Bone Marrow and Peripheral Blood Stem Cell Transplantation

Bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT) are two ways to restore blood-forming cells. Learn about Huntsman Cancer Institute's Blood and Marrow Transplant Program.

As part of their treatment, some patients receive high doses of chemotherapy and/or radiation therapy to destroy cancer cells. These treatments also destroy the patient’s blood-forming stem cells. BMT or PBSCT gives the patient new, healthy stem cells. The stem cells travel to the bone marrow and begin to produce new blood cells.

Frequently Asked Questions about Bone Marrow and Peripheral Blood Stem Cell Transplantation

What are bone marrow and blood-forming stem cells?
What are bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT)?
How are the donor’s stem cells matched to the patient’s stem cells in allogeneic transplantation?
How does the patient receive the stem cells during the transplant?
What are the possible side effects of BMT and PBSCT?
What is a tandem transplant?
Where can I get more information about BMT and PBSCT?

What are bone marrow and blood-forming stem cells?

Bone marrow is soft, sponge-like material found inside bones. It contains immature cells
called blood-forming (or hematopoietic) stem cells. Blood-forming stem cells are different
from embryonic stem cells. Embryonic stem cells can develop into every type of cell in the body.

Blood-forming stem cells divide and mature into one of three types of cells:

  • White blood cells, which fight infection
  • Red blood cells, which carry oxygen
  • Platelets, which help blood to clot

Most blood-forming stem cells are found in the bone marrow. Some cells, called peripheral blood stem cells (PBSCs), are found in the bloodstream. Blood in the umbilical cord also contains blood-forming stem cells. Stem cells from any of these sources—bone marrow, peripheral blood, or the umbilical cord—can be used in transplants.

What are bone marrow transplantation and peripheral blood stem cell transplantation?

Bone marrow transplantation (BMT) and peripheral blood stem cell transplantation (PBSCT) are two ways to restore blood-forming cells. Some patients receive high doses of chemotherapy and/or radiation therapy to destroy cancer cells. These treatments also destroy the patient’s blood-forming stem cells. BMT or PBSCT gives the patient new, healthy stem cells. There are three types of transplants:

  • Autologous transplant, in which a patient receives his or her own stem cells
  • Syngeneic transplant, in which a patient receives stem cells from his or her identical twin
  • Allogeneic transplant, in which a patient receives stem cells from his or her brother, sister, or parent. Stem cells from a person who is not related to the patient (an unrelated donor) may also be used.

How are the donor’s stem cells matched to the patient’s stem cells in allogeneic transplantation?

To reduce potential side effects, doctors use transplanted stem cells that match the patient’s own stem cells as closely as possible. People have different sets of proteins on the surface of their blood cells. These proteins are called human leukocyte-associated (HLA) antigens. A special blood test can show which set of proteins, or HLA type, a person has.

In most cases, the success of allogeneic transplantation depends in part on how well the HLA antigens of the donor’s stem cells match the recipient’s HLA type. Close relatives are more likely than unrelated people to be HLA-matched. The patient’s brothers and sisters (siblings) may have the best match. However, only 25 to 35% of patients have an HLA-matched sibling. The chances of obtaining HLA-matched stem cells from an unrelated donor are slightly better.

How does the patient receive the stem cells during the transplant?

After high-dose chemotherapy and/or radiation treatments, the patient receives stem cells through an intravenous (IV) line, just like a blood transfusion. This part of the transplant takes 1 to 5 hours.

Once the stem cells are in the bloodstream, they travel to the bone marrow. In the bone marrow, the stem cells begin to produce new blood cells in a process known as “engraftment.” Engraftment usually happens in about 10 days to 3 weeks. After transplantation, frequent blood tests confirm that new blood cells are being produced.

What are the possible side effects of BMT and PBSCT?

Side effects will differ from patient to patient. Talk with your doctor about side effects that may happen.

One big concern after transplantation is the risk of infection and bleeding. Doctors may give antibiotics to prevent or treat infection. They may also give transfusions of platelets to prevent bleeding and red blood cells to treat anemia.

Short-term side effects include the following:

  • nausea
  • vomiting
  • fatigue
  • loss of appetite
  • mouth sores
  • hair loss
  • skin reactions

Potential long-term risks include the following:

  • infertility
  • cataracts
  • secondary (new) cancers
  • damage to the liver, kidneys, lungs, and/or heart

With allogeneic transplants, Graft-Versus-Host-Disease (GVHD) sometimes develops. In GVHD, white blood cells from the donor (the graft) identify cells in the patient’s body (the host) as foreign and attack them. GVHD often damages the skin, liver, and intestines. This complication can occur within a few weeks of the transplant or much later. To prevent GVHD, the patient may receive medications that suppress the immune system.

What is a tandem transplant?

A tandem transplant is a type of autologous transplant. The patient receives two courses of high-dose chemotherapy, each followed by a stem cell transplant. Typically, the two courses are given several weeks to several months apart. Research studies show that this method may prevent the cancer from coming back.

