Bone Marrow Transplant (Stem Cell Transplant)

Recognized as one of the leading programs of its kind, UT Southwestern's hematologic malignancies team has performed approximately 2,500 bone marrow transplants (also known as stem cell transplants) while achieving some of the strongest survival rates for patients in the region.

Our highly specialized program is part of the Harold C. Simmons Comprehensive Cancer Center, the only National Cancer Institute-designated comprehensive cancer center in North Texas.

What Are the Types of Bone Marrow Transplant?

There are two main types of bone marrow transplants: autologous, which use the patient’s own stem cells, and allogeneic, which rely on stem cells from a donor. Doctors consider several factors to determine the best transplant option for patients.

Autologous Transplants

A person might receive an autologous transplant if their cancer is particularly sensitive to high-dose chemotherapy or radiation or if no suitable donor is available. It’s often chosen for conditions such as lymphoma and multiple myeloma , and it can be a good option for older patients who might not tolerate the risks associated with donor transplants.

With autologous transplants:

• Patients use their own stem cells, so there’s no need to find a match
• There's almost no chance of graft-versus-host disease, where the transplanted cells attack the recipient's tissues
• Immune function often returns more quickly, reducing the risk of severe infections
• Serious complications are less common, allowing some patients to handle treatment better

Autologous transplants pose a risk of reintroducing cancer cells if the harvested stem cells contain traces of the disease. They also don't provide the extra immune boost from donor cells that can attack any remaining cancer. As a result, relapse rates can be higher than with allogeneic transplants.

Allogeneic Transplants

A person might receive an allogeneic transplant when their cancer (often leukemia or myelodysplastic syndrome) requires not only high-dose chemotherapy but also the donor’s immune cells to help destroy lingering cancer. Common donor sources include a matched sibling, an unrelated volunteer found through a registry, or umbilical cord blood.

With allogeneic transplants:

• Donor immune cells can actively fight any remaining cancer cells, called the graft-versus-cancer effect
• Certain leukemias and related disorders have better long-term control because of this immune response
• There’s less chance of reintroducing cancer back into the body
• Related, unrelated, and cord blood donors offer multiple avenues to find a suitable match

Allogeneic transplants carry higher risks than autologous transplants, including graft-versus-host disease. Immune recovery can be slower, increasing the risk of severe infections. Treatment-related mortality is also higher, reflecting the complexity of matching, transplant procedures, and long-term care.