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Blood and Marrow Transplant Glossary | Frequently Asked Questions | Helpful Links
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Blood and Marrow Transplant Glossary (Printable PDF)
Absolute Neutrophil Count (ANC) - A calculation of the white blood cells that counts not only the mature white blood cells but also the less mature white blood cells; also called "absolute granulocyte count."
Acyclovir – a type of medicine that fights viral infection.
Allogeneic Transplant - Transplant of stem cells donated from another person. Genetic matching, called HLA matching, is done from blood samples prior to transplant. The donor may be a family member, unrelated donor, or umbilical cord blood.
Anemia - A condition in which there is a decreased number of red cells, resulting in weakness and fatigue.
Antibiotics - A group of medicines used to treat infections.
Antibody - A protein that helps the body fight foreign substances (antigens) in the body, such as bacteria, fungi and viruses.
Apheresis - A procedure where blood is withdrawn from the body and circulated through a machine that removes certain components and returns the remaining components to the body. This procedure is used to collect blood stem cells for transplant. It may also be used to collect platelets or other components of the blood.
Aplasia - Period of time when the bone marrow space inside the bone is empty. In bone marrow/stem cell transplant process, this occurs after chemotherapy with or without radiation in preparation for transplant.
Aplastic Anemia - A blood disorder in which the bone marrow is deficient in producing red blood cells, white blood cells and platelets.
Aseptic - A condition of being free from germs and infection.
Aspiration (of marrow) - The removal of marrow from the cavities in large bones by suction through a needle.
Autologous Transplant - A transplant in which a patient's own stem cells are collected, stored and then returned to the patient at a later date.
Biopsy - A small piece of tissue removed for microscopic examination.
Blood Cells - Cells formed in the bone marrow that makes up blood.
Blood Stem Cell Harvest - A procedure in which stem cells are collected from the circulating blood for use in a transplant.
Bone Marrow - The spongy tissue found inside large bones; also the home to the immune system. It is responsible for making blood cells including red blood cells, white blood cells and platelets.
Bone Marrow Stem Cell Harvest - A procedure in which bone marrow is taken from the pelvic bone (hip area) for use in a transplant.
Bone Marrow Transplant - A process in which a patient's bone marrow is destroyed by chemotherapy and/or radiation therapy and then replaced by previously harvested bone marrow stem cells from a donor or the patient.
Central Venous Catheter - A small tube that is inserted into a large vein through which drugs and blood products can be given and blood samples withdrawn.
Chemotherapy- Treatment that destroys cancer cells with drugs.
Clinical Trial - A very structured study to determine the effectiveness of a drug or treatment.
Colony Stimulating Factor - Proteins that stimulate the production and growth of certain types of blood cells.
Complete Blood Count - A blood test that determines the number of red blood cells, white blood cells and platelets in the blood.
Conditioning - A combination of chemotherapy drugs, and sometimes radiation, given a few days prior to transplant to eliminate cancer cells and destroy the immune system.
Cyclophosphamide - A drug used for immunosuppression and destruction of cancer cells. A commonly used brand name is Cytoxan.
Cyclosporine - An immunosuppressive drug used to treat and prevent graft versus host disease.
Cytomegalovirus (CMV) - A virus that can lie dormant in a person but may cause an infection after a transplant when the immune system has been compromised.
DMSO - A preservative used in the freezing of bone marrow and blood stem cells.
Electrolytes - Minerals found in the blood such as sodium and potassium and magnesium that must be maintained in a certain range to prevent complications.
Engraftment - The successful implantation and function of stem cells in the patient's bone marrow cavities.
Febrile - Having a fever.
Fungus – A mold or yeast infection in the body, especially after a transplant when the immune system has been compromised.
Gastrointestinal (GI) - Refers to that part of the body that includes the stomach and intestines.
Graft Rejection - When donated bone marrow/stem cells infused during transplant is rejected by the patient's body and does not grow and develop.
Graft vs. Host Disease - A condition that can occur following an allogeneic bone marrow/stem cell transplant in which some of the donor's bone marrow cells attack the patient's tissues and organs.
Granulocyte - One of the major groups of white blood cells. Includes three types of cells: neutrophils (segs and bands), eosinophils, and basophils.
Granulocyte Colony Stimulating Factor (GCSF) - A natural substance that stimulates white blood cell growth.
Growth Factor (Colony Stimulating Factor) - An injectable drug used to stimulate the development of blood cells (Neupogen, Filigrastin).
Harvesting - Term used for the collection of stem cells from the bone marrow or peripheral blood.
Hematology - The study and treatment of diseases of the blood and blood forming tissues.
Hematopoietic stem cells – Immature cells from which all blood cells develop. The "parent" or "seed" cells found in the bone marrow or peripheral blood produce several different types of blood cells. Blood cells grow in the same way as other human cells. The stem cells begin to divide and mature until they are fully developed, forming all the different types of blood cells white blood cells, platelets and red blood cells.
Hemoglobin - The part of a red blood cell that carries oxygen to tissue.
Hemorrhage - A general term for a large loss of blood brought about by injury to blood vessels or by a lack of necessary cells (platelets) to clot blood.
Herpes Simplex - A virus that can produce small, painful, fluid-filled blisters on the skin and mucous membranes.