Where can I get more information about BMT and PBSCT?

Visit the Blood and Marrow Transplant Program website. Also, contact the G. Mitchell Morris Cancer Learning Center (CLC), HCI’s free cancer information service and lending library. The CLC offers four easy ways to get cancer-related information:

  • Call toll free 1-888-424-2100
  • Visit the sixth floor of the cancer hospital
  • E-mail cancerinfo@hci.utah.edu
  • Text "askhci" to 66746

Djordje Atanackovic, M.D.

Specialties: Amyloidosis, Cancer Immunotherapy, Hematology/BMT, Myeloma, Plasma Cell Leukemia, Plasmacytoma, Tumor Immunology

Michael W. Boyer, M.D.

Locations
Huntsman Cancer Hospital (801) 585-2626
Primary Children's Hospital (801) 662-4700

Specialties: Blood and Marrow Transplantation, Hematology/BMT, Pediatric Hematology & Oncology, Stem Cell Transplant

Michael W. Deininger, M.D., Ph.D.

Locations
Huntsman Cancer Hospital (801) 585-6906
Huntsman Cancer Hospital (801) 587-4630

Specialties: Chronic Myeloid Leukemia, Hematology/BMT, Leukemia, Myeloproliferative Neoplasms

Martha J. Glenn, M.D.

Locations
Huntsman Cancer Hospital (801) 585-0100
Huntsman Cancer Hospital (801) 585-6906

Specialties: Chronic Lymphocytic Leukemia, Hematology/BMT, Hodgkin Lymphoma, Leukemia, Lymphomas, Lymphoproliferative Diseases, Non-Hodgkin Lymphoma, Oncology

Ahmad Halwani, M.D.

Locations
Huntsman Cancer Hospital (801) 585-2626

Specialties: Hematology/BMT, Medical Oncology

Teresa Herlevi, PA-C

Locations
Huntsman Cancer Hospital (801) 585-0303

Specialties: Hematology/BMT, Physician Assistant

Gerhard Carl Hildebrandt, M.D., FACP

Locations
Huntsman Cancer Hospital (801) 585-6906

Specialties: Amyloidosis, Aplastic Anemia, Hematology/BMT, Immunotherapy, Leukemia, Lymphomas, Multiple Myeloma, Myeloma

Tibor Kovacsovics, M.D.

Locations
Huntsman Cancer Hospital (801) 585-2626
Huntsman Cancer Hospital (801) 585-2626

Specialties: Hematology/BMT

Brenda S. Mueggenborg, APRN

Locations
University Hospital (801) 585-3229

Specialties: Hematology/BMT, Nurse Practitioner

Andy Nguyen, M.D.

Specialties: Hematology/BMT

J. Dane Osborn, M.D.

Specialties: Hematology/BMT

Charles J. Parker, M.D.

Locations
Huntsman Cancer Hospital (801) 585-3229
Veterans Administration Medical Center (801) 584-1272

Specialties: Hematology/BMT, Hemochromatosis, Paroxysmal Nocturnal Hemoglobinuria, Porphyria

Josef T. Prchal, M.D.

Locations
Huntsman Cancer Hospital (801) 585-6906
Veterans Administration Medical Center (801) 582-1565

Specialties: Anemia, Hematology/BMT, Myeloproliferative Disorders, Oncology, Thrombocythemia

Michael Allen Pulsipher, M.D.

Locations
Huntsman Cancer Hospital (801) 585-0100
Primary Children's Hospital (801) 662-4830
Primary Children's Hospital (801) 662-4700

Specialties: Benign Hematology, Blood and Marrow Transplantation, Brain Tumors, Hematology/BMT, Leukemia, Lymphomas, Neuroblastoma, Pediatric Hematology & Oncology

George M. Rodgers, III, M.D., Ph.D.

Locations
Huntsman Cancer Hospital (801) 585-2626

Specialties: Benign Hematology, Coagulation, Hematology/BMT, Hereditary Hemorrhagic Telangiectasia

Jaime Shahan, PA-C

Locations
Huntsman Cancer Hospital (801) 585-2626

Specialties: Hematology/BMT, Physician Assistant

Paul J. Shami, M.D.

Locations
Huntsman Cancer Hospital (801) 585-0100

Specialties: Hematology/BMT, Leukemia, Myelodysplasia, Oncology

Mary Steinbach, M.S.N., APRN

Locations
Huntsman Cancer Hospital (801) 587-4474

Specialties: Family Nurse Practitioner, Hematology/BMT

John Sweetenham, M.D., FACP

Locations
Huntsman Cancer Hospital (801) 585-6906

Specialties: Hematology/BMT, Lymphomas

Renee A. Vadeboncoeur, M.S.N., APRN

Locations
Huntsman Cancer Hospital (801) 585-0100

Specialties: Family Nurse Practitioner, Hematology/BMT