When is a blood and marrow transplant appropriate?
Thanks to advances such as reduced-intensity transplants, haploidentical transplants and related/unrelated donor transplants, a blood and marrow transplant (BMT) is available to more people than ever. Increased survival rates have gone hand-in-hand with innovative treatment approaches.
Today, BMT is often the treatment option of choice for patients diagnosed with:
- Hodgkin's and non-Hodgkin's lymphoma
- Acute lymphocytic leukemia
- Acute myeloid leukemia
- Multiple myeloma
- Chronic myeloid leukemia
- Severe aplastic anemia
- Chronic lymphocytic leukemia
- High-risk relapse lymphoma
- Immune deficiency disorders
- Relapsed testicular cancer
- Sickle cell anemia
- Bone marrow failure syndromes
- Myelodysplastic syndromes (MDS)
- Some solid tumors
What is bone marrow?
Bone marrow is a soft, gelatinous tissue inside some bones. There are two types of bone marrow, red and yellow, which produce the stem cells and blood cells that are essential to a person's health.
Healthy bone marrow makes a variety of stem cells:
- White blood cells
- Red blood cells
- Platelets
Immune effector cell therapy
For the past 30 years, adoptive cellular therapy with immune effector cells including a variety of lymphocytes, has been developed at research centers around the world.
Chimeric antigen receptor CAR T-cell have emerged from the lab as FDA-approved treatments for a variety of cancers. This includes some gene-modified T cells and natural (NK) cells. The future for effector cell therapy is bright, as it becomes the treatment of choice for many cancer patients. Baylor Scott & White Health will continue to play a leading role in these pioneering efforts.
Contact our patient nurse navigators at 214.820.3535 for more information about CAR T and immune effector cell therapies and clinical trials.
Blood and marrow transplant options
The blood and marrow physician specialist will recommend a specific type of blood and marrow transplant after considering individual patient factors.
Autologous transplant
Depending on their disease, some patients can have their stem cells removed and infused back into their body after they have undergone the appropriate procedure to either kill cancer cells, diminish the immune system to improve response to transplant, or destroy harmful bone marrow before the transplant takes place. This is an autologous transplant.
Allogeneic transplant
Note: Only offered at Baylor University Medical Center, part of Baylor Scott & White Health.
Other patients may not be able to use their own stem cells, so they must depend on matching with a donor who provides the stem cells for their transplant. This is an allogeneic transplant.
Related-donor transplant
Generally, patients begin the allogeneic transplant process by looking for a relative to be their donor.
Siblings are often the best candidates; identical twins are an exact match.
Matched unrelated-donor transplant
Patients who are unable to find a match with a relative can search donor registries for an unrelated donor who is a match.
Haploidentical and cord blood transplants
Haploidentical (half-matched) and cord blood transplants have expanded the pool of potential donors and made it possible for many more individuals to receive a blood and marrow transplant.
In the case of a cord blood transplant, the stem cells were collected and frozen at the time of the baby’s birth.
Reduced-intensity transplants
Some patients may have their bone marrow and immune systems weakened, but not destroyed, before infusing stem cells from a donor.
This is a reduced-intensity transplant.
What to expect
From start to finish, the transplant generally takes a few months.
- Stem cells are harvested (collected) from bone marrow for a BMT transplant
- A donor or the transplant patient him or herself can serve as the source for the bone marrow stem cells.
- Depending on the care plan devised by our team of specialists, the transplant patient will receive chemotherapy, radiation therapy or a combination of both, to kill her or his cancer cells, immune system, or both.
- The stem cells are infused (injected) into the patient’s bloodstream where they begin to produce healthy stem cells and bone marrow.
Clinical trials
Baylor Scott & White blood and marrow transplant programs have a strong foundation of innovation and clinical research. Physicians and researchers on staff participate in a variety of studies related to BMT.
Research trials become available frequently. If your physician has recommended BMT for you, you may view a list of current clinical trials.
National Marrow Donor Program
The National Marrow Donor Program (NMDP) was started in 1986 to serve as a national database of tissue types from individuals willing to donate marrow to patients needing a marrow transplant.
Since that time, the registry, now called the Be The Match® Registry, has over 8 million individuals registered.
It is linked with registries all over the world, making it an international registry to serve any patient needing a transplant anywhere in the world.
Donate bone marrow, stem cells or cord blood
If you would like to join a donor registry to donate bone marrow or stem cells for someone who doesn't have a matched relative available to donate, or if you would like to donate cord blood when your baby is born, you can do so through one these groups: