How the bone marrow functions
Bone marrow is the soft, spongy center of your bone where blood is produced. Marrow is filled with blood-producing cells, called stem cells, which develop into mature white blood cells, red blood cells or platelets.
White blood cells of various kinds make up part of your immune system for fighting infections.
Red blood cells are responsible for carrying oxygen throughout your body.
Platelets clot your blood to prevent bleeding. Stem cells are constantly being produced by your bone marrow, and will develop into the types of cells your body needs.
What started as fatigue and pneumonia ends successfully with a bone marrow transplant.
Types of bone marrow transplants
Most people who need to undergo a bone marrow transplant have cancer, such as leukemia or lymphoma. There are different types of bone marrow transplants. The type and severity of your disease determine what type of bone marrow transplant you will need.
Allogeneic Bone Marrow Transplants
An allogeneic bone marrow transplant involves receiving donor bone marrow or peripheral stem cells. This bone marrow transplant donor is genetically matched and can be related or unrelated to you. An autologous transplant involves receiving your own bone marrow or peripheral stem cells. A syngeneic bone marrow transplant involves receiving your identical twin's bone marrow or peripheral stem cells.
An allogeneic bone marrow transplant involves receiving very high-doses of chemotherapy and/or radiation therapy, followed by the infusion of your donor's bone marrow or peripheral stem cells. The high-dose cancer fighting treatments are given to eliminate the cancer in your body. The infusion of the new marrow or peripheral stem cells during an allogeneic bone marrow transplant replaces the bone marrow destroyed by the chemotherapy and/or radiation therapy.
You may be a potential candidate for an allogeneic bone marrow transplant if you have leukemia, aplastic anemia, myelodysplasia, myelofibrosis, high-grade lymphoma or other types of cancers.
A non-myeloablative (“mini”) allogeneic bone marrow transplant involves receiving low-doses of chemotherapy and radiation therapy followed by the infusion of your donor's bone marrow or peripheral stem cells. The objective of the bone marrow transplant is to suppress your own bone marrow by receiving just enough chemotherapy and radiation therapy to allow your donor cells to engraft and grow within you. The hope is these donor cells will mount an immunologic attack against your underlying cancer, generating a response called the "graft-versus-leukemia" effect or “graftversus- cancer” effect.
You may be a potential candidate for a mini allogeneic transplant if you have a slow growing, indolent disorder, such as chronic leukemia, multiple myeloma, myelodysplasia, low-grade lymphoma, and in some cases, renal cell carcinoma. The mini allogeneic transplant is not appropriate, for example, if you have fast-growing acute leukemia.
Autologous Bone Marrow Transplants
An autologous bone marrow transplant involves receiving very high-dose chemotherapy followed by the infusion of your previously-collected peripheral stem cells or bone marrow.
The high-dose chemotherapy treatments are given to eliminate the cancer in your body. The infusion of your new marrow through a bone marrow transplant or peripheral stem cells replaces the bone marrow destroyed by the chemotherapy and/or radiation therapy.
You may be a potential candidate for an autologous bone marrow transplant if you have lymphoma, multiple myeloma, Hodgkin's disease, germ cell cancer, breast cancer or certain types of leukemia.
Bone Marrow Transplant as a Treatment Option
Before a bone marrow transplant can be approved as a treatment option, you will have a pre-transplant evaluation. This evaluation includes a complete physical consultation with members of the Bone Marrow Transplant Team and a comprehensive series of tests. An evaluation is done prior to a bone marrow transplant and provides complete information about your overall health and helps determine if you are eligible for a bone marrow transplant.
After your bone marrow transplant physician has determined that you are a good candidate for a bone marrow transplant, a date for the transplant will be determined and the process of insurance clearance will begin. Please understand that insurance reimbursement for bone marrow transplantation is not automatic.
If you are to be admitted to the hospital for your bone marrow transplant, you can expect your stay to be about 3 to 4 weeks, depending on your recovery. During your recovery following bone marrow transplant, you will learn about your new medications, how to recognize signs of complications and infections, and when you can return to your normal activities.
If an allogeneic bone marrow transplant has been approved for you, you and your designated care-partner may be required to stay within a one-hour drive of Cleveland Clinic's main campus for approximately 100 days after your bone marrow transplant. After you go home, you can expect to recover gradually, usually over 3 to 6 months following your allogeneic bone marrow transplant.
If a “mini” allogeneic bone marrow transplant has been approved for you, you may be required to stay within a one-hour drive of Cleveland Clinic's main campus for at least 30 days after your bone marrow transplant. At that time, your doctor will evaluate your medical condition to determine where you can continue your follow-up care.
Follow-up care after your bone marrow transplant includes appointments with your transplant or local physician and tests to assess how you are recovering.