Blood and Bone Marrow Transplant

Autologous transplants can replace diseased or damaged bone marrow cells with new stem cells. This treatment is offered to patients diagnosed with multiple myeloma or certain types of lymphoma.

An autologous transplant involves these steps:

• Stem cell mobilization. Patients are given medications that will cause stem cells to move from the bone marrow to the blood for easier collection.
• Stem cell collection. Stem cells are harvested from the blood through a process called apheresis and frozen for later use.
• Conditioning. Patients undergo chemotherapy to destroy the remaining cells and make room in the bone marrow for the transplanted cells to grow.
• Reinfusion. Autologous transplants don’t include surgery. Instead, patients receive a reinfusion of their own stem cells through a central line or intravenous catheter.
• Survivorship. The care team provides follow-up care to monitor for long-term side effects and treatment success.

Patients diagnosed with certain types of cancer, such as acute leukemia, lymphoma, myelodysplastic syndrome or other types of blood disorders, may need an allogeneic transplant.

During this process, stem cells are collected from a donor and infused into the bloodstream. The stem cell donor could be a family member, a friend or someone unrelated from the national donor registry.

An allogeneic transplant involves these steps:

• Donor cell collection. Stem cells can be collected from a matched donor’s blood, removed from their hipbone through bone marrow harvest or from a donated umbilical cord through the National Marrow Donor Program.
• Stem cell processing. The stem cells are separated from the donor’s blood and processed.
• Conditioning. Patients who need allogeneic transplants will undergo chemotherapy with or without radiation therapy. This treatment destroys any remaining cancer cells, makes room in the bone marrow and weakens the immune system to prevent the body from rejecting the donated cells.
• Infusion. Allogeneic transplants don’t require surgery for the recipient. Instead, an infusion of the donor’s stem cells is given through a central line or intravenous catheter.
• Survivorship. The care team provides follow-up care to monitor for long-term side effects and treatment success.

CAR T-cell therapy is a type of immunotherapy in which a patient’s T lymphocyte cells (a type of immune cell) are modified in the laboratory so they will bind to cancer cells and kill them.

Steps for CAR T-cell therapy:

• Lymphocyte collection. A patient’s blood is collected through a process called apheresis.
• Cells shipped to manufacturer. The manufacturer modifies the cells and attaches the CAR T receptors to the cells.
• Cells are multiplied and shipped back. The goal is to produce millions of CAR T cells. Once the required dose of cells is made, the cells are shipped back to Sanford Health.
• Chemotherapy. The patient will receive chemotherapy before receiving the infusion of CAR T cells.
• Infusion. The patient will receive the CAR T cell infusion through a central line. The goal is for the CAR T cells to bind to and eliminate cancer cells.
• Survivorship. The care team provides follow-up care to monitor for long-term side effects and treatment success.