Blood and marrow transplantation can be a complex treatment that involves a long recovery process. Our team at the Blood and Marrow Transplant Program, part of Perlmutter Cancer Center, provides support throughout the process—answering questions and coordinating your follow-up care.
After your doctor refers you or your child to us for a transplant, we discuss your medical history and current health. We also conduct tests to determine the health of your heart, lungs, and other organs. This helps us decide whether you would benefit from transplantation and, if so, what type of transplantation would be the most appropriate.
Types of Blood and Marrow Transplantation
Experts at NYU Langone’s Blood and Marrow Transplant Program perform two types of blood and marrow transplantation: autologous and allogeneic.
Autologous Blood and Marrow Transplantation
Most transplantations performed at NYU Langone are autologous, meaning doctors use your own stem cells or bone marrow. In these procedures, healthy stem cells are removed from your peripheral blood or marrow before you begin treatment with chemotherapy or radiation therapy, as these treatments may damage stem cells. The harvested stem cells are then cryopreserved, which means they are processed and preserved in a freezer.
When your cancer treatment, or conditioning regimen involving chemotherapy or radiation therapy, is finished, the stem cells are thawed and given back to your body, so it can resume its job of creating healthy blood cells.
In addition, autologous transplantation can be used to treat several pediatric cancers, including neuroblastoma and brain tumors. Learn more about autologous blood and marrow transplantation in our guide for patients and caregivers.
Allogeneic Blood and Marrow Transplantation
During an allogeneic transplantation, stem cells are used from a donor other than yourself to help you recover from conditions such as leukemia and lymphoma. Sometimes, chemotherapy, with or without the use of radiation therapy, is used to completely destroy all of your bone marrow before the transplantation. This treatment is called myeloablative chemotherapy.
Other times, a nonmyeloablative regimen, which may also be called a mini-transplant, is used. During this treatment, chemotherapy, with or without the use of radiation therapy, is used to destroy some but not all of the diseased marrow, with the intention that the donor cells can destroy the remaining disease.
Besides bone marrow, allogeneic transplantation can also be performed using stem cells from a donor’s circulating blood, also known as peripheral blood, or a donor’s umbilical cord blood. To be considered a close match, a donor’s cells must have similar genetic markers to yours. Genetic markers are proteins found in the body that, when shared between two people, reduce the chance of your body rejecting the donor cells. For this reason, siblings or matched related donors are often good candidates because they offer some identical genetic material from their parents.
If no family member is a close match, our team searches for a donor, also called a matched unrelated donor, through the National Marrow Donor Program, which has a list of potential donors in the country and around the world. When a donor is found, we conduct medical tests to assure his or her health and willingness to participate.
We also offer haploidentical transplantation—a newer type of allogeneic transplantation where the donor, who is typically a family member, is at least a half match for the patient. Haploidentical transplants are an option when a patient cannot find a close match from a related or unrelated donor. Our doctors can help evaluate whether this type of transplantation is the right option for you.
Learn more about allogeneic blood and marrow transplantation in our guide for patients and caregivers.
After the procedure, adults stay at our Rita J. and Stanley H. Kaplan Stem Cell and Bone Marrow Transplant Center, an inpatient unit within NYU Langone’s Kimmel Pavilion, for two to three weeks. Inpatient care for children is provided at Hassenfeld Children’s Hospital—34th Street. Each patient has his or her own private suite that is designed to maximize safety and comfort.
Specialized air-filtering systems in the suite protect your immune system, which is weakened by the transplantation process, against infection. Your transplantation team coordinates your care in the hospital and after you return home. To help you recover, our nutritionists create a balanced diet plan for you, and our social workers can provide counseling and other emotional support.
Outpatient care for adults is provided at Perlmutter Cancer Center—38th Street. For children, outpatient care is provided at Stephen D. Hassenfeld Children’s Center for Cancer and Blood Disorders.