Stem cell (bone marrow) transplant

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).

If you have blood cancer, your doctors might recommend a bone marrow transplant. The treatment can help people with:

• Leukemia
• Lymphoma
• Multiple myeloma

Bone marrow transplantation is a complex process that should be done by experts with extensive experience. The team Penn’s Blood Cancer Program helps you understand what to expect before, during and after the procedure.

The stem cell transplant process takes a few weeks, and the steps generally include:

• Finding a donor: If allogenic transplant is right for you, we take blood 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 someone from a registry of volunteers.
• Stem cell collection: Over a few days, you (if you are having an autologous transplant) or your donor will receive injections of medications that stimulate your body to produce more stem cells. Our team then uses an IV 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 kill as many cancerous cells as possible.
• 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.

After transplantation, you’ll stay in the hospital for a few weeks. Our team will:

• Monitor you closely
• Take regular blood tests to make sure your blood counts are recovering
• Give you antibiotics to prevent infection
• Provide blood transfusions as needed

We’ll also monitor and treat any side effects, which may include:

• Anemia or bleeding
• Diarrhea, nausea and vomiting
• Fatigue
• Graft versus host disease, a serious condition which may occur if your body recognizes and attacks the new, transplanted cells
• Infection
• Infertility
• Mouth sores
• Other cancers

If you receive a bone marrow transplant through the Penn Medicine Blood Cancer Program, you’ll find:

• A team with extensive experience: Our program is the largest in the region and one of the largest in the country. We perform hundreds of transplants per year. Our physicians and nurses have extensive experience with transplantation which helps us detect potential problems early for prompt intervention.
• All possible donor sources: We offer transplants from all possible donor sources, including autologous, allogeneic, related and unrelated donors, and cord blood.
• Personal attention and education: The decision to have a bone marrow transplant is complex and personal. Our physicians and nurse navigators will take time to educate you about the specific process you need. We’ll answer any questions you may have and make sure you’re prepared.
• Network of specialists: The side effects and complications of bone marrow transplantation can affect many different body systems. The Penn Medicine network includes every kind of specialist you may need as you recover.
• Bloodless options: Some patients cannot receive blood products or prefer not to. Our program is one of few in the country that offers bloodless transplantation options.