Understanding Bone Marrow Transplants
And When They May Be Necessary
When a disease affects the bone marrow’s ability to produce healthy blood cells, a bone marrow transplant may be an option to restore the body’s function and treat certain complex hematological diseases.
A bone marrow transplant, also known as a hematopoietic transplant, replaces damaged or diseased blood stem cells to restore the body’s ability to produce healthy cells.
But how exactly does a bone marrow transplant work, and when might it be necessary?
What is a hematopoietic or bone marrow transplant?
A hematopoietic transplant, also known as a bone marrow transplant or blood stem cell transplant, is a procedure that aims to restore the body’s ability to produce healthy blood cells.
In other words, when the bone marrow stops functioning properly due to malignant diseases, congenital disorders, or intensive treatments, the transplant allows for the replacement or restoration of the patient’s hematopoietic system, which is responsible for producing red blood cells, white blood cells, platelets, and other cells essential for the body’s functioning.
According to Dr. Sara Villar, a specialist in hematology and hemotherapy at the Clínica Universidad de Navarra, “the entire hematopoietic system can be regenerated from a single stem cell.”
When might a hematopoietic or bone marrow transplant be necessary?
The main indication for this type of transplant is malignant hematological diseases, including:
❂ Myelodysplastic syndromes.
❂ Lymphomas.
❂ Multiple myeloma.
However, hematopoietic or bone marrow transplantation can also be used in other cases, such as:
❂ Certain pediatric solid tumors.
❂ Congenital diseases.
❂ Immunodeficiencies.
❂ Bone marrow aplasia.
❂ Some autoimmune diseases, such as multiple sclerosis.
Types of hematopoietic transplants
Depending on the type of disease, the patient’s condition, and the availability of donors, there are primarily two types of transplants: autologous and allogeneic transplants.
Autologous transplant:
In this case, the stem cells are harvested from the patient themselves. This type of transplant is usually indicated after intensive treatments, such as chemotherapy or radiation therapy.
Allogeneic transplant:
Stem cells come from a donor, who may be:
❂ A compatible or partially compatible family member.
❂ An unrelated donor found in international registries.
If you’d like to learn more about the differences between these two procedures, check out our article on autologous and allogeneic transplants.
Where are the stem cells for the transplant obtained?
Currently, the most common way to obtain stem cells for a transplant is from the blood circulating in the body.
To do this, stem cells are mobilized from the bone marrow into the bloodstream and then collected through a procedure called apheresis. This allows the cells to be obtained without the need for surgery or direct bone marrow extraction in most cases.
In some patients, umbilical cord blood may also be used, although its use has declined due to the increase in compatible donors available internationally.
How does the transplant process work?
Hematopoietic transplantation is a process involving several stages:
1. Patient evaluation
The medical team confirms that there is an appropriate indication for the transplant, and comprehensive evaluations are performed to reduce risks and prepare the patient.
2. Donor selection
If the transplant is allogeneic, the most suitable donor is sought based on:
❂ Compatibility.
❂ Urgency of the procedure.
❂ Availability.
3. Conditioning treatment
Before the transplant, the patient receives chemotherapy and, in some cases, radiation therapy. The goal is to eliminate the diseased bone marrow and prepare the body to receive the new cells.
4. Stem cell infusion
The hematopoietic cells are administered via an intravenous infusion similar to a transfusion.
5. Recovery and follow-up
After the transplant, a critical recovery phase begins. It is at this point that physicians look for the body to start producing blood cells again.
During this period, the patient remains under strict medical supervision due to the risk of:
❂ Infections.
❂ Toxicity.
❂ Rejection.
❂ Relapse of the disease.
You can learn more about this procedure, the types of donors, and the recovery process in our webinar on bone marrow transplantation.
Possible complications of hematopoietic transplantation
Bone marrow transplantation can lead to complications such as:
❂ Infections.
❂ Treatment-related toxicity.
❂ Relapse of the disease.
❂ Graft-versus-host disease (donor cells attack the patient’s tissues).
For this reason, many patients require immunosuppressive medications for months after the procedure.
The importance of having international access to specialized centers
In complex hematological diseases, access to a specialized international center can make a significant difference in the patient’s treatment and follow-up. However, in addition to medical expertise, this type of treatment also requires international coordination, financial support, and access to a high-level medical network.
Through VUMI®‘s international health plans, policyholders can access specialized medical care outside their country of residence, including international centers with expertise in bone marrow transplants, such as the Clínica Universidad de Navarra in Spain.
This coverage also offers VIP support, which includes:
❂ Remote evaluation to assess the patient in their home country before traveling to receive treatment.
❂ A second medical opinion from international experts.
❂ Medical coordination of all required appointments and treatments.
❂ Logistical coordination to guide the patient through the details of their trip.
❂ Post-treatment follow-up.
Consult your insurance agent to learn how VUMI® international health plans can open doors to specialized treatments and high-complexity international medical centers.
