How transplantation works
Transplantation is used to treat diseases of the blood and marrow, such as leukemia and lymphoma, but is also part of treatment for some solid tumors. In both cases, the large doses of chemotherapy (anticancer drugs) and, often, radiation needed to kill cancerous cells, also destroy life-sustaining bone marrow.
Robert Soiffer, M.D.
Bone marrow is critical because it is the source of all blood cells: red blood cells to carry oxygen and nutrients throughout the body, white blood cells to fight infections, and platelets to control bleeding by making the blood clot. These different types of blood cells all develop from "mother" cells called stem cells. These are found primarily in bone marrow, but also circulate throughout the body as peripheral stem cells. Even a moderate-sized sample of stem cells can travel to the bone-marrow cavity of a transplant patient and completely rebuild the patient's blood and immune system.
Peripheral stem cells are increasingly used for transplantation. The collection process is less invasive than the minor surgical procedure required to gather marrow from the hip bone. Peripheral stem cells are also an option for patients whose marrow is damaged or still contains cancer cells.
There are two general types of transplant — autologous transplant, in which the patient is also the donor, and allogeneic transplant, in which someone other than the patient donates bone marrow or peripheral stem cells.
Autologous transplant can be used to treat diseases of the marrow. When a patient's marrow becomes relatively cancer-free through treatment such as chemotherapy, the marrow is collected and stored, ready to use if the cancer returns. Advanced laboratory techniques allow technicians to purge lingering cancer cells from the marrow. Autologous transplants are also an option when cancer is located in areas other than the marrow.
Like other types of leukemia, Mayberger's chronic myelogenous leukemia (CML) is a disease of the bone marrow that causes white blood cells to proliferate. CML is a deadly form of leukemia that progresses more slowly than other types of the disease. Since cancer was growing in Mayberger's marrow and immediate treatment seemed the best choice, a marrow donor was needed.
