Bone Marrow Transplant |
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Autologous Transplant
 Preparation
Procedure
Recovery
Preparation Advances in the treatment of cancer and improvements in supportive care over the past 10 years have improved the results and tolerability of bone marrow transplants. However, a bone marrow transplant remains a dangerous and difficult procedure. For autologous transplantation, the patient receives his or her own bone marrow or stem cells that were collected and frozen before admission for high-dose chemotherapy or radiation.
Pre-Transplant Evaluation
A bone marrow transplant specialist will begin the evaluation by reviewing your medical record and history, performing a physical exam, and discussing the procedure with you. If your doctor decides that you are a candidate for an utologous bone marrow transplant, he will recommend a treatment plan.
Preadmission Tests
Before being admitted to the hospital, you will have several days of laboratory and other diagnostic tests to determine if you have normal function of the heart, lungs, kidney and liver and that you do not have an undiagnosed infection. Most of these tests will be done as an outpatient before you are admitted to the hospital and others may need to be completed after you are admitted for treatment. These tests may include:
Stem Cell Collection
Stem cells are found predominantly in the bone marrow but occasionally can be stimulated to travel out into the blood. When the stem cells are collected from the hip bone by performing many bone marrow aspirations, which are usually performed in the operating room, the transplant procedure is called a bone marrow transplant. When the stem cells are collected from the blood after stimulating the stem cells with a hormone called G-CSF, the transplant is called a peripheral blood stem cell transplant. Currently, most transplant procedures involve collecting stem cells from the peripheral blood. When bone marrow or blood stem cells are infused into the recipient, they are administered through an intravenous catheter or central venous catheter just like a blood transfusion. The stem cells are not administered directly back into the bone, but travel to the bones from the blood stream.
The collection of stem cells from the marrow is a surgical procedure in a hospital operating room, usually under general anesthesia. It involves little risk and minimal discomfort. While the patient is under anesthesia, a needle is inserted into the cavity of the rear hip bone called the iliac crest, where a large quantity of bone marrow is located. The bone marrow is a thick, red liquid which is extracted with a needle and syringe. Several skin punctures on each hip and multiple bone punctures are usually required to extract the bone marrow. There are no surgical incisions or stitches involved -- only skin punctures where the needle was inserted.
For more information, visit the Pre-Transplant Evaluation and In the Hospital sections of the Autologous Transplant Guide.
Reviewed by health care specialists at UCSF Medical Center.
Last updated May 8, 2007
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