Internal Medicine Department
Hematology Division

Stem Cell Transplantation

Blood and marrow transplantation, once considered experimental not more that twenty years ago, is now a potentially life-saving procedure for a number of otherwise incurable and terminal diseases.  These diseases include many forms of bone marrow cancer, such as leukemia and multiple myeloma, as well as serious non-cancerous conditions such as aplastic anemia, a cause of bone marrow failure.

Blood and marrow transplantation has evolved tremendously over this past two decades, and physicians as well as patients are now confronted by many confusing terms describing different variations of the procedure including "peripheral blood stem cell transplantation," "bone marrow transplantation," and "hematopoietic cell transplantation" to name but a few.  Whatever the term, however, what these have in common is that they are all "stem cell transplantations" and that’s how we commonly refer to the procedure here at the Utah Blood and Marrow Transplantation Program.

Types of Stem Cell Transplantations

There are three main types of stem cell transplantations performed here at the Utah Blood and Marrow Transplantation Program and at other transplant centers worldwide.  The type of stem cell transplant that is most appropriate depends on the patient’s diagnosis, age, physical condition and other factors, and is decided when the patient meets with a Utah stem cell transplant physician and our clinical care providers.

Autologous

An autologous transplantation is performed with stem cells collected from the patient themselves.  The stem cells are collected before the transplant and carefully stored frozen until needed for the transplant.  Stem cells collected from an identical, or syngeneic, twin sibling would also be considered an autologous stem cell transplant.  The effectiveness of an autologous transplant relies on administering high doses of chemotherapy or irradiation followed by infusion of cryopreserved stem cells to restore bone marrow function.

Allogeneic

An allogeneic transplantation is also preceded by high doses of chemotherapy or irradiation, but is performed with stem cells collected from someone other than the patient.  The stem cell donor may be a family member or an unrelated volunteer donor listed in the various marrow donor registries.  While ABO blood group type matching is not required, an allogeneic stem cell donor must be a match with the patient for the HLA tissue type, or a so-called “6 out of 6” or “10 out of 10” match.  This form of stem cell transplant is more complex than an autologous, but may be required to cure the more serious types of cancers.

Reduced-intensity

Reduced-intensity stem cell transplantation is also referred to as a “non-myeloablative transplant” or a “mini-transplant.” In this type of transplant, stem cells from an allogeneic donor are used but the transplant is performed without high doses of chemotherapy or irradiation.  This type of transplantation is still investigational but allows patients who cannot undergo conventional high dose chemotherapy, because of advanced age or concurrent medical circumstances, and who also cannot be cured without an allogeneic stem cell transplant to potentially benefit from this type of treatment.

Diseases Treated with Stem Cell Transplantation

Stem cell transplants have been performed at the Utah Blood and Marrow Transplant program for:

  • Acute Leukemia
    • Acute Lymphoid Leukemia (ALL)
    • Acute Myeloid Leukemia (AML)
  • Chronic Leukemia
    • Chronic Lymphoid Leukemia (CLL)
    • Chronic Myeloid Leukemia (CML)
  • Lymphoma
    • Hodgkin's Disease
    • Non-Hodgkin's Lymphoma (NHL)
  • Plasma Cell Dyscrasia
    • Multiple Myeloma
    • Amyloidosis
    • Waldenström's Macroglobulinemia
  • Other Hematologic Diseases
    • Aplastic Anemia
    • Myelodysplastic Syndrome (MDS)
    • Myelofibrosis
    • Immunodeficiency Syndrome
  • Selected Solid Tumors
    • Renal Cell Cancer
    • Breast Cancer
    • Testicular Cancer
    • Sarcoma
    • Neuroblastoma