Stem cells produce red blood cells, white blood cells, and platelets. In some cases, stem cells in your bone marrow may not be functioning well or need to be destroyed to help treat a disease. If this happens, you will need new stem cells.
It may take about a month for the donor stem cells in the bone marrow to begin to function fully. If the transplant is successful, new bone marrow cells will produce healthy red blood cells, white blood cells, and platelets.
Stem cell transplantation may be done using: Stem cells that were taken from your own bone marrow or blood and storedStem cells from a donor's bone marrow or blood
Location of Active Bone Marrow in an Adult
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Complications are rare, but no procedure is completely free of risk. If you are planning to have a stem cell transplant, your doctor will review a list of possible complications, which may include: Infection—until the donor blood-forming cells begin to functionRejection of the donor stem cellsAcute graft versus host disease—when the immune cells in the donor's bone marrow attack your tissue
Possible complications for the donor include: BleedingInfection
Stem cell transplant is usually avoided if you have: Disease of the heart, lungs, liver, or kidneysDiabetes
Be sure to discuss the risks with your doctor before the transplant.
The donor will be carefully tested to check for diseases. Both you and the donor will be tested to ensure that your tissues are compatible. In order for the transplant to be successful, certain markers on the blood cells and bone marrow cells must match.
As the recipient, you will be given medication to suppress your immune system. This is to prevent your body from rejecting the donor stem cells. In the weeks prior to the transplant, you may need to have: ChemotherapyRadiation therapy
This process is called conditioning. It will rid the body of diseased cells and clear the bone marrow cavities for the new bone marrow.
to block pain and keep the donor asleep through the procedure; given through an IV in the hand or arm
Recipient—will not need any anesthesia
If the stem cells will be from the donor's bone marrow, an area of the donor's hip will be cleaned. A hollow needle and syringe will be used to remove the bone marrow. The doctor will make several small punctures. This is to harvest enough bone marrow for the transplant (1-2 quarts). Lastly, the wounds will be covered with bandages.
If the stem cells will be from the donor's blood, the doctor will stick a needle in the donor's large vein or veins in the arms. A machine will receive blood from the vein. This machine will spin the blood so that the stem cells are concentrated. The rest of the blood will be given back to the donor. The puncture wounds will be covered with bandages. This procedure may require more than one blood donation. The donor may also be required to take pills that cause more stem cells from the bone marrow to go into the blood.
The donated stem cells will be filtered. The cells will be administered into one of your large veins through a small, flexible tube, called a catheter.
The donor will recover quickly. You, the recipient, will need to be placed in isolation. This is to avoid infection until the new stem cells in the bone marrow begin to produce infection-fighting cells.
Bone marrow transplant (BMT)—about 30 minutesPeripheral blood stem cell (PBSC)—several hoursRecipient—several hours
If the procedure done is a BMT, then the donor will have general anesthesia during the transplant. There may be pain and discomfort after the anesthesia wears off.If the procedure done is a PBSC transplant, then the donor will have pain from the needle sticks.Recipient: There will not be pain while the stem cells are infused. You may have some nausea. This can be treated with medication.
For BMT—overnightFor PBSC—several donations, each lasting a couple of hoursRecipient—1-2 months
The donor may receive: Pain medicineAntibiotics to prevent infection
While you are recovering at the hospital, you may receive the following care: Medication that keeps your immune system low to decrease the chance of transplant rejectionAntibiotics to prevent infection
Platelets, plasma, and red blood cell transfusions to prevent bleeding and
anemiaFrequent blood tests to monitor whether the new stem cells in the bone marrow are taking hold or being rejected
After you leave the hospital, contact your doctor if any of the following occur: Nausea and/or vomitingSevere painNew onset of pain more than 24 hours after the transplantRedness, swelling, increasing pain, excessive bleeding, or discharge from the catheter siteSigns of infection; including fever and chillsRashDiarrhea
In case of an emergency, call for medical help right away.
Bone marrow transplantation and peripheral blood stem cell transplantation
. National Cancer Institute website. Available at:
http://www.cancer.gov/cancertopics/factsheet/Therapy/bone-marrow-transplant. Updated September 24, 2010. Accessed June 24, 2013.
Stem cell transplant (peripheral blood, bone marrow, and cord blood transplants). American Cancer Society website. Available at:
http://www.cancer.org/treatment/treatmentsandsideeffects/treatmenttypes/bonemarrowandperipheralbloodstemcelltransplant/bone-marrow-and-peripheral-blood-stem-cell-transplant-toc. Accessed June 24, 2013.
Last reviewed May 2014 by Mohei Abouzied, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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