three to four days and
complete recovery within approximately two weeks.
Return to top of page
There are different types of transplants depending on who
donates the bone marrow or blood stem cells. The most common
are:
Allogeneic Transplant
- stem cells are donated from a genetically matched family
member (usually a brother or sister). Genetic matching,
called HLA matching, is done from blood samples.
Matched Unrelated Transplant -
another type of allogeneic transplant, but the stem cells
are donated by someone other than a family member. This
donor is found in one of the worldwide donor registries.
The University of Michigan is a member
center of the National
Marrow Donor Program.
Syngeneic Transplant - the person
donating the stem cells is an identical twin.
Autologous Transplant
- the patient donates his or her own stem cells prior to
treatment for infusion later.
Your doctor will discuss what type of transplant is available
for you.
“Peripheral Blood” Stem Cell Harvesting
(Apheresis)
Stem cells also can be collected from the circulating blood
system for transplant. This method of collection is called
“peripheral stem cell apheresis.” Apheresis is
performed as an outpatient procedure and
usually takes two to three hours per procedure. Most patients
or their donors will have one to three procedures done to
collect the required number of stem cells. For several days
prior to the procedure, a drug called “growth factor”
is taken in injection form to produce a greater number of
stem cells, which are released into the blood.
Apheresis is done by inserting a needle into one arm and
connecting attached tubing to a machine where the peripheral
stem cells are separated and collected. The remaining blood
components (white cells, red cells and platelets) are returned
to you through a needle in your other arm. The only discomfort
you may feel is when the needles are inserted. In some cases,
an IV catheter is inserted in the neck or groin if the veins
in the arms are not strong enough for the procedure.
Return to top of page
Approximately
two to four weeks after your
transplant you can expect to see signs of your bone marrow
“engrafting” or beginning to grow. The first sign
of this is the production of white blood cells. Platelets
often take a little longer to begin developing. Once you have
engrafted and your condition is stable, you will be discharged
from the hospital.
Discharge
Although each person varies in how long he or she takes to
recover, the following are general criteria used for discharge:
- no evidence of an emerging infection or graft versus host
disease
- able to tolerate oral medications, food and fluids
- active enough to function outside the hospital
- discharge teaching completed for you and your caregiver
Return to top
-last updated 12/07
