An autologous stem cell transplant uses your own stem cells. Your transplant physician or nurse will coordinate the stem cell collection process as part of your care.
An allogeneic stem cell transplant uses stem cells from someone whose white cell antigens closely match your own. The stem cell donor may be related to you or someone unrelated who is found through a donor registry search such as the National Marrow Donor Program.
A syngeneic stem cell transplant uses the stem cells of your identical twin.
Each type of stem cell transplant involves different procedures, side effects, and risks. The type of transplant you will have depends on a number of factors, including your disease, age, overall health, and donor availability. You and your physician will discuss which type of stem cell transplant is best for you.
Based on your medical history, test results, and consent, your stem cell physician will identify the treatment plan or clinical research trial that will best treat your specific disease.
Stem cell treatment plans
There are two types of stem cell treatment plans available: myeloablative and non-myeloablative.
Myeloablative treatment plan
Myeloablative (high-intensity) stem cell transplant uses high doses of chemotherapy and may use radiation therapy to destroy cancer cells. In this process, bone marrow/stem cells are also destroyed. Patients receive an infusion of new stem cells to rebuild blood and the immune system.
In cases when a patient’s own stem cells are healthy enough, they are transplanted (autologous transplant); otherwise, transplanted cells are from a donor (allogeneic transplant).
Non-myeloablative treatment plan
Non-myeloablative (reduced-intensity) transplant uses a lower dose of chemotherapy and no radiation, followed by an infusion of disease-fighting stem cells from a donor whose tissue type matches your own.
The chemotherapy suppresses the immune system to prevent graft rejection. It also creates some space in the marrow for the new stem cells. Although reduced-intensity transplants spare patients the intensive doses of chemotherapy, there is nothing reduced about the risks. These patients face the same odds of developing graft-versus-host disease (GVHD) as high-intensity transplant recipients.
How cells are collected for stem cell transplant
Peripheral blood stem cell transplant
Stem cells are collected from circulating blood in an outpatient setting using a procedure called apheresis. During apheresis, blood is removed from a central line or through a needle in one arm, the stem cells are collected, and the remaining blood components are returned through the central line or through a needle in the other arm.
Bone marrow transplant
Bone marrow is collected in an operating room while the donor is under general anesthesia. A harvest team uses needles and a syringe to take marrow from the hipbone.
Cord blood transplant
Stem cells are collected from the umbilical cord immediately after the birth of a baby and then frozen. The collection process does not affect the baby because the cord blood is taken after the baby has been delivered.