Blood and Marrow Transplant
Expert care for blood and bone marrow transplant
In addition to research activities related to blood and bone marrow transplants that expand potential treatment options, transplant patients also benefit from our team’s dedication to providing comprehensive and compassionate care. From treatment through recovery, the staff helps guide our patients through the transplant experience, offering support and expertise.
Our patient-centered program features:
- Board-certified physicians who customize diagnostic and treatment plans to each person’s individual needs and medical history
- On-site stem cell collection and processing, conducted by Scripps employees
- Treatment in an ideal BMT environment that includes high efficiency particulate air (HEPA) filters
- Special support, including transplant workshops for patients and their loved ones
Types of blood and marrow transplants
The blood and bone marrow transplant team performs stem cell transplants with the goal of rebuilding the recipient’s immune system and curing disease. Our team performs the following types of transplants:
- Autologous transplants – Patients receive their own stem cells, which are removed before receiving high-dose chemotherapy or radiation treatment and stored for later use.
- Allogeneic transplants – Patients receive stem cells from a donor. Special blood tests are done to determine if a donor is a good match for the recipient.
Donors and recipients are matched through national bone marrow registries, such as the National Marrow Donor Program.
Scripps BMT physicians choose the type of transplant based on several factors, including the type of disease, the stage of disease and the patient’s general condition.
Blood and marrow diseases treated by stem cell transplants
A bone marrow transplant — also called a blood stem cell transplant — is a procedure in which damaged or diseased bone marrow cells are replaced with healthy ones. It can be used to treat the following:
- Certain cancers, such as leukemia, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma and multiple myeloma
- Illnesses where the bone marrow does not produce the right kind of or enough cells, such as:
- Aplastic anemia
- Myelodysplastic syndromes (MDS)
- Severe immunodeficiency syndromes
- Sickle cell anemia
Stem cell sources and collection
Hematopoietic (blood-forming) stem cells are immature cells in the bone marrow that give rise to all of your blood cells. They can be harvested from any of the following sources for use in transplants:
- Peripheral blood – Stem cells are collected from the blood stream.
- Bone marrow – Stem cells are collected directly from the bone marrow.
Peripheral blood stem cell collection
The Scripps Blood and Marrow Transplant Program uses peripheral blood stem cell collection. Before this procedure, the donor receives daily injections of a medication that moves stem cells out of the bone marrow and into the blood.
On the day of the procedure, the donor is connected to a blood collection and processing machine through a needle inserted into their arm. As blood moves into the machine, it is filtered to collect only the stem cells, and the remaining blood is returned back to the donor through a needle in their other arm.
Peripheral blood stem cell collection takes several hours. The donor can go home the same day and resume normal activities almost immediately. Full recovery may take a week.
Surgical bone marrow collection
Because the procedure takes place under general anesthesia, there is no pain during the donation itself. All surgical procedures involving general anesthesia have risks, which will be thoroughly reviewed by the transplant team before the donor gives final consent for the donation.
Afterward, there may be discomfort at the site where the needle was inserted in the donor’s bone, but this discomfort goes away within a few days. The donor’s body naturally replenishes its supply of bone marrow in about two to three weeks.
Frequently asked questions about stem cell transplantation
If your doctor recommends a stem cell transplant, also known as a blood or bone marrow transplant, you may have many questions about the procedure and what to expect. Here are answers to frequently asked questions about stem cell transplantation. Always feel free to ask your physician or care team for more information and guidance.
What are stem cells?
Stem cells, also called pluripotent stem cells, are immature blood cells that develop into red blood cells, white blood cells and platelets. Each of these plays a vital role in your health. Red blood cells carry oxygen and nutrients throughout your body, white blood cells help fight infection and platelets help with blood clotting. Stem cells are found mostly in your bone marrow as well as in your blood.
What is a stem cell transplant?
A stem cell transplant is a procedure that infuses healthy stem cells into a person’s blood to replace cells damaged by diseases, such as cancer, or by treatments, such as chemotherapy, and rebuild their immune system to fight disease. The healthy stem cells develop and reproduce, creating new red blood cells, white blood cells and platelets.
