Blood and marrow transplant
Blood and marrow transplant (BMT) is often the best therapy for blood cancers. It’s also among the greatest success stories in cancer care — and it started right here.
Through the Blood and Marrow Transplant Program at Fred Hutchinson Cancer Center, we’ve performed more than 17,000 transplants. This makes our program not only the first, but also one of the most respected and successful of its kind in the world.
Our depth and breadth of knowledge allows us to treat both common and very rare blood diseases, and help manage any complications that might arise, helping you get better faster. And if you need a donor, we will help you find one. Today, because of advanced research, nearly everyone who needs a donor can be matched with one.
Looking for information on pediatric BMTs? With our alliance partners at Seattle Children’s, we also specialize in pediatric BMTs.
New discoveries and treatments
The world’s first bone marrow transplant took place in the 1970s, when one of our physician-researchers, E. Donnall Thomas, MD, and his team developed the clinical use of transplants — and won a Nobel Prize for this work.
Each year since then, our physicians and researchers have made more discoveries. And in the past few years alone, major advances have made treatment available for more people, such as those who are older and those who might not have found a donor in the past.
History of BMTs
1957: First allogeneic transplant
Dr. E. Donnall Thomas pioneers the first allogeneic — using cells from a donor — blood and marrow transplant.
1970s: Transplantation becomes widely available
Clinical blood and marrow transplantation comes into wide use during this decade. Because of the toxicity of chemotherapy or radiation, which is required to prepare patients for transplant, BMT is only available to otherwise healthy people in their 30s or younger.
1975: Fred Hutchinson Cancer Research Center opens
Fred Hutchinson Cancer Research Center (Fred Hutch), where Dr. Thomas and his team continue to refine their work on blood and marrow transplantation, opens its doors.
1979: First non-blood related allogeneic transplant
First transplant involving a donor who was not blood-related to the patient.
1981: First “mis-matched” transplant
The first “mismatched” BMT is performed on Dr. Jerry Liebermann. It’s referred to as mismatched because Dr. Libbermann and his donor did not share the same HLA markers — proteins on cells that the body uses to determine which cells belong and which cells do not.
1986: National Marrow Donor Program® established
The National Marrow Donor Program receives federal funding to start matching donors with patients.
1987: NMDP facilitates its first transplant
The National Marrow Donor Program facilitates its first transplant by finding a matched unrelated donor.
Late 1980s: Autologous blood and marrow transplants surpass allogeneic transplants
Autologous blood and marrow transplants — using a patient’s own cells — surpass allogeneic transplants — which use donor cells — as the most common type. This remains the case to this day.
1990: Dr. E. Donnall Thomas wins Nobel Prize
Dr. E. Donnall Thomas wins the Nobel Prize in Physiology or Medicine for his pioneering work on blood and marrow transplantation.
Late 1990s: Non-myeloablative transplant is developed
Dr. Rainer Storb develops the non-myeloablative transplant, sometimes called a "mini-transplant.” The procedure involves minimal pre-transplant radiation and extends the lifesaving benefits of blood and marrow transplantation to older or more-infirm patients who are not eligible for a traditional transplant.
2000: Transplants become more common among patients 60 and younger
By this time, blood and marrow transplants in people 60 and younger are common, and age gradually ceases to be a determining factor in successful transplantation over the next two decades.
2001: Seattle Cancer Care Alliance opens
Seattle Cancer Care Alliance opens with a focus, in part, on bringing promising new treatments to patients faster.
2013: One-millionth BMT is performed
The one-millionth blood and marrow transplant is performed.
2018: 55 percent of autologous transplants performed on patients 60 and older
55 percent of all autologous blood and marrow transplants are on patients 60 and older. This is in stark contrast to the early days of BMT, when transplants were only available to people in their 30s or younger.
Frequently asked questions (FAQs)
Conditioning is when a patient receives chemotherapy, radiation or both before a BMT. This is done to destroy or weaken the damaged cells in the patient’s body.
