Overview
A bone marrow transplant is a procedure that infuses healthy blood-forming stem cells into your body to replace bone marrow that's not producing enough healthy blood cells. A bone marrow transplant also is called a stem cell transplant or a hematopoietic stem cell transplant.
You might need a bone marrow transplant if your bone marrow stops working and does not produce enough healthy blood cells. A bone marrow transplant also may be the best way to treat leukemias and some other cancers.
A bone marrow transplant may use cells from your own body, called an autologous transplant, or cells from a donor, called an allogeneic transplant.
Your care team may recommend bone marrow transplant after you have tried other treatments or as a first option. The choice depends on your health and your treatment goals. Recovering your health after a bone marrow transplant may be a long process with setbacks, but most people can resume school, work and activities they enjoy.
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Why it's done
A bone marrow transplant may be used to:
- Safely allow treatment with high doses of chemotherapy or radiation by replacing or rescuing the bone marrow damaged by the treatment.
- Replace bone marrow that's not working properly with new stem cells.
- Provide new stem cells, which can help kill cancer cells directly.
Bone marrow transplants can benefit people with a variety of both cancerous and noncancerous diseases, including:
How a stem cell transplant works
Bone marrow is the spongy tissue inside some bones. Its job is to produce blood cells. If your bone marrow isn't functioning properly because of cancer or another disease, you may receive a stem cell transplant.
To prepare for a stem cell transplant, you receive chemotherapy to kill the diseased cells and malfunctioning bone marrow. Then, transplanted blood stem cells are put into your bloodstream. The transplanted stem cells find their way to your marrow, where — ideally — they begin producing new, healthy blood cells.
Risks
A bone marrow transplant can pose numerous risks. Some people have minimal issues with a bone marrow transplant, while others can have serious complications that require treatment or hospitalization. Sometimes, complications are life-threatening.
Your risks depend on many factors, including the disease or condition that caused you to need a transplant, the type of transplant, your age, and your overall health.
Possible complications from a bone marrow transplant include:
- Graft-versus-host disease, a complication of allogeneic transplant only.
- Stem cell failure, also called graft failure.
- Organ damage.
- Infections.
- Cataracts.
- Infertility.
- New cancers.
Your healthcare professional can explain your risk of complications from a bone marrow transplant. Together you can weigh the risks and benefits to decide whether a bone marrow transplant is right for you.
Graft-versus-host disease: A potential risk when stem cells come from donors
If you receive a transplant that uses stem cells from a donor, called an allogeneic transplant, you may be at risk of developing graft-versus-host disease (GVHD). This condition occurs when the donor stem cells that make up your new immune system see your body's tissues and organs as something foreign and attack them.
GVHD may happen at any time after your transplant. Many people who have an allogeneic transplant get GVHD at some point. The risk of GVHD is greater if the stem cells come from an unrelated donor. But GVHD can happen to anyone who gets a bone marrow transplant from a donor.
There are two kinds of GVHD: acute and chronic. Acute GVHD usually happens during the first months after your transplant. It typically affects your skin, digestive tract or liver. Chronic GVHD typically develops later and can affect many organs.
Chronic GVHD signs and symptoms include:
- Diarrhea.
- Dry mouth.
- Joint or muscle pain.
- Mouth sores.
- Nausea.
- Persistent cough.
- Rash.
- Shortness of breath.
- Skin changes, including scarring under the skin or skin stiffness.
- Vision changes, such as dry eyes.
- Vomiting.
- Yellowing of the skin and the whites of the eyes.
How you prepare
Pretransplant tests and procedures
You have a series of tests and procedures that assess your general health and the status of your condition. The tests and procedures also ensure that you're physically prepared for the transplant. The evaluation may take several days or more.
A long, thin tube, often called a central line, usually remains in place for the duration of your treatment. Your transplant team uses the central line to infuse the transplanted stem cells, medicines and blood products into your body.
Collecting stem cells for autologous transplant
If a transplant using your own stem cells, known as an autologous transplant, is planned, you undergo a procedure called apheresis (af-uh-REE-sis) to collect blood stem cells.
Before apheresis, you receive daily injections of growth factor to increase stem cell production and move stem cells into your circulating blood so that they can be collected.
During apheresis, blood is drawn from one of your veins and circulated through a machine. The machine separates your blood into different parts, including stem cells. These stem cells are collected and frozen for future use in the transplant. The remaining blood is returned to your body.
Collecting stem cells for allogeneic transplant
If you're having a transplant using stem cells from a donor, called an allogeneic transplant, you need a donor. Once a donor is found, stem cells are gathered from that person for the transplant.
Stem cells can come from your donor's blood or bone marrow. Your transplant team decides which is better for you based on your situation. Your care team compares proteins on your stem cells to proteins on the stem cells of potential donors to find a match for you.
Another type of allogeneic transplant uses stem cells from the blood of umbilical cords. This is called a cord blood transplant. Mothers can choose to donate umbilical cords after their babies' births. The blood from these cords is frozen and stored in a cord blood bank until needed for a bone marrow transplant.
