Blood and Marrow Transplant and Cellular Therapies

Cleveland Clinic BMT experts treat many different blood conditions and blood cancers in children and adults, including:

• Acute lymphoblastic leukemia (ALL).
• Acute myeloid leukemia (AML).
• Amyloidosis.
• Aplastic anemia.
• Germ cell tumors.
• Lymphoma.
• Multiple myeloma.
• Multiple sclerosis (MS).
• Myelodysplastic syndrome (myelodysplasia).
• Myeloproliferative neoplasms (MPN).
• Sickle cell disease.
• Systemic sclerosis.

Meet Our Blood and Marrow Transplant and Cellular Therapies Team

Our expert medical and surgical oncologists who specialize in blood cancers and conditions will lead your care team. You may also see:

• Radiation oncologists.
• Transplant coordinators.
• Physician assistants.
• Nurse practitioners.
• Clinical pharmacists.
• Dietitians.
• Physical therapists.
• Occupational therapists.
• Art and music therapists.
• Social workers.

Blood cancers and conditions can be complicated. Our specialists talk with you about your diagnosis and health goals when planning your personalized treatment plan. We also consider what stage (how advanced) your condition is and what risks you might have with a transplant. As part of your treatment, we may recommend a blood and bone marrow transplant or cellular therapy.

Both of these procedures, including chemotherapy and/or radiation therapy, stem cell infusion and all post-transplant care can be done either in the hospital (inpatient) or — if you’re medically eligible — without a hospital stay (outpatient). Your provider will go over which option is best for you. And they’ll give you details on the process for each.

Blood and bone marrow transplant

Your blood and bone marrow contain hematopoietic stem cells (cells that can become any type of blood cell your body needs). When these cells mature, they become either platelets (cells that help your blood clot), red blood cells or white blood cells. We use stem cell transplant to replace diseased cells with healthy cells. We may use stem cells collected from your blood or bone marrow. There are different types of BMT. The best type for you depends on your condition, your overall health and your goals. Your specialist may recommend:

• Allogeneic transplant: We transplant another person’s healthy stem cells into your body. Before an allogeneic transplant, you’ll have chemotherapy and/or radiation. This helps destroy any cancer cells in your body and gets your immune system ready to accept donor cells. BMT specialists will help you find a person (donor) who can give you stem cells for an allogeneic transplant.
• Autologous transplant (stem cell rescue): In autologous stem cell transplant, our specialists remove stem cells from your own blood or bone marrow before treating you with chemotherapy. We put the stem cells back into your body after chemo. These cells help your body make new blood cells and help your immune system recover after high doses of chemotherapy.

Cellular therapy

Chimeric antigen receptor T-cell therapy (CAR-T) is one type of cellular therapy. In this procedure, we take immune cells (T-cells) from your blood and reprogram them so they can fight your cancer better. Then we put them back into your blood through a thin tube (catheter) to attack cancer cells.

Second opinions for blood and marrow transplant and cellular therapies

Maybe you’ve tried everything, and a blood and marrow transplant or cellular therapy is next on the list. Or maybe this is what you’ve been working toward. Either way, it’s a big, important step, so you want to feel confident that your care team is the very best. That’s why, at Cleveland Clinic, we encourage second opinions.

Our cancer specialists are ready to answer questions, talk about treatment options and offer support. And, because cancer doesn’t wait, we always try to schedule your appointment with us as soon as possible after you reach out. Getting a second opinion can give you peace of mind knowing you’re in the most capable hands.

Preparing for Blood and Marrow Transplant and Cellular Therapies at Cleveland Clinic

There are several things we may do before you have a blood and marrow transplant or cellular therapy. These tests and treatments will help us prepare you for the procedure.

Pre-transplant diagnostic testing

We may recommend diagnostic testing to see how far along your condition is, and if there are any risks of transplant. Our experts may recommend:

• CT scan.
• MRI.
• PET scan.
• X-ray.
• Echocardiogram (Echo).
• Pulmonary functioning test (PFT).
• Bone marrow biopsy.

You may also have blood tests so we can check your platelet count, red blood cell and white blood cell levels, see how your liver and kidneys are working and check for signs of infection. We’ll use the results of the diagnostic and blood tests to help plan your treatment.

Chemotherapy or radiation treatment

Before you have blood and marrow transplant or cellular therapy, you may need chemotherapy or radiation therapy first. These treatments help destroy cancer cells and get your immune system ready to accept transplanted healthy cells. Your specialist will let you know if chemotherapy or radiation should be part of your treatment plan.

Follow-Up Care for Blood and Marrow Transplant and Cellular Therapies at Cleveland Clinic

The time you spend recovering in the hospital depends on the type of procedure you have. Typically for an autologous transplant, you’ll stay for about three weeks — and about a month for an allogeneic transplant. If you have CAR T-cell therapy, you usually spend one to two weeks in the hospital.

After you leave the hospital, we’ll keep a close eye on you for up to three months depending on the type of transplant or cellular therapy you had. You’ll have many follow-up appointments with our BMT experts during this time.

Sometimes, with CAR T-cell therapy, you might not have to stay in the hospital at all. If that’s the case, your healthcare provider will still check on your progress and recovery often. If you have side effects, you may have to go back to the hospital for more treatment.

Once you’ve recovered, Cleveland Clinic specialists will continue to track your health and progress in our survivorship clinic. You’ll see your specialist about once a month for the first year after BMT. After that, we’ll still check in with you often to make sure there are no complications.

Taking the Next Step

Blood and marrow transplant and cellular therapies can be the important next step in treating many blood cancers and conditions. If this is where you are on your journey, we want you to know that you aren’t alone. Our Cleveland Clinic BMT specialists are here to offer our expertise, support, compassion — and hope.