Sometimes the amount of radiation, chemotherapy or both that is needed to treat a cancer is so high that a patient’s stem cells will be badly damaged or destroyed by these treatments. Other times, bone marrow can be destroyed by a disease. BMT replaces these damaged cells with healthy new cells.
The cells that are transplanted, called hematopoietic (blood-forming) stem cells, can come from bone marrow, circulating blood or umbilical cord blood donated by a new mother.
BMT can be used to treat blood cancers, like leukemia, lymphoma, multiple myeloma and myelodysplastic syndrome. It can also be used to treat non-cancerous diseases like aplastic anemia, myelofibrosis and immune deficiency disorders.
Allogeneic transplant: When healthy stem cells used in a transplant come from a donor, it is called an allogeneic transplant.
Autologous transplant: When healthy stem cells come from a patient’s own body, it is called an autologous transplant.
Blood/stem cell transplant: When healthy stem cells come from a patient’s own blood (autologous) or a healthy donor’s blood (allogeneic), it is called a blood/stem cell transplant. These are the most common type of transplants.
Bone marrow transplant: When healthy stem cells come from a healthy donor’s bone marrow, it is called a bone marrow transplant.
Cord blood transplant: A cord blood transplant is a type of allogeneic transplant. It uses stem cells from the blood of a newborn’s umbilical cord.
After a baby is born, parents can choose to donate their umbilical cords. The blood from these cords is frozen, then stored in a cord blood bank until it is used in a transplant.
Haploidentical (haplo) transplant: Sometimes a parent, sibling or child can be a donor, even if they are not a very close match to the patient. In a haploidentical transplant, these first-degree relatives only need to be a 50 percent match to the patient.
Your initial consultation
At our Blood and Marrow Transplant Program, you will begin with an initial consultation with a transplant oncologist, who will talk with you about your treatment options and make recommendations for you and your referring physician. This appointment can be in person or through telehealth.
If your appointment is in person, you’ll also meet with a transplant nurse, who will tell you more about BMT and give you a tour of the South Lake Union clinic. This is also a time for us to get to know you better and answer any questions you may have.
Care at Fred Hutch
Your Fred Hutch transplant team is here to treat you, to listen to you and to take care of you and your family. They are BMT experts who focus exclusively on treating patients just like you, every day, who are going through BMT.
About your transplant team
Your team includes a group of world-class professionals including a transplant oncologist, transplant nurse, advanced practice provider, pharmacist, registered dietitian, team coordinator and social worker, all here to support you. We also offer supportive care services to care for your well-being in every sense.
BMT involves several steps. It will take about four months if you’re receiving cells from a donor and about two months if your own cells will be used.
After your initial consultation, the next step is finding and preparing a stem cell donor, if you need one, or preparing to have your own stem cells collected for use in your transplant later. We will guide you, step by step, as you get ready.
When you arrive at Fred Hutch for your transplant, your experienced team thoroughly evaluates your health before providing your conditioning treatment (chemotherapy, radiation or both) and transplanting the stem cells.
After the transplant infusion, as your bone marrow and immune system recover, we will carefully monitor and support you and your caregiver until you’re ready to return to your referring physician’s care.
When it’s time to go home, we’ll make sure you feel ready and tell you about our Long-Term Follow-Up (LTFU) Program.
Through the Fred Hutch Long-Term Follow-Up (LTFU) Program, we provide support not only in the months after you leave our care, but for the rest of your life. LTFU is an exclusive program for Fred Hutch patients who have completed BMT.
At Fred Hutch, our team of dedicated BMT experts gives you the highest level of care and support. You’re part of the care team, too. And you’re at the center of everything we do.
More than 50 years ago, Nobel Prize-winner E. Donnall Thomas, MD, and his team at Fred Hutch first developed clinical use of transplants. Today, the internationally renowned physician-researchers at Fred Hutch BMT Program continue to lead the way.
Before you have a BMT, you will need to choose a responsible family member or friend who can be your caregiver and stay with you during your treatment and recovery. As part of planning for your transplant, it is important to know more about what caregivers do, then decide who can be your caregiver.