Blood and bone marrow transplant

A blood and bone marrow transplant (BMT) is used to resupply the bone marrow with hematopoietic (blood-forming) stem cells after the body's blood cells—including the leukemia cells—have been wiped out with high doses of chemotherapy and radiation. BMT allows patients to receive the high doses of chemotherapy and radiation therapy needed to kill off leukemia cells—higher than they could normally tolerate.

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Depending on the source of the stem cells, this procedure may be called a bone marrow transplant, a peripheral blood stem cell transplant, or a cord blood transplant. In a cord blood transplant, the cells come from a newborn baby's umbilical cord. The stem cells used for a BMT are most often donated by a related matched family member or an unrelated but matched donor; this is called an allogeneic transplant. A transplant from an identical twin is called a syngeneic transplant and a transplant of your own stem cells is an autologous transplant. The latter is possible if you go into remission and then save healthy bone marrow for a future transplant, in case the leukemia returns.

For people with leukemia, the first step in a BMT is "conditioning," in which they have high doses of chemotherapy, sometimes combined with radiation therapy. After conditioning, donated stem cells are infused using an IV. No surgery is required for a BMT.

A BMT is a lengthy process that includes several phases, no matter the type of transplant or the source of stem cells. Complete recovery to normal blood cell counts and a fully functional immune system may take six months to one year. During this time, one's life and family relationships will be disrupted. Side effects of BMT can be significant and vary with the phase of treatment and the type of chemo or radiation therapy and type of donor cells. Some problems may appear even a year or more after healthy cells are infused. However, a BMT is a lifesaving procedure for many people with leukemia.