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Sometimes transplant does not work. Your body may not accept the donated cells, or the disease may come back. If the transplant doesn’t work, it’s normal to have feelings of anger and grief. It’s not your fault, and there may be other treatment options available for you. Your doctor will talk to you about other treatment options. Remember that you are not alone.

Here are some reasons why transplant may not work:

Graft failure

The cells you get during your transplant are called a graft. Graft failure happens when the new cells don’t make the new white blood cells, red blood cells, and platelets you need. This is also called “failure to engraft” or “non-engraftment.” This is serious but uncommon.

The most common treatment for graft failure is another transplant. A second transplant may use cells from the same donor or from a different donor. If you had a cord blood transplant, you can’t get more cells from the same cord blood unit. Doctors may be able to use a different cord blood unit or an adult donor instead. Other treatment options may include clinical trials, treatment with white blood cells from your donor (donor lymphocyte infusion), and supportive care. Ask your doctor about your options.


Relapse is when the disease comes back. Usually, the goal of transplant is to cure blood diseases. But, sometimes a disease comes back (relapses) after transplant. Relapse is most common in the first year after transplant and the risk lowers over time. If your disease comes back, you have choices. Ask your doctor about other treatment options. These could include clinical trials, more treatment, and supportive care.

For more information on relapse, download When Cancer Returns from the National Cancer Institute.

Dealing with grief or loss

If transplant doesn’t work, patients and families may experience feelings of grief or loss. There is no best way to work through grief. It may be helpful to talk with family, friends, a faith community, social worker or professional counselor to cope with grief. If you or your loved ones need help dealing with grief, talk to your transplant team to find out what resources are available to you.

The NMDP® Patient Support Center offers free confidential counseling services. We provide one-on-one support by phone to help you and your loved ones cope with changes in treatment plans. If your loved one died following transplant, a support group may help you cope.

BMT Grief Support Group

Those who have experienced the death of a loved one can join the BMT Grief Support Group to:

  • Connect with caring peers
  • Share experiences
  • Learn more about the grief process and available resources

Here's what you need to know:
- The chats are facilitated by BMT Social Workers and Patient Navigators
- The group is offered as an 8-session series and will meet for 75 minutes every other week
- Each session, we will explore a different topic related to grief and bereavement
- Participants are encouraged to join all eight sessions

If you would like more information or to register for an upcoming BMT Grief Support Group series, please call 1 (888) 999-6743 or email


CALL: 1 (888) 999-6743 or (763) 406-3410
Monday through Friday, 8:00 a.m. – 5:00 p.m. Central Time
All of our programs and resources are free.

Llame al: 1 (888) 999-6743 or (763) 406-3410
De lunes a viernes, de 8:00 AM – 5:00 PM (Horario central)

For some people, a clinical trial may be a treatment option if transplant doesn’t work. Learn more about clinical trials.