Bone Marrow Transplantation
Stem Cell Transplants Using Bone Marrow, Blood, and Umbilical Cord Blood
Call for an AppointmentA bone marrow transplant -- also called a stem cell transplant -- is an effective treatment for people who are diagnosed with life-threatening blood diseases. If you have been told you need a bone marrow or stem cell transplant, choosing Duke as your transplant center puts you in good hands. We are one of the few programs in the nation to use stem cell transplant as part of the treatment for scleroderma (systemic sclerosis). We also treat sickle cell disease and blood cancers such as leukemia, lymphoma, and multiple myeloma.
What Is a Stem Cell Transplant?
Stem cells are special blood cells found in the bone marrow and in umbilical cord blood. During stem cell transplantation, your unhealthy blood cells or stem cells are destroyed using chemotherapy or radiation. They are replaced with healthy cells from your body or cells from a donor. If a donor is not available, stem cells from cord blood can be used. Duke was one of the first transplant centers in the world to perform cord blood transplants.
There are also different types of transplants, based on the source of the healthy cells.
- Autologous transplant: Uses your own stem cells.
- Allogeneic transplant: Uses cells from a related or unrelated donor.
- Syngeneic transplant: Uses stem cells from your identical twin.
The Duke Blood Cancer Center in Durham is an outpatient treatment center that includes the Blood and Marrow Transplant Clinic and the Hematologic Malignancies Clinic.
Stem Cell Transplant Process
Your Transplant Team
Your transplant team includes board-certified hematologists and medical oncologists, clinical pharmacists, specially trained nurses, dietitians, and social workers. They meet regularly to discuss your care so they can offer the best recommendations and treatment to meet your needs. Your transplant coordinator will facilitate appointments and coordinate your care. We also help you find nearby housing during your weeks-long treatment and help you navigate 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 chemotherapy treatment.
Conditioning Regimen
Chemotherapy alone or with radiation therapy kills any cancer or unhealthy 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 Transplant
The transplanted stem cells enter your bloodstream in a method similar to a blood transfusion. Once in your bloodstream, they make their way to the bone marrow and begin making blood cells.
Patient Care
We are one of the only programs in North Carolina where you will receive most of your care in our 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 hospital as an inpatient.
If you receive donor cells, you may spend a some of your time in the hospital, which offers a dedicated area for stem cell transplant recipients, and undergo your remaining transplant care as an outpatient. We are currently leading the nation's first clinical trial to offer stem cell 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 to 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.
Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest ranked program in North Carolina, according to U.S. News & World Report for 2021–2022.
Why Choose Duke
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 6,000 transplants since 1984 and the first cord blood transplant in 1993. Currently, about 260 stem cell 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 transplants as an option to a broader number of people -- including those who are older or lack 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% 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.