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Visit Choosing a transplant center to learn about different transplant centers and get tips on how to choose the best center for you.

Before transplant there are many things to think about and important medical decisions to be made. Below are 4 key things to consider and talk about with your doctor. Your doctor will guide you through these options and make recommendations based on your situation.

If you haven't been referred to a transplant doctor, you should ask to see one.

Autologous vs. allogeneic transplant

There are 2 types of transplants: autologous and allogeneic.

  • An autologous transplant uses the patient’s own blood-forming cells. The cells are collected from the bloodstream (or, less often, from the marrow) and stored for transplant.
  • An allogeneic transplant uses healthy blood-forming cells from a family member, unrelated donor, or umbilical cord blood unit. These are typically referred to as related or unrelated transplants.

Your doctor will make a recommendation on transplant type based on:

  • What disease you have—some diseases can only be treated with allogeneic transplant
  • What phase or stage your disease is in
  • Your overall health
  • Disease or health risk factors

Questions to ask your doctor:

  • What are my chances of survival with or without a transplant?
  • What are the risks or benefits of waiting or having a transplant now?
  • What type of transplant do you recommend (autologous or allogeneic)? Why?
  • If an allogeneic transplant is recommended:
    • Which family members will you test as possible donors?
    • If a matched family member is not available, how will you find an unrelated donor for me?

Cell source

There are 3 different cell sources:

  • Bone marrow: The soft, blood-forming tissue inside of bones. 
  • Peripheral blood stem cells (PBSC): Blood-forming cells from the circulating blood. 
  • Umbilical cord blood: The blood collected from the umbilical cord and placenta after a baby is born.

Your doctor will recommend which cells are best for you based on:

  • Your overall health.
  • Your disease status or stage, including how urgent a transplant is needed.
  • Your weight — umbilical cord blood units contain fewer blood-forming cells than an adult donor can donate, so more than one cord blood unit may be needed.

Autologous transplants are mostly done with PBSC. Allogeneic transplants may use any of the 3 sources above.

Learn more about the 3 different cell sources and the factors that influence which source is best for you.

Questions to ask your doctor:

  • Which is the best cell source for me? Why?
  • How does my age, weight, disease, etc. influence this decision?
  • Do the risks and benefits of transplant for me change with different cell sources? 
  • Does this hospital prefer to use one source over another? Why?
  • Would my preparative regimen, or the chemotherapy and radiation given before transplant, change with different cell sources? 
  • How will my care after transplant differ based on the different cell sources?

Reduced intensity vs. standard intensity preparative regimen (allogeneic transplant only)

The preparative or conditioning regimen is the treatment given to prepare a patient’s body to receive new blood forming cells from the donor. In some cases, doctors recommend a less intense preparative regimen, called a reduced intensity transplant. A reduced intensity transplant is appropriate to treat some but not all diseases treated with transplant. This option may be helpful for those with health conditions who aren’t able to have very strong chemotherapy.

Your doctor will make a recommendation based on:

  • Your disease
  • Your overall health
  • If you have had a previous transplant or many other treatments

Questions to ask your doctor:

  • Is reduced intensity transplant an option for me? Why?
  • What are the risks and benefits of reduced intensity transplant?
  • How might my care after transplant differ with a reduced intensity transplant?

Transplant timing

In most cases, the earlier you meet with a transplant doctor after your diagnosis, the better. Doctors have disease-specific medical guidelines to make recommendations on the best timing for transplant. In general, transplants are most successful if:

  • You are in the early stages of disease, rather than waiting until your disease has worsened
  • You are in remission or there is very little disease in your body
  • Your disease is responsive to chemotherapy
  • You are in good overall health

Your doctor will recommend when transplant is best for you based on:

  • What type of disease you have
  • The status of your disease
  • Your overall health

Questions to ask your doctor:

  • Will a transplant be an option at some point in my treatment? If so, when?
  • Should I see a transplant doctor now? If not now, when will you refer me to a transplant doctor?
  • Is there a risk or benefit of waiting until later to meet with a transplant doctor?

For more information on transplant and these considerations, download or request our educational materials.

Be The Match® is here to assist you and your family as you learn about transplant. Our patient services coordinators can answer your questions and provide support and education to help you navigate your transplant journey. Contact us at 1 (888) 999-6743 or patientinfo@nmdp.org. Whatever you are feeling, no question or concern is too big or too small.