Last Modified: August 20, 2006
Dear OncoLink "Ask The Experts,"
How many times can you get a bone marrow transplant? Can you get it more than once?
Carolyn Vachani RN, MSN, AOCN, OncoLink's Nurse Educator, responds:
This depends on the type of transplant. For an autologous transplant where the patient is transplanted with his or her own cells, multiple transplants are common. A series of transplants is commonly used in the treatment of multiple myeloma and some lymphomas. In many cases, a patient who had an autologous transplant can then receive an allogeneic transplant.
As for can then receive an allogeneic transplant, where the transplanted cells come from a donor, this is less likely. This procedure has much more toxicity, and oftentimes the body (in particular, the organs) cannot tolerate a second transplant. In studies that looked at giving a second allogeneic transplant, the relapse rates after the procedure were very high, in some studies as high as 100%.
More recently doctors have started using "non-myeloablative" allogeneic transplants. These are less toxic to the body and can be repeated with less potential danger. Even so, the relapse rates in these cases are unfortunately still very high.
One issue with multiple transplants that is often raised is: what will be different about the repeat transplant to make us think it will work this time, and enough so to make it worth the risk?