Where do the healthy stem cells come from?
In an autologous transplant, patients receive their own stem cells, which are removed from their blood or bone marrow before they receive high-dose chemotherapy or radiation treatment. The stem cells are then stored for later use.
In an allogeneic transplant, patients receive stem cells from a donor. The closer the donor’s stem cells are to your own, the lower the risk that the new stem cells will be rejected by the recipient’s body (called graft versus host disease).
How do I know if a donor is a good match?
Special blood tests are done to determine if a donor’s stem cells are a good match for the recipient. While a first-degree relative, such as a parent, child or sibling is usually the best match, many patients do not have a family member who meets the donation criteria. In this case, a matched unrelated donor (MUD) may be found through registries such as the National Marrow Donor Program.
What should I expect during the stem cell transplant procedure?
Before the new stem cells are transplanted, you will receive chemotherapy to help destroy your diseased cells and make space inside your bones for the new stem cells. In most cases, after a couple of weeks the healthy stem cells will be placed into your body through an intravenous (IV) catheter; the cells will then move into the space inside your bones and begin to produce new cells.
How long will it take to recover from a stem cell transplant?
It may take you several weeks to several months to recover after a stem cell transplant. You may need to stay in or near the hospital for three months or more to allow your medical team to monitor your recovery and address any side effects or complications. You will continue to recover at home.
Because your immune system is building itself back up during recovery, you will need to be especially careful about avoiding infection. Your team will want you to rest and regain your strength in a clean, low-stress environment where you will not come into contact with large groups of people. If you receive stem cells from a donor, your recovery may take longer. Your physician will determine when you can return to work and resume other activities.
CAR T-cell therapy
Chimeric antigen receptor (CAR) T-cell therapy is a newer type of immunotherapy. Immunotherapy makes changes to a person’s immune system that enables it to recognize and attack harmful cells. T cells help the immune system kill diseased cells, but they normally don’t recognize cancer cells as being dangerous.
CAR T-cell therapy changes T cells so that they are more effective at recognizing and attacking cancer cells. CAR T-cell therapy has been FDA-approved to treat several types of cancer. It has a high success rate and has even eliminated cancer in some patients, but it does not work for everyone.
How CAR T-cell therapy works
During CAR T-cell therapy, the patient’s T cells are collected from the blood using apheresis, a procedure which removes some components of blood and returns the remaining blood to the patient’s body. Scientists genetically modify the T cells so that they make a type of protein called a receptor. The receptor recognizes a type of protein called an antigen that is found on the surface of cancer cells. The modified T cells are multiplied and pumped back into the patient’s blood, where they can recognize and attack cancer cells. The modified T cells are multiplied by the hundreds of millions and then infused back into the patient to fight the disease.
What to expect from CAR T-cell therapy
After the T cells are collected through apheresis, it usually takes a few weeks to modify and multiply the cells. Most patients will stay in the hospital during this time, and may have a short course of chemotherapy to weaken their immune system and help the modified T cells do their job. Following the T-cell infusion, patients spend a few more days in the hospital, and generally stay close to the hospital for several weeks to monitor and treat any side effects.
Blood and Marrow Transplant Program locations
Scripps Health’s Blood and Marrow Transplant Program is offered at the following locations:
Scripps Clinic Rancho Bernardo
15004 Innovation Drive
San Diego, CA 92128
10666 North Torrey Pines Road
La Jolla, CA 92037
Inpatient services are provided at Scripps Green Hospital, which shares a campus with Scripps Clinic Torrey Pines. The hospital and clinic are located about 15 miles north of downtown San Diego.
Patient support and resources
Scripps offers a wide range of supportive services to meet the specialized needs of transplant patients and their loved ones, including support groups and educational classes. Learn more about the support and resources you have access to at Scripps. Our inspirational transplant patient success stories are another great resource to learn more about the supportive, life-affirming aspects of Scripps transplant services and care.