Stem Cell Transplant: Patient FAQs
National Marrow Donor Program
Last Modified: January 24, 2003
Blood stem cells produce all of your red blood cells, white blood cells, and platelets. (Red blood cells carry oxygen to your organs and tissues, white blood cells help protect the body from infection, and platelets help control bleeding). Sources of stem cells are bone marrow, circulating blood and the umbilical cord blood of newborn babies.
Each year, more than 30,000 patients in the United States will be diagnosed with leukemia and other life-threatening diseases that can be treated with a blood stem cell transplant. Some of these diseases include:
- Various forms of leukemia
- Congenital immune system disorders
- Severe aplastic anemia
- Hodgkin's disease
- Non-Hodgkin's lymphoma
When you have a blood stem cell transplant, doctors replace your diseased bone marrow with healthy new blood stem cells from either a family member or, when no family member is a suitable donor, from a volunteer bone marrow or peripheral (circulating) blood stem cell donor or umbilical cord blood unit that has already been collected and stored for use. Here's a brief overview of what happens:
- You are given chemotherapy and/or radiation to kill diseased cells.
- You receive the new, healthy blood stem cells through a vein. This process is similar to a blood transfusion.
- The transplanted cells begin to grow and produce healthy red and white blood cells and platelets.
The process of growing new blood cells takes three to four weeks.
The first sign that the transplant is working is an increase in the number of white blood cells in your body. These cells protect your body from infection. As you get better, these cells will continue to grow in number, and the number of red cells and platelets (the cells that help prevent bleeding) will begin to increase as well.
A blood stem cell transplant is a very serious procedure. Some patients will suffer from life-threatening complications as a result of the transplant. However, many transplants have been successful. Before you decide to move forward with a transplant, you will be fully informed of the risks and benefits involved. Related Links: The Donation and Transplant Process Disease Outcomes Monitoring Donor & Patient Safety
A hematologist/oncologist who specializes in transplantation will be able to answer your questions and help you decide if it is a good option for you. You will be referred to this specialist by your doctor. You will want to discuss transplantation as well as other treatment options with your doctor and your family members.
A bone marrow transplant uses stem cells taken from the bone marrow of a donor, a peripheral blood stem cell (PBSC) transplant uses stem cells from the circulating blood of a donor, and an umbilical cord blood transplant uses stem cells from the umbilical cord of a newborn baby. Each source of stem cells has advantages and disadvantages. You'll need to talk with your doctor to decide which is right for you.
The National Marrow Donor Program currently facilitates more than 160 transplants a month, and has arranged more than 15,000 transplants since 1987 (as of January 2003). Although the stem cells for most of these transplants have come from bone marrow, peripheral blood stem cells (PBSC) transplants are starting to become more common. Clinical outcomes vary with each patient. It depends on a number of factors, including the disease being treated, the stage of the disease, and the patient's age and condition. Survival rates (two to three years after transplant) currently range from 40 to 60 percent.
Stem cell donors are matched based on tissue type—not blood type. Your donor's tissue type needs to closely match yours, so the best donor is usually someone from your own family. Each of your brothers and sisters, who have the same parents as you, has a 25 percent chance of matching your tissue type. If a related donor is not available, your doctor can search for an unrelated donor in the National Marrow Donor Program's Registry of nearly 5 million donors and 27,000 umbilical cord units (as of January 2003).
If both the donor and patient want to meet each other, they may do so, but not until at least one year after the transplant. At that time, they will sign a consent form for information to be released, and the NMDP will help to arrange a meeting. This policy ensures confidentiality for both the donor and patient. If desired, the NMDP will help the donor and patient communicate anonymously (without knowing each other's identities). For example, before the transplant, the donor receives general information about the patient's age, sex and medical condition. After the transplant, the donor may obtain updates on the patient's progress.
Not all hospitals have experience doing stem cell transplants. Ask your doctor to refer you to a transplant hospital. The National Marrow Donor Program's Office of Patient Advocacy (OPA) can also provide a list of hospitals with transplant experience for you to contact. OPA can be contacted at (888) 999-6743, press 1, then extension 7262. Office of Patient Advocacy (OPA) can also provide a list of hospitals with transplant experience for you to contact.
A blood stem cell transplant is expensive. Most health insurance plans cover all or part of the total cost. Check with your health care plan or place of work to learn what your benefits are. If you are already a patient at a hospital, someone in the hospital's finance office may be able to help you with this.
What if I have questions? A: Nurses and social workers at transplant hospitals can help you. The National Marrow Donor Program's Office of Patient Advocacy can also answer your questions about the transplant process, as well as provide you with information on transplant costs and getting financial help. If English is not your first language, translation services are available. To speak with a case manager, call (888) 999-6743, press 1, and then extension 7262.