Blood & Bone Marrow Stem Cell Transplant & Immune Cell Therapy

What to Expect with Bone Marrow & Blood Stem Cell Transplant

What are Bone Marrow and Stem Cells?

Bone marrow is a sponge-like tissue found inside bones. Within bone marrow, stem cells grow and develop into the three main types of blood cells:

• Red blood cells carry oxygen through the body
• White blood cells fight infection
• Platelets help your blood clot

Stem cells also grow many other cell types of the immune system.

What are the Types of Bone Marrow Transplants?

At IU Health, we offer many types of bone marrow transplant, including:

Autologous Transplants

For this type of transplant, we use your own stem cells. We collect the stem cells and then place them back into your body.

We use this method to treat blood-related cancers like multiple myeloma, non-Hodgkin lymphomas and Hodgkin disease, as well as certain germ-cell cancers.

Chimeric Antigen Receptor (CAR) T-Cell Therapy

CAR T-cell therapy is an emerging form of cancer immunotherapy. This therapy involves supercharging a patient’s T cells, a subtype of white blood cell, to recognize and attack cancer cells.

IU Health is the first healthcare system in Indiana to offer CAR T-cell therapy to treat non-Hodgkin lymphoma and Acute Lymphoblastic Leukemia (ALL).

Allogeneic Transplants

For this type of transplant, the stem cells of another person are used. The donor can be a relative or a nonrelative whose blood cells are a close match.

The stem cells can come from peripheral (circulating) blood, bone marrow or umbilical cord blood (the blood in the cord connecting a fetus to a placenta).

This method is used to treat blood-related cancers like leukemias and some lymphomas or multiple myeloma. It is also used to treat bone marrow failure disorders like myelodysplastic syndrome (MDS) and aplastic anemia.

If you have an acute leukemia or lymphoma, IU Health Medical Center conducts haploidentical (half-matched) stem cell transplantation. This procedure also greatly expands the potential donor pool, making more patients eligible for the transplant.

Preparing for Bone Marrow Transplant

Depending on the type of bone marrow transplant, stem cells will be collected from your own marrow or blood, donated by another person, or collected from umbilical cord blood.

Blood stem cells are collected from bone marrow in a surgical procedure or using a process called apheresis. In this process:

• You, or the stem cell donor, will be connected to a special cell-separation machine via a needle in your arm or an IV line called a central venous catheter.
• Blood circulates though the machine, which removes the stem cells.
• The remaining blood and plasma is returned back to you or the donor through the opposite arm or the central venous catheter.
• Stem cell apheresis may take more than one day if not enough cells are collected.

To prepare your body for a bone marrow transplant, you’ll be treated with high doses of chemotherapy with or without radiation to destroy cancerous cells.

Some healthy cells may also be destroyed, which can cause unpleasant side effects. These side effects typically go away after a few weeks.

Once we collect your stem cells and your chemotherapy is complete, we will transplant new stem cells through your veins. These cells will make their way to your bone marrow. They will mature into healthy marrow, producing healthy blood and immune cells.

After Your Bone Marrow Transplant

After your bone marrow transplant, you should be able to return to your normal activities within a few weeks or months.

If you had an allogenic transplant, you’ll need to take medications to suppress your immune system. This prevents rejection and keep the donor’s immune cells from attacking your normal cells.

Your doctor can explain in detail what side effects you need to be prepared for, and how best to handle them. Your care team will closely monitor your recovery and watch you for complications.

Questions to Ask Your Provider About Bone Marrow & Stem Cell Transplant

• Is bone marrow transplant a good treatment option for me?
• Which type of transplant (my own cells or donor cells) will I get?
• What are the side effects of the preparation and treatment?
• How long will I be in the hospital?
• When can I return to work or my other activities?
• Will I need to be on long-term medications?
• What are the risks of a bone marrow transplant?

Support Services for Bone Marrow Transplant

If you are an inpatient for bone marrow transplant, you have access to the CompleteLife therapies at the IU Health Simon Cancer Center. This includes:

• Art therapy
• Music therapy
• Yoga therapy
• Massage therapy
• Cosmetology—Wig Bank

You’ll learn more about these therapies at your pre-transplant meeting with your bone marrow transplant social worker. Visit our Classes & Events page for upcoming events.

We offer a weekly Open Art Studio for bone marrow transplant patients. We invite you, your caregivers and IU Health team members to find comfort and emotional healing through these creative arts. An art therapist facilitates this group and is limited to bone marrow transplant patients and families.

The Cancer Resource Center is open to 9 am — 5 pm Monday through Friday on the first floor of IU Health Simon Cancer Center.

Our trained volunteers and staff will also provide you resources to help you during your cancer journey. They can help you find information about your diagnosis and treatment. They can also connect you to community programs and services to help you with your needs. This can include help in areas such as arranging transportation or lodging, connecting to support groups and learning about financial resources.