A transplant is not an operation. It is a rescue: very high-dose treatment wipes out the diseased marrow, and healthy blood-forming stem cells — your own or a donor's — are infused to rebuild it. Everything that patients find hard about it comes from the weeks in between, when the new marrow has not started working yet.
What you'll read
Two kinds of transplant
| Autologous | Allogeneic | |
|---|---|---|
| Cell source | Your own stem cells | A matched donor |
| Typical use | Myeloma, some lymphomas | Leukaemia, some lymphomas, marrow failure |
| Main benefit | Allows very high-dose chemotherapy | The donor immune system also attacks the cancer |
| Main risk | Infection during the low-count weeks | Graft-versus-host disease and infection |
| Hospital time | 2 – 4 weeks | 4 – 8 weeks |
How a donor is matched
Matching is done on HLA — tissue-type markers inherited from your parents, not on blood group. A sibling has about a one-in-four chance of being a full match. If none is, the search moves to international donor registries, and increasingly to a half-matched family member, which modern haploidentical protocols have made a realistic option for almost everyone.
The weeks that matter most
- Work-up. Heart, lung, kidney and liver function are checked, infections screened, and dental problems fixed in advance.
- Mobilisation and collection. Growth-factor injections push stem cells into the blood; they are collected over one to three sessions.
- Conditioning. Several days of high-dose chemotherapy, sometimes with total body irradiation.
- Transplant day. The cells are infused like a transfusion, and it takes under an hour. This is day zero.
- Engraftment. Ten to twenty days when blood counts are at their lowest, fever is common and transfusions are routine.
- Discharge. Once counts recover and you can eat and drink, with daily outpatient checks for several more weeks.
Graft-versus-host disease
This is the defining risk of an allogeneic transplant: the donor's immune cells recognise your tissues as foreign and attack them, most often the skin, gut and liver. Mild disease is common and treatable with steroids, and it comes with a silver lining — the same donor immunity that causes it also attacks residual cancer cells. Severe disease is serious, which is why prevention with immunosuppressive drugs is part of every protocol.
Recovery, month by month
- Month 1 — inpatient or daily outpatient care, strict infection precautions, appetite and energy at their lowest.
- Months 2 to 3 — counts recover, visits become weekly, most patients can walk and eat normally again.
- Months 4 to 6 — immunosuppression is slowly reduced after an allogeneic transplant; fatigue is still the main complaint.
- Months 6 to 12 — childhood vaccinations are repeated because immune memory was lost; many people return to work part-time.
- Year 2 onward — long-term follow-up for thyroid, bone, fertility and second cancers continues for life.
Frequently asked questions
Is donating stem cells painful?
Most donations today are taken from the blood, not the hip bone: the donor has injections for a few days, which can cause aching like a flu, and then sits connected to a cell separator for a few hours. Marrow harvest under anaesthesia is now the less common route.
What does a transplant cost abroad?
In the United States an autologous transplant is commonly quoted between $150,000 and $300,000 and an allogeneic one considerably higher. At licensed transplant units in Türkiye the same procedures are typically a third to a quarter of that, but the quote must state clearly how many weeks of complications are covered.
Will I be in isolation the whole time?
You stay in a filtered-air room during the weeks when your white cells are lowest, usually with one designated visitor allowed under precautions. It is restrictive but not solitary — and the restrictions ease as counts recover.
Considering a transplant abroad?
Send your haematology file and donor typing if you have it. A transplant physician will confirm whether you are a candidate and what the realistic timeline is.