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Bone Marrow (Stem Cell) Transplantation

Bone Marrow and Stem Cell Transplantation

The Adult and Pediatric Bone Marrow and Stem Cell Transplant Programs of North Shore-LIJ Health System are advancing care for patients with blood and marrow disorders through compassionate treatment, education and research. A multidisciplinary team approach is used to provide comprehensive care for adults and children undergoing transplantation. Our team of dedicated specialists include medical hematologist/oncologists who specialize in bone marrow and stem cell transplantation, transplant coordinators, nurse practitioners, oncology nurses, social workers, pharmacists and nutritionists who work together to develop an individualized treatment plan and are committed to helping patients and their families through all phases of the transplant process.

Our services include:

  • Allogeneic transplants, with family member, unrelated donor or umbilical cord blood
  • Autologous transplants, using a patient's own stem cells
  • Comprehensive support services for related and unrelated donors
  • A dedicated team of clinicians and coordinators that follows patients through the continuum of transplant services

Bone Marrow and Stem Cell Transplant Programs are provided at three Cancer Institute locations:

  • North Shore University Hospital, Adult Bone Marrow Transplant Program
  • Cohen Children’s Medical Center of New York, Pediatric Bone Marrow and Stem Cell Transplantation
  • Staten Island University Hospital's Nalitt Institute for Cancer and Blood Related Disorders, Adult Bone Marrow Transplant Program

Bone Marrow Transplantation: An Overview

What Is a Bone Marrow Transplantation?

Bone marrow transplantation (BMT) is a special therapy for patients with certain cancers or other diseases. A bone marrow transplant involves taking cells that are normally found in the bone marrow (stem cells), filtering those cells, and giving them back either to the patient or to another person. The goal of BMT is to transfuse healthy bone marrow cells into a person after their own unhealthy bone marrow has been eliminated.

Bone marrow transplantation has been used successfully to treat diseases such as leukemias, lymphomas, aplastic anemia, immune deficiency disorders and some solid tumor cancers since 1968.

What Is Bone Marrow?

Bone marrow is the soft, spongy tissue found inside bones. It is the medium for development and storage of most of the body's blood cells. The blood cells that produce other blood cells are called stem cells. The most primitive of the stem cells is called the pluripotent stem cell, which is different than other blood cells with regards to the following properties:

  • Renewal — It is able to reproduce another cell identical to itself.
  • Differentiation — It is able to generate one or more subsets of more mature cells. It is the stem cells that are needed in bone marrow transplantation.

What Are the Different Types of Bone Marrow Transplants?

There are different types of bone marrow transplants depending on who the donor is. The different types of bone marrow transplant include the following:

  • Autologous bone marrow transplant — The donor is the patient him/herself. Stem cells are taken from the patient either by bone marrow harvest or apheresis (a process of collecting peripheral blood stem cells), then frozen and returned to the patient after intensive treatment. Often the term "rescue" is used instead of "transplant."
  • Allogeneic bone marrow transplant — The donor shares the same genetic type as the patient. Stem cells are taken either by bone marrow harvest or apheresis from a genetically-matched donor, usually a brother or sister. Other donors for allogeneic bone marrow transplants may include the following:
    • Parent — A haploid-identical match is when the donor is a parent and the genetic match is at least half identical to the recipient. These transplants are rare.
    • Unrelated bone marrow transplants (UBMT or MUD for matched unrelated donor) — The genetically matched marrow or stem cells are from an unrelated donor. Unrelated donors are found through the national bone marrow registries.
  • Umbilical cord blood transplant — Stem cells are taken from an umbilical cord immediately after delivery of an infant. These stem cells reproduce into mature, functioning blood cells quicker and more effectively than do stem cells taken from the bone marrow of another child or adult. The stem cells are tested, typed, counted and frozen until they are needed for a transplant.

How Can Bone Marrow Transplantation Help?

The goal of a bone marrow transplant is to cure many diseases and types of cancer. When a person's bone marrow has been damaged or destroyed due to a disease or intense treatments of radiation or chemotherapy for cancer, a marrow transplant may be needed.

A bone marrow transplant can be used to:

  • Replace diseased, non-functioning bone marrow with healthy functioning bone marrow (for conditions such as leukemia, aplastic anemia and sickle cell anemia)
  • Replace the bone marrow and restore its normal function after high doses of chemotherapy and/or radiation are given to treat a malignancy; this process is often called "rescue" (for diseases such as lymphoma and neuroblastoma)
  • Replace bone marrow with genetically healthy functioning bone marrow to prevent further damage from a genetic disease process (such as Hurler's syndrome and adrenoleukodystrophy)

The risks and benefits must be weighed in a thorough discussion with your physician and physicians that specialize in bone marrow transplants prior to procedure.

What Are Some Diseases that May Benefit from Bone Marrow Transplantation?

The following diseases are the ones that most commonly benefit from bone marrow transplantation:

  • Leukemias
  • Severe aplastic anemia
  • Lymphomas
  • Multiple myeloma
  • Immune deficiency disorders
  • Some solid-tumor cancers
However, patients experience diseases differently, and bone marrow transplantation may not be appropriate for everyone who suffers from these diseases.