Stem Cell Transplants: What They Are and What to Expect

Stem cell transplants replace damaged or diseased bone marrow with healthy stem cells. They’re used for leukemia, lymphoma, multiple myeloma, some genetic disorders and severe aplastic anemia. The idea is simple: wipe out bad cells, give new ones a chance to grow.

There are three main types. Autologous transplants use your own cells collected before treatment. Allogeneic transplants use cells from a donor — a sibling, unrelated match, or a half-match. Cord blood transplants use stem cells from umbilical cord blood. Each has different risks and benefits.

Not everyone is a candidate. Doctors look at diagnosis, age, overall health and prior treatments. You’ll see hematologists, transplant coordinators and infectious disease experts during evaluation. Expect tests for heart, lung and liver function plus infection screening.

The transplant process — step by step

First comes collection. For autologous or peripheral blood stem cells, doctors give drugs that push stem cells into the blood, then collect them through apheresis. Bone marrow collection is done in the OR under anesthesia. Donor cells follow similar collection steps.

Next is conditioning: high-dose chemo and sometimes radiation to destroy diseased marrow. This is the toughest part and causes low blood counts and side effects like nausea, mouth sores and fatigue. After conditioning the stem cells are infused through an IV — a quick procedure that feels like a blood transfusion.

Recovery starts in the hospital where staff watch for infections, bleeding and organ problems. Low white blood cell counts make infection a big risk so you’ll stay in a protected environment until counts recover. For allogeneic transplants, doctors monitor for graft-versus-host disease (GVHD), where donor cells attack your tissues.

Practical tips for patients and caregivers

Focus on infection prevention: frequent handwashing, avoid crowds and follow food safety rules. Nutrition matters — small, frequent meals and protein help healing. Keep a simple checklist: medication schedule, symptom log, and emergency contacts.

Ask these questions when choosing a center: how many transplants do you perform each year, what’s the transplant-related mortality rate, and do you offer clinical trials? Find a center with a dedicated transplant team and good social support services.

Call your transplant team if you have a fever above 100.4°F (38°C), uncontrolled bleeding, severe shortness of breath, new severe pain or sudden confusion. Financial planning is key — ask your insurer about coverage, preauthorization and out-of-pocket costs. Patient advocacy groups and hospital social workers can help with funds, lodging and travel.

Stem cell transplant is intense but can be lifesaving. Knowing the steps, risks and practical tips helps you feel more in control. If you or a loved one face this option, prepare questions and build a strong support team before treatment starts.

Talk openly with your care team about expected timelines, possible late effects and fertility preservation. If fertility might be affected, ask about sperm or egg banking before conditioning. Look into survivor clinics after recovery — they help manage long-term follow-up, vaccinations and quality-of-life issues daily.