Stem cell transplantation for leukemia

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on May 26, 2022.

A stem cell transplant may restore healthy bone marrow in patients with leukemia. Stem cells help stimulate new bone marrow growth and restore the immune system.

Types of stem cell transplants for leukemia

The two main types of stem cell transplants are listed below.

Autologous stem cell transplant: In this procedure, stem cells are collected from the patient's blood, harvested, frozen and stored until needed, then infused back into the patient after he/she has received high dose chemotherapy and/or radiation therapy to destroy the cancer cells.

Allogeneic stem cell transplant: In this type of transplant, stem cells are taken from a matching donor. To determine if a donor’s stem cells are the right match, the patient undergoes a human leukocyte antigens (HLA) test. In an HLA test, the care team compares the patient’s blood and tissue type with blood samples from the donor.

What to expect

Before a stem cell transplant for leukemia, the patient undergoes a conditioning regimen, which involves intensive treatment to destroy as many leukemia cells as possible. The patient may receive high doses of chemotherapy and, in some cases, radiation therapy. The patient may also receive reduced-intensity conditioning (sometimes referred to as a mini-allogeneic transplant), which uses lower, less toxic doses of chemotherapy and/or total body irradiation before the transplant.

Once this preparative regimen is complete, the patient is ready to undergo the transplant. Much like a blood transfusion, the patient receives the stem cells intravenously. The procedure takes about an hour. After entering the bloodstream, the stem cells travel to the bone marrow and start to make new blood cells in a process known as engraftment.

In the months following the transplant, the patient's care team will monitor his or her blood counts. The patient may need transfusions of red blood cells and platelets. Sometimes, the intensive treatments the patient receives before the stem cell transplantation for leukemia can cause side effects, such as infection. In this case, the care team may administer IV antibiotics.

An advantage of an allogeneic transplant is that the stem cells come from a healthy donor with no malignant cells. However, since it can be difficult to find a matching donor, an autologous transplant is usually more common. Also, if the patient had an allogeneic stem cell transplant, his or her doctor may prescribe certain drugs to reduce the risk of graft-versus-host-disease (GVHD), a condition where the donated cells attack the patient's tissues.

Recovery from a leukemia stem cell transplant may take several months. The patient's hematology oncology team works with the rest of the care team to support the patient throughout the process.

Next topic: How is leukemia treated with chemotherapy?

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