Patient education: Autologous bone marrow transplant (The Basics)

What is a bone marrow transplant? — A bone marrow transplant is a procedure that replaces abnormal or missing cells in the bone marrow with healthy cells. The bone marrow is the tissue in the center of certain bones. Normally, bone marrow makes blood cells, which the body needs to work normally. There are different types of blood cells, and all of them are made from cells in bone marrow called "hematopoietic stem cells."

If the bone marrow does not work normally, it can't make the blood cells that a person's body needs. To treat this, a doctor can put healthy stem cells, called "donor" cells, into the bone marrow. The donor cells can then make normal blood cells. A bone marrow transplant is also called a "stem cell transplant" or "hematopoietic stem cell transplant."

Why might I have a bone marrow transplant? — You might have a bone marrow transplant to help treat some kinds of cancer, such as leukemia or lymphoma, or another medical condition that affects your bone marrow.

What does "autologous" mean? — This means that the healthy stem cells come from your own body. ("Auto" means "self.") If the donor cells come from another person, it is called an "allogeneic" bone marrow transplant.

The right type of bone marrow transplant for you depends on many different things, including:

●What kind of cancer or other medical problem you have

●Your other health conditions

●Your age

●Your preferences

Your doctor will do an exam and tests to make sure that you can donate your own cells for transplant. The tests you get will depend on your medical condition, but will likely include:

●Blood tests

●Bone marrow biopsy – This involves taking a small sample of your bone marrow, then looking at it under a microscope.

●Imaging tests – Imaging tests create pictures of the inside of your body. They include chest X-ray, CT scan, and tests to check how well your heart is working.

How are the donor stem cells collected? — When it is time for the doctor to collect the "donor" stem cells from your body, you will go to the hospital or transplant center.

Most likely, the donor stem cells will come from your blood. To collect them, a needle will be inserted into a vein in each of your arms. Your blood will be taken from 1 arm and run through a special machine that collects the stem cells. After the stem cells are taken out, the rest of the blood goes back into your body through the other arm. This usually takes a few hours. Most people only need to do this once for enough stem cells to be collected, but some people need to go back a second time.

You will need to take a medicine to help your blood produce extra stem cells for several days before the collection. This medicine comes in a shot that might be given at the doctor's office, or you might give yourself the shot at home each day. It causes temporary muscle or bone pain in most people. Acetaminophen (brand name: Tylenol) can help with this.

In some situations, it is possible to collect donor cells from your bone marrow instead of your blood. This is done through a different procedure. Your doctor will talk to you about your situation and how best to collect the cells from your body.

After the cells are collected, they will be frozen and stored until it is time to transplant them back into your bone marrow.

What else will happen before my transplant? — Your doctor will put a thin tube into a blood vessel in your upper chest. This tube, called a "central line," will stay in place during your hospital stay. Your doctor will use it to give you treatments, as well as take blood for tests.

Just before your transplant, you will get "conditioning" treatment. This involves chemotherapy, radiation therapy, or both, usually given at high doses. Conditioning treatment kills cancer cells and prepares your bone marrow to receive the donor stem cells. Then, when your stem cells are transplanted back into your bone marrow, called "stem cell rescue," they can start making healthy blood cells again.

What will happen during my transplant? — Soon after the conditioning treatment, your doctor will put the donor cells into your body through your central line or another vein. The stem cells will find their way to your bone marrow. There, they can start making normal blood cells.

What will happen after my transplant? — Most people stay in the hospital for several days to weeks after an autologous bone marrow transplant.

Right after a bone marrow transplant, your body has a higher chance than usual of getting an infection. Because of this, you will need to stay in a special hospital room and get certain medicines.

Your doctor might give you other treatments, depending on your symptoms. They will also do blood tests regularly to check that your bone marrow transplant is working.

Once your bone marrow is working normally and you go home, you will need to see your doctor for regular follow-ups.

What are the side effects of a bone marrow transplant? — The side effects depend on where your donor cells came from, as well as which treatments you have before the transplant.

After an autologous bone marrow transplant, the most common short-term side effects include:

●Mouth sores and diarrhea

●Nausea and vomiting

●Hair loss

●Lung, liver, or bone problems

People can also have long-term side effects that include:

●Trouble getting pregnant – If you want to have a baby in the future, talk with your doctor before your bone marrow transplant.

●Other cancers that can happen years later

More on this topic

Patient education: Donating bone marrow or blood stem cells (The Basics)
Patient education: Neutropenia and fever in people being treated for cancer (The Basics)
Patient education: Allogeneic bone marrow transplant (The Basics)
Patient education: Bone marrow aspiration and biopsy (The Basics)

Patient education: Hematopoietic cell transplantation (bone marrow transplantation) (Beyond the Basics)