Stem cell transplant overview

Overview

A stem cell transplant is a medical procedure that replaces damaged or diseased stem cells in your bone marrow with healthy ones. Stem cells are the building blocks of your blood and immune system. This transplant is used to treat certain cancers and blood disorders.

Stem cell transplants are not common for most people. They are used for specific, often serious conditions. Thousands of transplants are done around the world every year.

This procedure is used for people of all ages, from children to older adults, who have certain blood cancers, bone marrow failures, or genetic disorders. Your doctor will decide if it is right for you based on your health and condition.

Symptoms

Common symptoms

• Stem cell transplant is a treatment, not a disease. It is used for conditions that can cause symptoms like fatigue, easy bruising, frequent infections, or unexplained fevers.

Symptoms in children

• In children, the same underlying conditions may cause pale skin, poor growth, or recurrent illnesses.

Symptoms in older adults

• Older adults may experience more severe fatigue, confusion, or breathlessness from the underlying condition.

Causes

Main causes

• The need for a stem cell transplant is caused by conditions that damage or destroy your bone marrow, such as leukaemia, lymphoma, multiple myeloma, aplastic anaemia, or certain genetic disorders.

Risk factors

• Your own risk of needing a transplant depends on the underlying condition. For example, family history of blood cancers, exposure to high levels of radiation or certain chemicals, and some genetic syndromes may increase your risk of diseases that could lead to a transplant.

When to see a doctor

See a doctor urgently if:

• If you have symptoms like unexplained high fever, easy bruising or bleeding, severe shortness of breath, or new lumps or swollen glands.

Book a routine appointment if:

• If you have ongoing tiredness, night sweats, weight loss, or recurrent infections that do not get better.

Diagnosis

Doctors diagnose the condition that may lead to a stem cell transplant through blood tests, bone marrow biopsy, imaging scans, and sometimes genetic tests.

Tests that may be done

• Blood tests to check blood cell counts and look for abnormal cells
• Bone marrow biopsy – a small sample of bone marrow is taken to examine under a microscope
• Imaging tests like X-rays, CT scans, or PET scans to see if the disease has spread
• Genetic tests on blood or bone marrow cells to find specific mutations

What to expect at your appointment

You will have a thorough evaluation by a specialist, usually a haematologist or oncologist. They will explain the diagnosis and discuss whether a stem cell transplant is a suitable option for you.

Treatment

Treatment for conditions that may need a stem cell transplant usually starts with chemotherapy, radiation, or targeted therapies. A stem cell transplant is a major procedure that involves giving high-dose treatment to destroy diseased cells, followed by an infusion of healthy stem cells to rebuild your blood and immune system.

Self-care at home

• Stay as healthy as you can before the transplant by eating well, resting, and avoiding infections.
• Follow all instructions from your medical team about hygiene and preventing illness.
• Keep all appointments for tests and check-ups before the procedure.

Medical treatments

Before a stem cell transplant, you may receive chemotherapy, radiation therapy, or other medicines to prepare your body. The transplant itself is an infusion of stem cells through a vein, like a blood transfusion. After the transplant, you will stay in hospital for several weeks while the new stem cells settle and start making healthy blood cells. You will be given supportive care including medicines to prevent infection, control nausea, and manage pain. No specific drug names or doses are given here – your doctor will decide what is right for you.

When is surgery considered?

Stem cell transplant is not a surgery in the traditional sense. It is a procedure performed in a hospital, often requiring a special transplant unit. You may need a minor procedure to place a central line (a tube in a large vein) to give the stem cells and other treatments.

Living with this condition

Recovery from a stem cell transplant takes months. You will gradually regain strength. Your medical team will monitor you closely for complications. You will need to avoid crowds and people who are sick, practice good hand washing, and protect your skin from the sun. It is common to feel tired for a long time.

Lifestyle tips

• Avoid contact with people who have infections or who have recently been vaccinated with live vaccines.
• Wash your hands often and keep your home clean.
• Wear a mask in public places as advised by your team.
• Avoid plants, soil, and pets that might carry infections while your immune system is weak.

Diet and exercise

Eat a balanced diet with well-cooked food to lower the risk of foodborne infections. Your doctor may recommend a low-microbial diet. Gentle exercise like walking can help your strength, but rest when you need to. Always follow your medical team's advice on activity.

Mental health and emotional wellbeing

A stem cell transplant can be emotionally draining. You may feel anxious, depressed, or isolated. It is normal to have strong feelings. Talk to your care team about mental health support – many hospitals have counsellors or social workers. If you are struggling, reach out to a friend, family member, or supportive group.

Prevention

You cannot prevent the underlying conditions that require a stem cell transplant. However, some risk factors like smoking, excessive alcohol, or exposure to chemicals can be avoided to lower your risk of blood cancers.

Vaccines

Vaccinations are important before and after transplant, but you must follow your doctor’s schedule. Some live vaccines are not safe during immune suppression.

Screening programmes

If you have a family history of certain blood disorders, talk to your doctor about whether genetic testing or earlier check-ups may be appropriate. There is no routine screening for most conditions that need a transplant.

Complications

If left untreated

• Without treatment, the underlying condition (such as leukaemia or aplastic anaemia) can get worse and be life-threatening.
• If a stem cell transplant is needed but not done, the disease may progress and become harder to treat.

Long-term outlook

Stem cell transplant can be a challenging treatment, but it offers a chance for cure or long-term control of many serious illnesses. Many people recover and lead full lives after a transplant. It is important to have realistic expectations and strong support. Your medical team will explain your personal outlook based on your specific condition and overall health.

Find support

International organisations

• Leukemia & Lymphoma Society
• Bone Marrow Transplant Foundation

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