Bone Marrow Transplantation

Stem Cell Transplants Using Bone Marrow, Blood, and Umbilical Cord Blood

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919-684-8964

A bone marrow transplant -- also called stem cell transplantation -- is an effective treatment for people who are diagnosed with life-threatening blood diseases. If you have been told you need a bone marrow or stem cell transplant, choosing Duke as your transplant center puts you in good hands. We are one of the few programs in the nation to use stem cell transplantation as part of the treatment for scleroderma (systemic sclerosis). We also treat sickle cell disease and blood cancers such as leukemia, lymphoma, and multiple myeloma.

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What Is Stem Cell Transplantation?

Stem cells are essential for blood cell production and are found in the bone marrow and in umbilical cord blood. During stem cell transplantation, your unhealthy blood cells or stem cells are destroyed using chemotherapy or radiation. They are replaced by healthy stem cells collected from your body or a healthy donor and transfused into your body, like a blood transfusion. Stem transplantation is not a surgical procedure. The infusion takes less than two hours, but the recovery takes several months.

The decision to use stem cells from your body or from a healthy donor depends in part on the disease being treated. If a healthy adult donor is not available, stem cells from umbilical cord blood can be used. Duke was one of the first transplant centers in the world to perform umbilical cord blood transplantation.

  • Autologous stem cell transplantation uses your own stem cells.
  • Allogeneic stem cell transplantation uses cells from a healthy related or unrelated donor.
  • Syngeneic transplantation uses stem cells from an identical twin.

Before Your Stem Cell Transplant

Your First Appointment
Before your first visit to the Duke Blood Cancer Center, you will be assigned a dedicated stem cell transplant doctor, who will review your health history. At your appointment, your doctor will discuss the risks and benefits of the procedure and make treatment recommendations.

Meeting Your Transplant Team
If you decide to proceed with stem cell transplantation, you will meet your transplant coordinator who will facilitate your appointments and coordinate your care. They will work with your financial counselor to help you find nearby housing during your treatment and help you navigate any financial and insurance concerns. Other members of your transplant team include board-certified hematologists and medical oncologists, clinical pharmacists, specially trained nurses, dietitians, and social workers. They meet regularly to discuss your care so they can offer the best recommendations and treatment to meet your needs.

Duke Blood Cancer Center

The Duke Blood Cancer Center in Durham is an outpatient treatment center that includes the Blood and Marrow Transplant Clinic and the Hematologic Malignancies Clinic.

Pre-Transplant Tets

To help doctors learn more about your blood disorder, you may have one or more of the following tests.

Blood Tests

Blood will be drawn to evaluate your exposure to certain viruses and to check your organ function. These tests help ensure the stem cell transplant can be done safely. You may have additional specialized blood tests to learn more about your disease.

Human Leukocyte Antigen (HLA) Typing

We use this blood test to determine donor matching, should you require a healthy stem cell donor for your transplant.

Bone Marrow Biopsy and Aspiration

A small sample of bone marrow is taken from the back of the hips and studied to determine how well your bone marrow produces cells. It also is evaluated for signs of disease in the marrow.

Imaging Tests 

CT, MRI, and PET scans use computers to produce pictures of the area being evaluated.

New Patient Appointment

The Stem Cell Transplant Process

Donor Search, Obtaining Cells

If you are receiving an allogeneic (healthy donor) transplant, we will begin the process of finding a suitable donor and collecting stem cells from them. If you are having an autologous transplantation, we will create a plan for collecting stem cells from your body.

Conditioning

You will have chemotherapy alone or combined with radiation therapy to kill cancer cells or unhealthy cells in your body. This conditioning regimen also prepares your body to accept the stem cells transplanted into your body. Most of our patients will receive the conditioning regimen as an outpatient in the Blood Cancer Center. If you need to be in the hospital, you will stay in a dedicated area for stem cell transplant patients.

Stem Cell Transplantation

Healthy stem cells are transfused into your bloodstream in a method similar to a blood transfusion. Once in your bloodstream, they make their way to the bone marrow and begin making blood cells. 

After Stem Cell Transplantation

Recovery
Recovery from stem cell transplantation takes approximately one to three months. We are one of the only programs in North Carolina that allow you to receive most or all of your care as an outpatient. This lets you stay in the comfort of your own home or nearby temporary residence. A caregiver must be with you at all times when you are not in the hospital.  

Support for You and Your Family
Before, during, and after your treatment, our cancer support services help you minimize the side effects of treatment and cope with the emotional and psychological effects of diagnosis and treatment. 

Follow-Up Care
Once you complete your treatment, you will be discharged back to the care of your local doctor. Periodically you will undergo tests, either at Duke or with your doctor, to monitor your response to therapy and your major organ function.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

Why Choose Duke

Duke maintains a well-established program with a long history of success. Here's what you need to know to feel confident when choosing Duke as your transplant center.

We Offer Unique Cell Therapy Options for Transplant
Duke is one of the few centers in the U.S. qualified to provide Omisirge®. This allogeneic (from a donor) modified umbilical cord blood–based product was recently approved by the FDA for stem cell transplantation. Our doctors were leaders of Omisirge® clinical trials ​​​and are pleased to offer it to our patients.

We Perform More Transplants than Other Centers in Our Region
We've performed more than 6,000 transplants since 1984, and we performed the first cord blood transplant in 1993. Currently, about 260 stem cell transplants take place at Duke each year. 

We Are FACT-Accredited and Nationally Recognized

More Transplant Options for More People

  • We offer stem cell transplantation to a diverse group of people -- including those who are older or lack a closely matched donor -- using less-intense chemotherapy regimens and careful selection of donor cells. 
  • We treat an array of disorders including non-cancerous diseases such as sickle cell disease, scleroderma, aggressive multiple sclerosis, and aplastic anemia.

Clinical Trial Access​
You may have access to the latest therapies through our innovative research programs and clinical trials, which test experimental therapies and provide new therapies for people with advanced or complex diseases. 

This page was medically reviewed on 04/03/2023 by