Quick answer. A bone marrow transplant, also called a stem cell transplant, replaces diseased or damaged bone marrow with healthy blood-forming stem cells, and is used to treat conditions such as leukaemia and lymphoma. It can use a person’s own cells (autologous) or a matched donor’s (allogeneic), and is led by a haematologist or oncologist.
A bone marrow transplant, more accurately called a stem cell transplant, is an intensive treatment that replaces unhealthy bone marrow with healthy blood-forming stem cells. In Singapore, it is offered at specialist centres for conditions such as leukaemia, lymphoma, myeloma and certain inherited or marrow-failure disorders. It is a major undertaking, but for many people it offers the best chance of long-term control or cure of their illness.
This guide explains, in plain terms, what a bone marrow transplant involves – the difference between using your own cells and a donor’s, how donor matching works, the steps in the process, the recovery period and the main risks such as graft-versus-host disease and infection. It is a general overview; your haematologist will tailor the details to your diagnosis.
At a glance
| Type | Source of stem cells | Typically used for |
|---|---|---|
| Autologous | Your own collected stem cells | Some lymphomas and myeloma |
| Allogeneic | A matched donor (related or unrelated) | Many leukaemias, marrow failure |
| Donor matching | Based on tissue (HLA) typing | Sibling, registry or cord blood donors |
| Conditioning | High-dose chemo, sometimes radiotherapy | Clears the old marrow before transplant |
| Engraftment | New cells start producing blood | Usually over the weeks after infusion |
What is a bone marrow transplant?
Bone marrow is the soft tissue inside bones that produces blood cells – red cells, white cells and platelets – from stem cells. A bone marrow transplant, or stem cell transplant, replaces marrow that is diseased, damaged or destroyed by treatment with healthy blood-forming stem cells, allowing the body to make normal blood cells again.
There are two main types. An autologous transplant uses the patient’s own stem cells, collected and stored beforehand, then returned after high-dose treatment. An allogeneic transplant uses stem cells from a matched donor – a brother or sister, an unrelated registry donor, or umbilical cord blood. The choice depends on the condition being treated. The stem cells are usually collected from the bloodstream nowadays, rather than directly from the bone.
When and why it is used
A transplant is considered when the benefits outweigh the considerable risks. Conditions it may be used for include:
- Leukaemias – cancers of the blood and bone marrow
- Lymphomas – cancers of the lymphatic system
- Multiple myeloma – a cancer of plasma cells
- Bone marrow failure conditions such as aplastic anaemia
- Certain inherited blood disorders, including some forms of thalassaemia
The decision rests on the diagnosis, the disease stage, the person’s overall health and fitness, and the availability of a suitable donor. It is always made by a specialist team after detailed discussion.
How the process works
A transplant is carried out in stages over several weeks, with careful preparation:
- Assessment and matching – tests of organ function, and tissue (HLA) typing to find a suitable donor for an allogeneic transplant
- Stem cell collection – cells are harvested from the bloodstream of the patient (autologous) or donor (allogeneic), or from cord blood
- Conditioning – high-dose chemotherapy, sometimes with radiotherapy, to clear out the existing marrow and make room for the new cells
- The transplant – the stem cells are given through a drip, much like a blood transfusion
- Engraftment and recovery – the new cells travel to the bone marrow and begin producing blood cells over the following weeks, during which blood counts are very low
Most of this takes place in hospital, often in a protected environment because the immune system is severely weakened during the process.
Recovery and risks
Recovery is gradual and can take many months, with close monitoring. The main risks and challenges include:
- Infection – the weakened immune system makes infections a serious risk, so precautions and preventive medicines are used
- Graft-versus-host disease (GVHD) – in allogeneic transplants, the donor cells can attack the recipient’s tissues; this is managed with medication and monitored closely
- Low blood counts – causing tiredness, bleeding or bruising risk, often needing transfusions
- Side effects of conditioning – such as nausea, mouth soreness and fatigue
- Longer-term effects – fertility, hormonal and organ effects, which the team will discuss in advance
Regular follow-up continues long after discharge to watch for complications and check the transplant is working.
Treatment overview and what to ask
A bone marrow transplant is one part of an overall treatment plan, not a standalone decision. Before proceeding, it helps to understand:
- Why a transplant is recommended for your specific condition, and the alternatives
- Whether it would be autologous or allogeneic, and how a donor would be found
- The likely hospital stay, recovery timeline and impact on work and family
- The main risks for your situation and how they would be managed
- The support available – dietitians, nurses, counsellors and patient support services in Singapore
Your haematologist or oncologist will guide each step. Costs vary considerably depending on the type of transplant, hospital and ward class, and on subsidies or insurance; ask the hospital’s financial counsellors for an estimate specific to your plan.
When to see a doctor & which specialist
If you have been diagnosed with a blood cancer such as leukaemia, lymphoma or myeloma, or a marrow failure or inherited blood disorder, ask your specialist whether a transplant might be relevant to your treatment. During and after a transplant, contact your transplant team urgently for any of these, and call 995 or go to A&E if you are unwell and cannot reach them quickly:
- A fever or signs of infection (especially with a weakened immune system)
- Unusual bleeding, bruising or a widespread new rash
- Breathlessness, chest pain or persistent vomiting and diarrhoea
- Severe weakness, confusion or feeling acutely unwell
Bone marrow transplants are led by haematologists and oncologists at specialist centres. To find a cancer specialist, see the best oncologists in Singapore directory, who can advise on or refer you for transplant assessment.
Related guides
- Best Oncology Clinics in Singapore — our editorial shortlist
- oncology clinics directory
- Nasal polyps
- Throat cancer
- Sinus headache
- Low blood pressure
- Brain tumour
Sources
- NHS – Stem cell and bone marrow transplants
- Mayo Clinic – Bone marrow transplant
- National Cancer Centre Singapore
- Singapore Cancer Society
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