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Hematopoietic Stem Cell Transplantation

Authors:
  • Cynthia M. Johnson, MA
Publication Type:

Procedure

Hematopoietic Stem Cell Transplantation

(HSCT; Bone Marrow Transplantation (BMT); Peripheral Blood Stem Cell (PBSC) Transplantation; Cord Blood Transplantation)

Definition

This procedure replaces defective bone marrow with healthy stem cells. Stem cells produce red blood cells, white blood cells, and platelets.

Stem cell transplantation may involve stem cells that were taken from:

  • The person's own bone marrow or blood—and stored
  • A donor's bone marrow or blood
Location of Active Bone Marrow in an Adult

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Reasons for Procedure

This procedure is done if the stem cells in a person's bone marrow do not function. It may also be done if a person does not have enough stem cells. These problems may be caused by:

  • Infection
  • Certain cancers, such as leukemia and lymphoma
  • Certain immune system problems
  • Severe anemia
  • Blood disorders, such as sickle cell disease and thalassemia

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Infection
  • Rejection of the donor stem cells
  • Graft versus host disease—immune cells in the donor's bone marrow attack the person's tissue

Things that may raise the risk of problems are:

  • Heart, lung, liver, or kidney diseases
  • Diabetes

What to Expect

Prior to Procedure

The donor will be carefully tested to check for diseases. The person getting the transplant and the donor will be tested to ensure that their tissues match. For the transplant to be successful, certain markers on the blood cells and bone marrow cells must match.

The person getting the transplant with be given medicine to lower the immune system. This is to prevent their body from rejecting the donor stem cells. In the weeks before the transplant, the person may also need to have:

  • Chemotherapy
  • Radiation therapy

This process is called conditioning. It will rid the body of diseased cells and clear the bone marrow cavities for the new bone marrow.

Anesthesia

Anesthesia will not be needed.

Description of the Procedure

An IV placed into their skin to a blood vessel. The donated stem cells will be delivered through a tube to the IV. It will take a few hours for the treatment to finish. The new stem cells will find their way to the bones. There they will grow new, healthy blood cells.

Immediately After Procedure

Conditioning will make the immune system weak. It will take some time for the new, healthy blood cells to develop. The immune system will get stronger as the cells grow. The person will need to be isolated until the new cells develop. This is to help avoid infections during recovery.

How Long Will It Take?

It may take 1 to 5 hours for the transplant to complete.

It may take about a month for the donor stem cells in the bone marrow to begin to function fully. If the transplant is successful, new bone marrow cells will produce healthy red blood cells, white blood cells, and platelets.

Will It Hurt?

There should be no pain while the stem cells are infused. Some people have nausea. This can be treated with medicine.

Average Hospital Stay

You may be isolated in the hospital for about 1 to 2 months.

Post-procedure Care

At the hospital, you may be given:

  • Medicines to:
    • Reduce the risk of transplant rejection
    • Prevent infection
  • Platelets, plasma, and red blood cell transfusions—to prevent bleeding and anemia
  • Frequent blood tests—to monitor the new stem cells

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves and masks

During your stay, you can also take steps to lower your risk of infection, such as:

  • Washing your hands often and reminding any visitors and staff to do the same
  • Reminding staff to wear gloves and masks

Problems to Look Out For

Once you are home, contact the doctor if you are not recovering well or have:

  • Nausea and/or vomiting
  • Severe pain
  • New onset of pain
  • Signs of infection, such as fever and chills
  • Rash
  • Loose stools (poop)

If you think you have an emergency, call for medical help right away.

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References

  • Battiwalla M, Hashmi S, et al. National Institutes of Health Hematopoietic Cell Transplantation Late Effects Initiative: Developing recommendations to improve survivorship and long-Term outcomes. Biol Blood Marrow Transplant. 2017;23(1):6-9.
  • Blood-forming stem cell transplants. National Cancer Institute website. Available at: http://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant/stem-cell-fact-sheet.
  • Hematopoietic stem cell transplant (HSCT) complications. EBSCO DynaMed wesbite. Available at: https://www.dynamed.com/condition/hematopoietic-stem-cell-transplant-hsct-complications.
  • Stem cell transplant for cancer. American Cancer Society website. Available at: http://www.cancer.org/acs/groups/cid/documents/webcontent/003215-pdf.pdf.
Last Updated:
2022-09-01

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This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.