Quick Answer
A patient-focused guide to transplant types, preparation, recovery and long-term follow-up.
Medically reviewed by Dr. Sachita Baniya • NMC 20158 • Kathmandu Neurology Clinic & Cognitive Center
Bone marrow transplant — more precisely haematopoietic stem cell transplant — replaces a patient's marrow with healthy stem cells. It is used to treat selected blood cancers and bone marrow failure disorders. There are three main types, and the choice depends on the disease, risk, fitness and donor availability.
Autologous transplant
The patient's own stem cells are collected, stored and returned after high-dose chemotherapy. It is commonly used in myeloma and relapsed lymphoma. Because the cells are the patient's own, there is no graft-versus-host disease, but there is also no graft-versus-cancer effect.
Allogeneic transplant
Stem cells come from a matched donor, usually a sibling or an unrelated volunteer. The donor immune system can attack residual cancer — the graft-versus-disease effect — but can also attack normal tissues, causing graft-versus-host disease. Infection risk is higher because the immune system is rebuilt from donor cells.
Haplo-identical transplant
A half-matched family donor — often a parent, child or sibling — is used when a fully matched donor is unavailable. Modern conditioning and post-transplant cyclophosphamide-based GVHD prophylaxis have made this approach more widely available.
What the assessment involves
- Disease status and response to prior treatment
- Cardiac, lung, kidney and liver function
- Infection screening
- HLA typing and donor search
- Fertility counselling and psychosocial support
The transplant course
Conditioning prepares the marrow for the graft. Stem cells are infused, and engraftment is monitored with blood counts. Supportive care includes transfusion, infection prevention, nutrition and management of mucositis. After discharge, close follow-up continues for months.
Long-term follow-up
Survivors need monitoring for infection, GVHD, relapse, organ toxicity, endocrine problems and second cancers. Vaccination is reviewed, and fertility and psychological support are part of care.
The bottom line
Transplant is a powerful but demanding treatment. It is not right for every patient, and the decision requires a detailed discussion of benefits, risks and alternatives. A structured assessment and an experienced team make the process safer.
Frequently asked questions
Answers reviewed by Dr. Jitendra Prasad Yadav • MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM • NMC 8029
Myeloma is generally not considered curable with standard therapy, but it is highly treatable and many patients live for years with good disease control. Treatment is individualised.
It uses the patient's own stem cells after high-dose melphalan to deepen response. Eligibility depends on age, fitness, response and patient preference.
AML can be cured in a proportion of patients, particularly younger adults who achieve remission and proceed to appropriate consolidation or transplant. Outcomes vary widely with genetic subtype, age and fitness, so the treating team discusses prognosis for the individual case rather than giving a single figure.
Induction is the first phase of treatment, aiming to clear leukemia cells from the marrow and restore normal blood production. It usually requires hospital admission and close support with transfusion, infection prevention and monitoring.
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References & Review
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-11-10
- International Classification of Headache Disorders, 3rd edition (ICHD-3).
- Harrison's Principles of Internal Medicine — Neurology sections.
- American Academy of Neurology guidelines for selected conditions (where applicable).
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.