There are several types of bone marrow transplants, also referred to as stem-cell transplants. Which type is used for any given patient depends on the specific patient's disease as well as other factors such as the patient's age and the availability of a suitable donor.
Autologous (self-transplant): This is the simplest form of transplant, and involves collection of the patient's own cells, which are counted, analyzed, and then frozen for later use. This type of transplant is most commonly performed for
- Hodgkin Disease
- Germ Cell (Testicular) Cancer
- Lymphomas
- Multiple myeloma, and related diseases. Occasionally, this type of transplant is used for treatment of leukemia
Bloodless Transfusions: For patients requiring a bloodless stem cell transplantation, our transplant center specializes in doing what is known as Bloodless Autologous transplants where patients do not receive any allogenic blood or blood products after the stem cell reinfusion. The period of cytopenias is managed with growth factors and other drugs to prevent bleeding.
Syngeneic (identical twin transplant): An identical twin is an ideal donor because of the genetic identity between the donor and recipient. It is like using one's own cells, except that the cells are not damaged from prior exposure to chemotherapy, and the risk to tumor cell contamination is eliminated.
Allogeneic (donor transplant): For this form of transplant, the stem cells are collected from a relative (usually a sibling), or other donor (volunteer unrelated donor or umbilical cord blood), whose tissue type matches closely with that of the patient. The chances of a brother or sister being a suitable match are about 1 in 4. The chances of any other family member being a match are much less, so we usually do not recommend extended family typing. Allogeneic transplants are most commonly done for Leukemias and bone marrow or immune system failure diseases.
Reduced intensity or "mini" transplant refers to a type of allogeneic transplant in which the pre-transplant chemotherapy and/or radiation (called conditioning, see below) is less than maximally intensive. This type of transplant depends heavily on the anti-tumor effect of the donor cells for its therapeutic effect, so it generally requires that the disease either be in remission or very slow growing at the time of transplant. The immediate side effects of a reduced intensity transplant are less than those associated with a standard transplant, making it possible to offer transplant to a wider variety of people, including those who might otherwise not be transplant candidates because of age or other illnesses.