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A blood and marrow transplant 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.
Preparing for a Transplant
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 a transplant and, if so, what type of transplant would be the most appropriate.
Types of Blood and Marrow Transplants
Experts at NYU Langone’s Blood and Marrow Transplant Program perform two types of blood and marrow transplants: autologous and allogeneic.
Autologous Blood and Marrow Transplants
Most transplants 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 transplants can be used to treat several pediatric cancers, including neuroblastoma and brain tumors. Learn more about autologous blood and marrow transplants in our guide for patients and caregivers.
Allogeneic Blood and Marrow Transplants
During an allogeneic transplant, 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 transplant. 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 transplants 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.
During a haploidentical transplant, which is a newer type of allogeneic transplant 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 transplant is the right option for you.
Learn more about allogeneic blood and marrow transplants in our guide for patients and caregivers.
Care After a Transplant
After the procedure, adults stay at our Rita J. and Stanley H. Kaplan Blood and Marrow Transplant and Cell Therapy 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 transplant process, against infection. Your transplant 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 and Perlmutter Cancer Center at NYU Langone Hospital—Long Island. For children, outpatient care is provided at Stephen D. Hassenfeld Children’s Center for Cancer and Blood Disorders.