Stem Cell Transplant

A stem cell transplant restores blood-forming stem cells after treatment that has damaged or removed the patient’s marrow. The cells may come from the patient’s own collected cells or from a matched donor. They are given through an intravenous line; the cells travel to the bone marrow and begin making new blood cells.

This is intensive treatment delivered by a specialist team. The plan depends on the disease, the purpose of transplant, general health, organ function and whether a suitable donor is available.

Preparation includes blood tests, organ checks, infection screening, discussions about fertility and a central line if needed. Conditioning treatment, often chemotherapy with or without radiotherapy, creates space in the marrow and treats abnormal cells. On transplant day, stem cells are infused through the line. The team then checks blood counts, medicines, fluids and signs that the new cells are settling in.

Conditioning may cause nausea, vomiting, diarrhoea, mouth soreness, tiredness, hair loss and reduced blood counts. Low counts can lead to infection, anaemia or bleeding, so protective measures and transfusions may be needed. A donor transplant can cause graft-versus-host disease, in which donor immune cells attack tissues such as skin, bowel or liver. Fever, chills, new rash, persistent diarrhoea, jaundice, breathlessness or bleeding require urgent contact with the transplant team.

The aim and likely course differ by disease, disease status, transplant type and overall health. Some people need a long hospital stay and prolonged monitoring; others continue part of their recovery as an outpatient. The transplant team discusses remission goals, relapse risk, immune complications and personal factors before treatment. Results cannot be predicted from the transplant procedure alone.

An autologous transplant uses the patient’s collected cells. An allogeneic transplant uses donor cells and may provide an immune effect against abnormal cells, but it also brings donor-immune complications. Vaccinations, infection precautions and medicines are reviewed during recovery. Keep a written list of medicines and the transplant team’s urgent contact instructions.

Specialists may consider transplant for selected blood cancers, including some forms of leukaemia, when intensive treatment and blood-forming cell replacement are appropriate. The decision weighs disease features, response to earlier treatment, donor options, organ health, infections and the person’s ability to manage a demanding recovery.

The usual stages are specialist assessment; stem-cell collection from the patient or donor; conditioning treatment; stem-cell infusion; close monitoring while blood counts recover; and follow-up for immune effects, infections, organ health and recurrence. Collection may involve medicines that move cells into the bloodstream before they are taken through a machine and returned through the line.

Early recovery centres on blood-count recovery, infection prevention, nutrition, symptom control and gradual activity. Fatigue can persist after leaving hospital. Donor-cell recipients may need immune-suppressing medicines and repeated checks for graft-versus-host disease. Follow-up continues after the initial recovery because immune function, vaccinations and organ health may need ongoing review.

Important risks include severe infection, bleeding, organ injury, graft failure, graft-versus-host disease and recurrence of the underlying illness. Fertility can be affected by conditioning. Ask the team about fertility preservation, dental care, food safety, visitors and when to seek emergency help. Do not stop immune-suppressing medicine without instructions.

Depending on the illness and treatment goal, alternatives may include chemotherapy, targeted medicines, immunotherapy, radiotherapy, a less intensive transplant approach, a clinical trial or supportive care. The suitable choice depends on test results and previous treatment, so the transplant team should explain why one route is being recommended.

Choose a specialist haematology service with transplant experience and access to infection, transfusion, intensive-care and donor-matching support. Ask who coordinates care after discharge, how urgent symptoms are handled, and which family member can help with medicines and appointments. For background on one condition treated with transplant, see [Leukaemia](/conditions/leukaemia/).