Stem cell (bone marrow) transplant

Bone marrow transplants, also known as stem cell transplants, help your body make healthy blood cells. During this procedure, blood-forming cells, called hematopoietic stem cells, are infused into your bloodstream and travel to the bone marrow, a spongy material inside bones where blood cells are formed. This encourages the growth of healthy red blood cells, white blood cells, and platelets that can help treat blood cancers and other blood disorders.

At Penn Medicine, bone marrow transplants are performed by experts in our nationally recognized blood cancer care program. We combine extensive transplant experience with access to leading research, innovative therapies, and coordinated support to help you feel confident and cared for throughout your treatment journey.

Healthy stem cells for a transplant can come from several places:

• Allogeneic (allo) transplant: This uses cells from a donor. The donor’s cells should be a close match to yours to help prevent side effects. Family members are often good matches for allogenic transplant.
• Autologous (auto) transplant: This is a procedure that uses cells from your own body.
• Umbilical cord blood transplant: This type of transplant uses stem cells from umbilical cord blood (the cord that connects a fetus to a mother until birth).
• Transfusion-free (bloodless) stem cell transplant: This allows patients to undergo bone marrow or stem cell replacement without receiving any donor blood products.

People with certain blood cancers, like leukemia, lymphoma, or multiple myeloma, are often candidates for a bone marrow transplant. These diseases can affect the bone marrow’s ability to produce enough healthy red blood cells, white blood cells, and platelets. In some cases, a transplant may also be recommended to treat other blood disorders or conditions that damage the bone marrow. Your care team will consider your diagnosis, overall health, and response to previous treatments when determining whether a transplant is right for you.

Bone marrow transplantation is a complex process, and the length of treatment varies depending on your specific condition and care plan. There are some typical steps in the process, including:

• Finding a donor: If an allogenic transplant is right for you, we take a blood sample or swab the inside of your cheek, then perform human leukocyte antigen (HLA) typing. This testing identifies characteristics of your immune system that help identify the right donor. We’ll also do HLA typing on potential donors. The donor may be someone in your family or from a registry of volunteers.
• Stem cell collection: Over a few days, you or your donor will receive injections of medications that stimulate your body to produce more stem cells. Our team then uses an IV (intravenous line) in the arm or chest to draw out stem cells. We’ll store the cells until transplant day. Bone marrow donors may have a surgical procedure to collect their marrow.
• Pre-transplant treatment: You may have chemotherapy or radiation therapy before a stem cell transplant to eliminate as many cancerous cells as possible before treatment begins.
• Transplantation: Our team infuses the stem cells into your body through a thin, flexible tube called a catheter. The infusion doesn’t take long, usually about 30 minutes to an hour.

Your Penn Medicine care team will answer any questions you have about the procedure and offer individualized support to explain each step in the transplant process.

After your transplant, you may remain in the hospital for several weeks while your care team closely monitors your recovery, performs regular blood tests, and provides supportive care. They’ll manage possible side effects like fatigue or nausea and watch for signs of complications like infection or graft-versus-host disease.

You’ll have regular follow-up care visits to monitor your progress once you return home. At this stage, it’s common to still experience fatigue and an increased risk of infection. Your care team will continue to check for any issues and guide you on medication use, activity levels, and when to seek care as your immune system rebuilds.

When you receive a bone marrow transplant at Penn Medicine, you’ll have access to:

• A team with extensive experience: Our program is one of the largest in the country, performing hundreds of transplants each year. Our expert physicians and nurses are highly skilled at providing this complex care.
• All possible donor sources: We offer a variety of donor options for bone marrow transplants, including autologous (using your own stem cells), allogeneic (using donor stem cells), related and unrelated donor transplants, and cord blood transplants.
• Personalized education and support: Our physicians and nurse navigators take the time to explain your treatment plan, answer your questions, and help you feel prepared throughout the process.
• Access to specialists across Penn Medicine: Transplant recovery can involve many aspects of your health. Our network includes specialists across medical fields who can support you before, during, and after your transplant.
• Transfusion-free options: Some patients decline blood transfusions for medical, personal, or religious reasons. Penn Medicine performed the world’s first bloodless stem cell transplant and continues to lead the development of new alternatives to blood transfusion in other areas of care.