Blood and Marrow (Bone Marrow) Transplants for Multiple Myeloma

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A blood and marrow transplant (BMT) is a treatment used for certain cancer types that works by resetting the body’s ability to make healthy blood cells. It does this by replacing damaged or destroyed blood-forming stem cells with healthy ones. This helps the body produce its own new healthy blood cells.

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Fred Hutch Pioneered Bone Marrow Transplants

The first BMT in the world took place in the 1970s, when Fred Hutch physician and researcher, E. Donnall Thomas, MD, and his team developed them. This work won a Nobel Prize. 

Today, renowned Fred Hutch and UW Medicine researchers lead the way and continue this important work – finding new and even better ways to use BMTs to treat patients with multiple myeloma and other types of cancer.

Types of Transplants

There are different types of BMTs used in cancer treatment.

  • Autologous transplant: This type of transplant uses the patient’s own stem cells to replace the ones destroyed by the treatment. This is the type of transplant used most often for multiple myeloma.
  • Allogeneic transplant: Uses stem cells from a donor, such as a biological family member.
  • Cord blood transplant: This is less common, and uses stem cells collected from a newborn baby’s umbilical cord. 
Andrew J. Cowan, MD

“The strides we’ve made in multiple myeloma treatment are very exciting. Groundbreaking research at Fred Hutch and UW Medicine is moving the standards of care forward. As this happens, we want oncologists in the community to be aware of what’s new in the field so they can optimize the care of their patients."

– Andrew J. Cowan, MD

How a Blood and Marrow Transplant Is Used to Treat Multiple Myeloma

It’s important to understand that when a BMT is used to treat your multiple myeloma it isn’t a one-time event. It is a process that involves several steps as well as meetings with your care team, and will take about four months. 

Stem Cell Mobilization

The first step is called stem cell mobilization, which is preparing your body so your healthy stem cells can be removed. This involves taking medications to help your stem cells move into your bloodstream so it is easier to collect them. 

Apheresis

Next is a process called apheresis. This is when healthy stem cells are removed from your own body or a donor. The blood is draw out from a vein and goes into a machine where the stem cells are separated and removed. Then, the rest of the blood is returned to the donor. Those collected stem cells are kept and frozen, to be used later.

Conditioning

The step that comes next is called conditioning and takes about one week. This involves using high doses of chemotherapy and/or radiation to destroy diseased cells. The final step is when the healthy cells are transplanted (infused into your bloodstream using an intravenous catheter, an IV) and travel to the bone marrow and begin producing new blood cells. 

Recovery

After this, you will go through a recovery phase that will last several weeks or months. You will have frequent follow-up appointments to monitor how you are doing and check your blood cell levels. 

Why Choose Fred Hutch for Blood and Marrow Transplant for Multiple Myeloma 

Through the Blood and Marrow Transplant Program at Fred Hutch, we’ve performed more than 18,500 transplants for patients with multiple myeloma and other diseases. This makes our program not only the first, but also one of the most respected and successful of its kind in the world.

Dr. Geoffrey Hill
Dr. Geoffrey Hill, hematologist and director of Hematopoietic Stem Cell Transplantation at Fred Hutch

Leading the Way in BMT Research

Fred Hutch physician and researcher, Geoffrey Hill, MD, FRACP, FRCPA, is one of the top experts on the transplant complication known as graft-vs.-host disease, or GVHD, which sometimes occurs in multiple myeloma patients. His lab’s discoveries have led to new therapies for GVHD and helped establish new standards of care for patients undergoing transplants.

The landscape has also improved for BMT patients when it comes to GVHD: Life-threatening gut GVHD is now rare, and researchers are focusing on optimizing treatment and preventing relapse.

Read the Story

Blood and Marrow Transplant for Multiple Myeloma FAQ

A BMT can cause different types of side effects, some that are temporary and others that may take longer to improve. Many patients who have a BMT experience fatigue, nausea and loss of appetite, especially in the weeks following the transplant. Mouth sores can develop and hair loss due to the high-dose chemotherapy that is used before the transplant can happen, too. Your immune system is weakened for a period of time. This increases the risk of getting an infection, and blood counts could drop, leading to bruising, bleeding or anemia.

You can expect to experience some side effects from your treatment. But it is helpful to know that significant progress has been made in treating or minimizing many of them. Learning about therapies available to help with side effects can help reduce any anxiety you may have and allow you to plan ahead as much as possible. Talk to your care team about what medications or therapies can help if you need them. There are also many types of supportive care services at Fred Hutch, such as acupuncture and oral care services.

Making sure your caregiver understands the possible side effects can make a big difference, too. They can help by keeping track of symptoms, making sure you stay hydrated and nourished, and knowing when to call the medical team if something changes. 

The time you start conditioning to when you are well enough to be able to leave the hospital and return home can take several weeks to several months. Keep in mind that every patient is unique in their recovery. During this period, your Fred Hutch transplant team will carefully monitor you, helping prevent or manage any side effects or complications.