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Patient Education

A Patient’s Guide to Understanding BMT & Cellular Therapy

At ASTCT, we know learning that you or a loved one has cancer can be filled with many emotions — and the idea of a stem cell transplant may seem daunting. It is important to understand the transplant process and the terms you need to know through each step. Below is a list of terms you may hear as you consult with your healthcare team. Always ask your doctor for additional information.

This is just a starting point of your BMT and cellular therapy knowledge. Need more information? Check out our Patient Education Resource to learn more terms, diseases, treatments, and research as you discuss with the healthcare team.

What is BMT?

BMT stands for Blood and Marrow Transplantation.

This is also called a bone marrow transplant, a stem cell transplant, or a hematopoietic (blood-forming) cell transplant. Learn more.

Hematopoietic Stem Cell

Hematopoietic Stem Cell (HST) is an immature cell that can develop into all types of blood cells, including white blood cells, red blood cells, and platelets. Hematopoietic stem cells are found in the peripheral blood and the bone marrow.

Hematopoietic stem cells are created in the bone marrow, which is the soft material inside the bones. They develop into specific kinds of blood cells, depending on what your body needs.

Transplantation is a medical treatment recommended to treat certain types of cancer, such as leukemia, myeloma, and lymphoma, and other blood and immune system diseases
that affect the bone marrow.

A bone marrow transplant replaces damaged bone marrow or stem cells with healthy cells. This transplant can come from your body or from a donor. There are two different types of transplants, autologous and allogeneic.

What is Cellular Therapy?

Cell therapy is the transfer of intact, live cells into a patient to help lessen or cure a disease. Specifically, cellular immunotherapy uses parts of the immune system to seek out and attack specific cancer cells. The cells used may originate from the patient or from a donor. Most of the time, this treatment requires that doctors obtain cells from the bloodstream using apheresis. Learn more.

Apheresis: A process that withdraws blood from the body of a patient or donor and removes one or more blood components. The remaining components are returned to the body of the donor.
Hematopoietic cell transplantation is a type of cellular therapy. Other types of cellular therapies include CAR T Therapy (Chimeric Antigen Receptor T Cell Therapy).

The kind of cell therapy that may help a patient is highly dependent on the disease they are suffering from. To learn more about cellular therapy and your specific circumstance, please check out our external resources page or speak with your doctor.

Step 1: Diagnosis

The first step in treatment, diagnosis, is the identification of the nature of an illness or disease. Please see below for common conditions that may be treated with BMT or cellular therapy. This list is not exhaustive. Each patient's treatment is different, and it all starts with their diagnosis.

Diseases

  • Leukemia: These are cancers of the blood and bone marrow that affect the patient's ability to make healthy blood cells. Leukemia can present as an acute or chronic illness. There are many different types of leukemia, depending on the type of white blood cell that is affected. See more.
    • Acute Lymphocytic Leukemia (ALL)
    • Acute Myelogenous Leukemia (AML)
    • Chronic Lymphocytic Leukemia (CLL)
    • Chronic Myelogenous Leukemia (CML)
    • Juvenile Myelomonocytic Leukemia (JMML)
    • Myelodysplastic Syndrome (MDS)
  • Lymphoma: These are cancers of the lymphatic system. Lymphomas can also present in different ways, either acutely or as chronic diseases. See more.
    • Hodgkin Lymphoma (HL)
    • Non-Hodgkin Lymphoma (NHL)
    • B Cell Lymphomas:
      • Burkitt Lymphoma (BL)
      • Diffuse Large B Cell Lymphoma
      • Follicular Lymphoma (FL)
      • Mantle Cell Lymphoma (MCL)
      • Marginal Zone Lymphoma (MZL)
    • T Cell Lymphomas:
      • Adult T Cell Leukemia/Lymphoma
      • Angioimmunoblastic T Cell Lymphoma (AITL)
      • Peripheral T Cell Lymphoma
  • Plasma Cell Disorders: These are cancers of plasma cells, the cells responsible for producing antibodies. Plasma cell disorders can also vary significantly in terms of severity. See more.
    • Multiple Myeloma
    • Plasma Cell Leukemia
  • Other Cancers: There are many other types of cancer that are treated with transplant, particularly in young patients. See more.
    • Ewing's Sarcoma (ES)
    • Germ Cell Tumor (GCT)
  • Non-Cancer Diseases: In some cases, a non-cancerous condition can affect the body's ability to make normal blood cells. See more.
    • Aplastic Anemia (AA)
    • Adrenoleukodystrophy (ALD)
    • Krabbe Disease (GLD)
    • Metachromatic Leukodystrophy (MLD)
    • Severe Combined Immunodeficiency (SCID, all types)
    • Sickle Cell Disease (SCD)
    • Thalassemia
    • Wiskott-Aldrich Syndrome (WAS)

Step 2: Treatment Plan

It is important to note that each treatment plan timeline differs based on disease, disease state, and type of treatment. Talk to your doctor if you have questions about your treatment plan duration. During the treatment plan stage, patients will discuss with their physician on the best treatment options for their diagnosis. Below are common medications and treatments that could be part of your treatment plan. Please contact your doctor if you have specific questions regarding your treatment plan. Learn more.

Parts of Your Treatment

  • Learn about your transplant
  • Contact your insurance company
  • Choose a caregiver
  • Fill out a health care proxy form
  • Meet with a social worker
  • Arrange for disability or a leave of absence from work
  • Plan where you'll stay
  • Make decisions about your family, fertility, and hair loss
  • Have your pre-transplant evaluation
  • Meet with a clinical dietitian nutritionist
  • Meet with a pharmacist

Step 3: Preparing for Transplant or Cell Therapy

Having a transplant is a long process, and preparing for your transplant is only the start of your journey. Some patients undergo inpatient transplants, meaning you will be in the hospital 24 hours a day before, during, and a while after your transplant. People receiving certain types of transplants may have the option of outpatient transplants, where you and your caregiver(s) will stay near the hospital and come to the hospital every day for treatment. Please discuss with your doctor to decide which type of transplant is best for you and what your transplant recovery will look like.

Step 4: Transplant/Cell Therapy

During transplant and cellular therapy, you will be met by a team of experts. It is important to know what they do and how they can help you as you are going through this process. In this stage of the process, you will undergo the transplant of cellular therapy process that was chosen based on your diagnosis. As a patient, you have probably heard these terms before, as they are the most commonly used, but it is important to make sure you know the difference between them and the specifics of your specific treatment. Please note that the transplant and cellular therapy process also includes monitoring for early complications until the engraftment process. See more.

Transplant Team

  • Attending Doctor
  • Fellow
  • Resident
  • Intern
  • Advanced Practice Provider (APP)
  • Clinical Nurse Coordinator
  • Nursing Staff
  • Nursing Assistant or Patient Care Technician
  • Pharmacist
  • Social Worker
  • Clinical Research Coordinator
  • Nutritionist
  • Physical Therapist/ Occupational Therapist

Step 5: Post-Treatment Monitoring

The Post-Treatment Monitoring stage is different for everyone. However, it is important to note that this stage is the longest of them all. After a transplant, each patient will be monitored closely for side effects from the transplant. In addition, your healthcare team will continue to prescribe blood tests and, in some cases, bone marrow biopsies or scans to make sure cancer has not returned. Below are some common terms you will hear are you go through the monitoring for disease relapse and complications process, as well as additional information and resources.