Treatments

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. 
for you.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets.
“A misconception about BMT is that it is almost impossible to find a donor, particularly if you are from a certain race or ethnicity. This used to be true, but not now. Today, treatments and techniques have improved, too, which are making BMTs even more successful.”
— Marco Mielcarek, MD, PhD, Medical Director, Adult Blood and Marrow Transplant Program

Frequently asked questions

What is a BMT?

A BMT restarts your body’s ability to make healthy new blood cells by replacing abnormally forming stem cells with healthy cells.

What is conditioning?

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. 

Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Conditioning Treatments to prepare patients for stem cell transplantation. May include chemotherapy, monoclonal antibody therapy and radiation. The treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A conditioning regimen may include chemotherapy, monoclonal antibody therapy and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow; prevent the patient's body from rejecting the transplanted cells; and kill any cancer cells that are in the body.
Why is BMT needed?

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.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.
Where do you get the cells to transplant?

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.

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.
What types of diseases can BMT treat?

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.

Anemia A condition in which the number of red blood cells is below normal. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Lymphoma Cancer that begins in the cells of the immune system. There are two basic categories of lymphomas: Hodgkin lymphoma and non-Hodgkin lymphomas. Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.
What are the different types of BMTs?

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.
 

Fred Hutch Blood and Marrow Transplant Program

South Lake Union clinic
phone (206) 606-1024
Call us to set up a transplant phone consultation, Monday–Friday, 6:30 am–6 pm.
phone (800) 804-8824
Hours: Monday–Friday, 6:30 am – 6 pm
fax (206) 606-1025

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.

Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.

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. 

Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation.
“What motivates me is the depth and breadth of treatments we can offer our patients, including clinical trials. Along with that is the wealth of expertise across our clinical program that gives hope and promise to making every day better for our patients and families.”
— Effie W. Petersdorf, MD, Medical Director, Unrelated Donor Transplant Program

Transplant path

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.
 

Bone marrow The soft, spongy material in the center of your bones that produces all your blood cells, such as white blood cells, red blood cells and platelets. Bone marrow transplant The process of treating disease with high doses of chemotherapy, radiation therapy or both. Bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. The process of treating disease with high doses of chemotherapy, radiation therapy or both. Because this treatment destroys the bone marrow’s ability to produce blood cells, bone marrow or peripheral blood stem cells are given after treatment to help the body make more blood cells. Caregiver A person who gives care to people who need help, such as children, older people or patients who have chronic illnesses or disabilities. A person who gives care to people who need help taking care of themselves, such as children, older people or patients who have chronic illnesses or disabilities. Caregivers may be health professionals, family members, friends, social workers or members of the clergy. They may give care at home, in a hospital or in another health care setting. Conditioning Treatments to prepare patients for stem cell transplantation. May include chemotherapy, monoclonal antibody therapy and radiation. The treatments used to prepare a patient for stem cell transplantation (a procedure in which a person receives blood stem cells, which make any type of blood cell). A conditioning regimen may include chemotherapy, monoclonal antibody therapy and radiation to the entire body. It helps make room in the patient’s bone marrow for new blood stem cells to grow; prevent the patient's body from rejecting the transplanted cells; and kill any cancer cells that are in the body. Infusion An injection of medications or fluids into a vein over a period of time. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells. Stem cell A cell from which other types of cells develop. For example, blood cells develop from blood-forming stem cells.
“My whole family would agree that our whole experience here from Day 1 was, and still is, one of the most defining things in our lives. These are the best kind of people who you never want to see. When we came here, there was clearly a different mentality.”
— Ted Ave’Lallemant, acute lymphocytic leukemia patient

Other resources

Long-Term Follow-Up Program
Long-Term Follow-Up 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.
 

Care team
Care team

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.

Research
Research

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.

Caregivers and BMT
Caregivers and BMT

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.