Blood and Marrow Transplant for Leukemia
If you have leukemia, the blood stem cells in your bone marrow don’t work properly. Sometimes, a procedure known as a blood and marrow transplant, or bone marrow transplant, will be done to replenish the body’s supply of blood stem cells and potentially cure the leukemia.
The Blood and Marrow Transplant Program at Siteman Cancer Center, located at Barnes-Jewish Hospital and the Washington University School of Medicine in St. Louis, is one of the largest transplant programs in the world.
Since our program began in 1982, our physicians have conducted more than 7,500 transplants. We are national leaders in cancer with an international reputation for excellence: patients have travelled to our facility from all over the United States, and some have even come from other countries.
When you receive a blood or marrow transplant at Siteman, you will be treated by Washington University Physicians and cared for by specialist nurses and staff. The size and breadth of our program means that we have every available drug, technology, and resource at your disposal. Many of our patients receive cutting-edge treatments through clinical trials, studies that test new medications and techniques.
Our team also partners with Washington University’s Center for Gene and Cellular Immunotherapy to offer advanced treatments that can harness the immune system to fight cancer. These treatments, which include CAR T-cell therapy, are only available at a limited number of institutions.
What are the different types of blood and marrow transplant?
There are three different kinds of blood and marrow transplant. The types indicate where, or who, the stem cells come from. Patients with leukemia typically receive allogeneic transplants.
- Allogeneic transplant: In an allogeneic transplant, the stem cells come from a donor. The donor can be a close blood relative or an individual located through a national donor registry program, such as Be the Match. Occasionally, stem cells will be taken from umbilical cord blood that has been donated after the birth of a child.
- Autologous transplant: When you receive an autologous transplant, you donate stem cells for yourself. Stem cells will be removed from your blood or bone marrow and then returned to you after an intense regimen of chemotherapy and radiation to eliminate the remaining cancerous cells in your body.
- Syngeneic transplant: In syngeneic transplants, the stem cell donor is an identical twin. This is the rarest type of transplant.
How are donors found?
The donor’s stem cells must be a “match” for your own. Doctors look at genes called human leukocyte antigens to determine whether a donor will be a good match or not. There are several options for finding donated stem cells.
- A relative: Close blood relatives, such as your parents, siblings, or children, are more likely to have similar antigens to you. There’s an approximately 25 percent chance that one of your relatives will be a complete match.
- An unrelated donor from a registry: If none of your family members match, or you don’t have enough living family members to test, we will look for a donor for you on the National Marrow Donor Program Registry (NMDPR). The NMDPR connects patients with donors from across the country, and sometimes from around the world.
- Cord blood: Sometimes, a match will be found through an umbilical cord blood bank. This type of transplant is more common in pediatric patients.
What if I can't find a donor?
If there is difficulty locating a donor who matches your human leukocyte antigen profile, it is still possible to receive a transplant using cells from one of your close relatives, even if he or she is not a complete match. This is called a haploidentical or half-match transplant. Washington University Physicians at Siteman Cancer Center have been performing an increasing number of half-match transplants in recent years, with positive results.
How do I get a referral for a transplant?
If your physician believes that you are a good candidate for a blood or marrow transplant, he or she should contact our referral specialists at 314-747-3046 or 877-251-6485 from 8 a.m. to 4:30 p.m. Referrals also can be made online through a secure appointment request service at https://www.siteman.wustl.edu/refer.
What is the transplant process like?
A blood or marrow transplant is a months-long process that can be physically and emotionally taxing. Though the procedure itself does not take a long time, patients usually enter the hospital at least one week before the transplant for preparatory treatments and then stay for several weeks afterwards to recover.
First, stem cells are collected from the donor or the patient. Then, they are transfused into the patient after a preparatory regimen of chemotherapy and radiation.
What are the risks and side effects of a blood and marrow transplant?
A blood or marrow transplant is a major medical procedure that impacts the entire body. Consequently, there are a number of risks to transplant patients. Your care team at Siteman will design your treatment plan so as to minimize the risks you experience. They will also continue to monitor your health and progress long after you leave the hospital. Be sure to share your concerns with your physicians and care team, and they will do what they can to provide guidance and reassurance.
Learn more more information about some of the risks associated with a transplant, along with the strategies Washington University Physicians at Siteman often use to manage them.