Bone Marrow Transplant

Bone Marrow Transplant, Stem Cell Transplant, Cord Blood Transplant
Transfers healthy bone marrow cells when your own unhealthy bone marrow has been eliminated following chemotherapy or radiation. The terms bone marrow transplant, stem cell transplant, and cord blood transplant refer to cells obtained from the bone marrow, blood, or umbilical cord blood.

Autologous Transplant, Allogeneic Transplant, Syngeneic Transplant
There are also different types of transplants. 

• Autologous transplant: your own stem cells
• Allogeneic transplant:  cells from a related or unrelated donor
• Syngeneic transplant: stem cells from your identical twin

The first step in the transplant process is a comprehensive evaluation by your bone marrow transplant team to determine which transplant procedure is best for you. The process involves many tests to ensure it is safe for you to have the transplant.

Blood Tests

Blood will be drawn to evaluate your past exposure to certain viruses and to check your organ function. These tests will help us treat you before and after your transplant.

Human Leukocyte Antigen (HLA) Typing

We search for stem cell donor matches based on your HLA typing. This blood test will be repeated at our lab even if it was done previously at your local doctor's office or the American Red Cross. It is our responsibility to verify your typing. Any potential donors will also have HLA typing compared with yours to see if they are a suitable match.

Echocardiogram

Evaluates the pumping ability of your heart. An instrument that transmits high-frequency sound waves called a transducer is placed on your ribs near the breastbone. It picks up the echoes of the sound waves and transmits them as electrical impulses. The impulses are converted into moving pictures of the heart.

Pulmonary Function

Evaluates your lung function and measures different capacities of your lungs.

Imaging Tests

CT, MRI, and PET scans create images that are similar to X-rays but use computers to produce pictures of the area being evaluated.

Bone Marrow Biopsy and Aspirate

A small sample of bone marrow is taken from the back of the hips and studied to determine how well your bone marrow produces cells. It also is evaluated for signs of disease in the marrow.

Your Transplant Team

Your transplant team will include board-certified hematologists and medical oncologists, clinical pharmacists, specially trained nurses, dieticians, and social workers. They meet regularly to discuss your care, collect opinions, and offer the best recommendations for your needs. Your transplant coordinator will facilitate the appointments and coordinate your care. We also assist you in finding nearby housing during your weeks-long treatment and help you navigate through any financial and insurance concerns. 

Donor Search, Obtaining Cells

If you are receiving a transplant from a donor, a search to identify a donor will take place on your behalf with immediate family members and the National Marrow Donor Program. Arrangements will be made for the cells to be harvested. If you are receiving an autologous transplant, ​your stem cells will be harvested and frozen for your use after your conditioning regimen.

Conditioning Regimen

Chemotherapy alone or with radiation therapy kills any cancer cells in your body. This conditioning regimen also makes room in your bone marrow for the transplanted cells to grow. You receive your stem cell transplant after you complete the conditioning regimen. The transplanted cells enter your bloodstream in a method similar to a blood transfusion.  

Outpatient Care

We are one of the only programs in North Carolina where you will receive the majority of your care in our day hospital as an outpatient. This allows you to live in the comfort of your own home or nearby temporary residence. If you are eligible to receive your own cells, you may spend no time in the main hospital as an inpatient. If you receive donor cells, you may spend a portion of your time in the hospital and undergo your remaining transplant care as an outpatient. We are currently leading the nation's first clinical trial to offer bone marrow transplant care in the home. 

Support for You and Your Family

Before, during, and after your treatment, our cancer support services help you minimize the side effects of treatment and cope with the emotional and psychological effects of diagnosis and treatment. Following your transplant, you will receive supportive care in our daily clinic with medicines, monitoring for side effects, and symptom management. You will be required to stay at Duke or live locally for 30-90 days following your transplant. This ensures a safe recovery following your treatment. You will also be required to have a caregiver with you at all times.

Follow-Up Tests

Once you complete your treatment, you will be discharged back to the care of your local doctor. Periodically, you will undergo tests, either here or with your doctor, to monitor your response to therapy and your major organ function.

Duke maintains a well-established program with a long history of success. Here's what you need to know to feel confident when choosing Duke as your transplant center.

We Perform More Transplants than Other Centers in Our Region
We've performed more than 4,500 transplants since 1984 and the first cord blood transplant in 1993. Currently, about 300 blood and marrow transplants take place at Duke each year. 

We Are FACT-Accredited

• The Foundation for Accreditation of Cellular Therapy (FACT) conducts rigorous inspections of transplant programs and certifies programs that offer high-quality care.
• We are one of only a few National Cancer Institute-designated Comprehensive Cancer Centers, which are dedicated to improving patient outcomes.  
• We are part of the National Comprehensive Cancer Network (NCCN), an alliance of the nation’s leading cancer centers dedicated to improving care for our patients.

More Transplant Options for More People

• We offer stem cell transplantation as an option to a broader number of people -- including those who are older or lacking a closely matched donor -- using less-intense chemotherapy regimens and careful selection of donor cells. 
• Our researchers manipulate donor blood cells to reduce complications and make transplants available to more people.
• Our research is especially vital in adult bone marrow transplant, as fewer than 25 percent of adults have access to closely matched donors. 

Clinical Trial Access​
You may have access to the latest therapies through our innovative research programs and clinical trials, which test experimental therapies and provide new therapies for people with advanced or complex diseases. For example, you may be eligible to participate in a study that is exploring transplant care in the comfort of your home.