Bone marrow transplant

A blood and marrow transplant, also called a bone marrow or stem cell transplant, takes unhealthy, blood-forming marrow cells and replaces them with healthy ones. A blood and marrow transplant may be performed using stem cells from the patient's body or a donor.

Blood and marrow transplant risks may include graft-versus-host-disease (GVHD), organ damage, infection and infertility. Blood and marrow transplant recovery involves careful monitoring of your condition to check for infection or any other possible complications.

Several types of blood cancers are commonly treated with a blood or marrow transplant, including lymphoma, myeloma and leukemias. Blood and marrow transplants (BMTs) are performed for individuals with diseased bone marrow or for patients with cancer who are about to undergo high doses of cancer therapy, damaging their bone marrow.

Methodist Healthcare provides a full spectrum of cancer services, so patients with blood cancer can receive comprehensive care close to home.

The Sarah Cannon Pediatric Transplant and Cellular Therapy Program at Methodist Children’s Hospital offers the only Pediatric Blood and Marrow Transplant Program of its kind in South Texas. Additionally, it is one of the busiest locations for pediatric blood and marrow transplants in the U.S.

Our program is one of the most experienced in the nation, with extensive experience in treating benign hematological issues, and cell and gene therapy research. Our multidisciplinary team includes a long-term approach to care for pediatric transplant survivors. We work closely with Sarah Cannon Research Institute and accredited by the Foundation for the Accreditation of Cellular Therapy.

To refer a patient to the Sarah Cannon Pediatric Transplant and Cellular Therapy Program at Methodist Children’s Hospital, please call (210) 575-2222.

Located within the John E. Hornbeak Building on the campus of Methodist Hospital, the Sarah Cannon Transplant and Cellular Therapy Program at Methodist Hospital is one of the most preferred in the nation and performs more than 200 blood and marrow transplants every year.

To refer a patient to the Sarah Cannon Transplant and Cellular Therapy Program at Methodist Hospital, please call (210) 575-7800.

Our affiliated clinics offer full-service care, which includes:

• Blood and marrow transplant
• Blood and marrow transplant evaluations and infusions
• Bone marrow biopsies
• CAR T-cell therapy
• Catheter placements
• Chemotherapy infusions
• Gene therapy
• Immunotherapy
• Transfusions

Blood and marrow transplants are often performed as a treatment for various diseases and conditions, including:

• Amyloidosis–An abnormal protein, called amyloid, produced in the bone marrow builds up in the organs.
• Aplastic anemia–The body stops producing an adequate amount of new blood cells.
• Hemoglobinopathies–A general term for blood conditions affecting the red blood cells.
• Hodgkin’s lymphoma–A cancer of the lymphatic system impairing the body's capacity for fighting infection.
• Leukemia (acute and chronic)–A type of blood cancer affecting the body's tissue and bone marrow, inhibiting its ability to fight off infection.
• Multiple myeloma–A cancer forming in a type of white blood cells, called plasma cells, that is indicated by a multiplying of cancerous plasma cells.
• Myelodysplastic syndrome–A syndrome resulting in immature, unhealthy blood cells within the bone marrow.
• Non-Hodgkin’s lymphoma–A cancer of the lymphatic system indicated by tumors within a type of white blood cells, called lymphocytes.
• Testicular cancer–A cancer of the testicles, the male sex organs located inside the scrotum.

Your transplant physician will discuss with you which type of transplant will provide the best clinical outcome. We routinely perform the following types of transplants:

• Autologous blood and marrow transplant–Stem cells are collected, stored and re-infused back to the same patient after high-dose chemotherapy and/or radiation treatments.
• Tandem autologous transplant–Also known as a double autologous transplant, this procedure requires the patient to undergo two planned autologous blood and marrow transplants within six months. Stem cells are collected once before the initial transplant and half are used for each procedure. The second transplant is performed after recovery from the first procedure.
• Allogeneic blood and marrow transplant–Stem cells are taken from one person and given to another. The patient receives stem cells from a matched or partially matched family member, an unrelated donor or umbilical cord blood.
• Umbilical cord blood transplant–This method uses stem cells, which have been collected from a clamped, separated umbilical cord following delivery. The stem cells are then processed and frozen until transplantation.

A blood and marrow transplant requires a thorough consultation with your physician and a referral. Once referred, the transplant team schedules the patient's first visit to the clinic. During the appointment, the patient and his or her family meets their transplant physician and spends a significant amount of time with other transplant professionals who further educate the patient about transplantation.

If the patient, family and transplant team decide a transplant is the best option, the patient undergoes testing to complete the evaluation process. The type of transplant most appropriate determines how quickly the procedure can be performed.

Private insurance, as well as Medicare and Medicaid, may provide coverage for blood and marrow transplants. Some costs may not be fully reimbursed. Financial coordinators and social workers work with the patient to ensure they understand coverage benefits and help minimize out-of-pocket expenses by accessing various community resources.

Recipients of blood and marrow transplants are closely followed in the clinic on a daily basis after their operation to ensure there are no infections or rejections. The patient may still feel too weak to fully engage in normal activities for several weeks, but they are encouraged to continue participating in daily activities, as tolerated, to increase strength and energy.

Allogeneic transplant recipients are at risk for developing graft-versus-host-disease (GVHD). With this condition, the new blood and marrow stem cells begin fighting against, or “rejecting,” the patient's tissues. To minimize the risk of GVHD, doctors prescribe immunosuppressive or “anti–rejection” medications.

The chances of infection and rejection are highest during the first month after blood and marrow transplant when the medications taken to suppress the immune system are at their peak effectiveness. Patients may be required to wear a mask to limit the risk of infection potentially leading to rejection.

Transplant patients are required to have routine follow-up visits. The frequency of visits is discussed at the time of transplant. Patients are informed when they are able to return to their oncologist for continued care.

All resources available to the patient and family pre-transplant, including but not limited to the oncology support group, social worker, dietitian, financial coordinator and hospital chaplain are also available on an unlimited basis post-transplant.