The conditioning process
After completing the pretransplant tests and procedures, you begin a process known as conditioning. During conditioning, you undergo chemotherapy and possibly radiation to:
- Destroy cancer cells if you're being treated for cancer that may spread to other parts of the body.
- Suppress your immune system.
- Prepare your bone marrow for the new stem cells.
The type of conditioning process you receive depends on several factors, including the disease being treated, your overall health and the type of transplant planned. You may have both chemotherapy and radiation or just one of these treatments as part of conditioning.
Side effects of the conditioning process can include:
- Anemia.
- Bleeding.
- Cataracts.
- Diarrhea.
- Fatigue.
- Hair loss.
- Infection.
- Infertility or sterility.
- Mouth sores or ulcers.
- Nausea and vomiting.
- Organ complications, such as heart, liver or lung failure.
You may be able to take medicines or other measures to lessen such side effects. If you lose your hair, it usually grows back after treatment.
Reduced-intensity conditioning
Based on your age and health history, you may receive lower doses or different types of chemotherapy or radiation for your conditioning treatment. This is called reduced-intensity conditioning.
Reduced-intensity conditioning kills some cancer cells and suppresses your immune system. Then, the donor's cells are infused into your body. Donor cells replace cells in your bone marrow over time. Immune factors in the donor cells may then fight your cancer cells.
What you can expect
During your bone marrow transplant
Your bone marrow transplant occurs after you complete the conditioning process. On the day of your transplant, stem cells are infused into your body through your central line.
The transplant infusion is painless. You are awake during the procedure.
After your bone marrow transplant
When the new stem cells enter your body, they travel through your blood to your bone marrow. In time, they multiply and begin to make new, healthy blood cells. This is called engraftment. It usually takes several weeks before the number of blood cells in your body starts to return to the standard range. In some people, it may take longer.
In the days and weeks after your bone marrow transplant, you have blood tests and other tests to monitor your condition. You may need medicine to manage complications, such as nausea and diarrhea. Your caregiver is very involved during this period.
After your bone marrow transplant, you remain under close medical care. If you're having infections or other complications, you may need to stay in the hospital for several days or longer. Depending on the type of transplant and the risk of complications, you need to remain near the hospital for several weeks to months to allow close monitoring.
You also may need periodic transfusions of red blood cells and platelets until your bone marrow begins producing enough of those cells on its own.
You may be at greater risk of infections or other complications for months to years after your transplant. For the rest of your life, you meet regularly with your healthcare professional to check for late complications.
Medications
If your bone marrow transplant is using stem cells from a donor, known as an allogeneic transplant, you may take medicines to help prevent graft-versus-host disease (GVHD) and reduce the reaction of your immune system. These medicines are called immunosuppressive medicines.
After your transplant, your immune system needs time to recover. During this time, you may be given medicines to prevent infections.
Diet and other lifestyle factors
After your bone marrow transplant, you may need to adjust your diet to stay healthy and to prevent too much weight gain. Your nutrition specialist, called a dietitian, and other members of your transplant team work with you to create a healthy-eating plan that meets your needs and matches your lifestyle.
Your dietitian also can give you food suggestions to control side effects of chemotherapy and radiation, such as nausea.
Your dietitian may advise that you:
- Follow food safety guidelines to prevent foodborne infections.
- Eat a wide variety of healthy foods, including cooked vegetables and fruits; whole grains; well-cooked lean meats, poultry and fish; legumes; and healthy fats, such as olive oil.
- Limit salt intake.
- Limit alcohol.
- Avoid grapefruit and grapefruit juice due to their effect on a group of immunosuppressive medicines.
After your bone marrow transplant, regular physical activity helps you manage your weight, strengthen your bones, increase your endurance, strengthen your muscles and keep your heart healthy. As you recover, you can slowly increase your physical activity.
Taking steps to prevent cancer is even more important after your transplant. Don't smoke. Wear sunscreen when you're outside and be sure to get recommended cancer screenings.
Results
A bone marrow transplant can cure some diseases and put others into remission. Goals of a bone marrow transplant depend on your condition but usually include controlling or curing your disease, extending your life, and improving your quality of life.
Some people have few side effects or and complications from a bone marrow transplant. Others may experience short- and long-term side effects and complications. It can be hard to predict the severity of side effects and the success of the transplant.
It can be helpful to remember that many people who have transplants experience some very hard days during the transplant process. But ultimately, they have successful transplants and return to typical activities with good quality of life.
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Coping and Support
Having a bone marrow transplant or waiting for one can be hard. It's typical to have concerns and feel anxious. You may not feel like yourself for several months after a transplant. You may find that new routines to protect your health are isolating.
Having support from your friends and family can be helpful. You, your family and your caregiver may benefit from joining a support group of people who understand what you're going through and can share their experiences.
Support groups offer a place for you and your family to share concerns, difficulties and successes with people who have had similar experiences. You may meet people who have already had a transplant or who are waiting for one.
Aug. 21, 2026