Herpes Zoster - A virus that can produce shingles (painful skin eruptions that follow the underlying nerve routes inflamed by the virus).
Histocompatibility - Referring to the similarity of tissue between different individuals. The level of histocompatibility describes how well the patient and donor are matched. The major histocompatibility determinants are the Human Leukocyte Antigens (HLA). HLA typing is performed between the potential marrow donor and the potential transplant recipient to determine how closely their HLAs match. The closer the match, the less the donated marrow and the patient's body will react against each other. (See "GVHD.")
Human Leukocyte Antigens (HLA) - The genetic "fingerprint" present on the surface of white blood cells, platelets, and most other cells of the human body, which allow the body to recognize self versus non-self. Made up of proteins, it plays a critical role in activating the body's immune system to respond to foreign organisms.
HLA Typing - - The identification of an individual's specific HLA type.
Host - The patient's body.
Hypertension - High blood pressure.
Hypotension - Low blood pressure.
Iliac Crest - The "hip bone" where large quantities of bone marrow is found.
Immune System - The body's defense network against infection and foreign particles.
Immunoglobulin - Proteins made by the body that attach to infections and tend to decrease their action. They can be given intravenously or orally.
Immunosuppression - A state of decreased immunity or a lowering of the body's immune response to prevent a reaction against donor marrow or stem cells and to prevent GVHD. This can also occur after receiving chemotherapy.
Intravenous (IV) - Within or into a vein.
Irradiation - High energy rays used to kill diseased cells before or during transplant.
Laminar Air Flow (LAF) Room - A room that is specially designed to create a germ-free atmosphere through airflow and filtration.
Leukocytes - A general term for all the types of white blood cells.
Lymph Node - A gland in the body that produces lymph (the clear fluid that circulates through the body and contains white blood cells and antibodies).
Lymphocyte - One major group of white blood cells. B lymphocytes make antibodies against bacteria. T lymphocytes attack virus infected cells directly.
Lymphoma - Cancer of the lymph nodes.
Malignant - Cancerous; abnormal growth of cells.
Match - In marrow transplantation, the word "match" relates to similarity in HLA typing between the donor and the recipient.
Matched Unrelated Transplant - Another type of allogeneic transplant, but the stem cells are donated by someone other than a family member.
Microbe (or microbial) - Minute forms of life such as bacteria, fungi or viruses.
Morbidity - Sickness, side effects and symptoms of a treatment or disease.
Magnetic Resonance Imaging (MRI) - A method of taking pictures of the body tissue using magnetic fields and radio waves.
Mucositis - Inflammation of the mucous membranes, which include tissues lining the mouth and throat.
Neutropenia - Low counts of neutrophils, a type of white blood cells.
Neutrophil - The most common type of white blood cell in the bloodstream. It helps defend against bacterial (also called segs and bands) infections.
Oncology - The study and treatment of cancer.
Packed Red Blood Cells - Red blood cells collected from one individual that are "packed" into a small volume for a transfusion into a patient.
Petechiae - Small red spots under the skin caused by a low platelet count.
Platelets - Blood cells that promote blood clotting.
Prednisone - A steroid drug used to treat and prevent GVHD.
Preparative regimen - The chemotherapy with or without radiation therapy given to a patient prior to a bone marrow/stem cell transplant.
Protocol - The plan of treatment.
Purging - Process by which certain types of cells are removed from bone marrow prior to transplant to kill diseased cells and/or make space for healthy new marrow and/or suppress the immune system so graft rejection does not occur.
Red Blood Cells (Erythrocytes; RBC) - Cells that carry oxygen from the lungs to tissues throughout the body (measured by the hematocrit or HCT).
Relapse - Recurrence of the disease following a period of remission.
Remission (complete or partial) - No cancer cells can be detected by a microscope and the patient appears to be disease free. Partial indicates that there has been at least a 50% regression of the disease following treatment.
Sepsis - The presence of infection in the blood.
Steroid - A drug commonly used in bone marrow/stem cell transplant to prevent or treat graft verses host disease.
Stomatitis - Mouth sores.
Syngeneic Transplant - Transplant in which the donor is an identical twin.
T Cell (Lymphocyte) - A type of white blood cell that can distinguish which cells belong in a person's body and which do not.
Titer - A blood test that assesses levels of antibodies against such things as viruses.
Total Body Irradiation (TBI) - A form of radiation therapy where virtually the entire body is exposed to the radiation.
Total Parenteral Nutrition (TPN; also called Hyperalimentation) - Intravenous feedings consisting of fluids high in calories and essential nutrients.
Transfusion - The transfer of any product derived from blood cells from one individual to another.
Urinary Catheter - A catheter inserted into the urinary bladder to allow continuous bladder irrigation and drainage during the conditioning phase.
Veno Occlusive Disease (VOD) - A disease that sometimes occurs following high dose chemotherapy and/or radiation therapy in which the blood vessels that carry blood through the liver become swollen and clogged.
Virus - A specific type of organism that invades cells and alters their genetic machinery, turning them into "factories" for production of more of the virus.
White Blood Cells (leukocytes) - Blood cells that fight infection in the body; neutrophils are the most important type.
Frequent Questions and Answers (Printable PDF)
What is bone marrow?
Bone marrow, found inside bones, is a spongy material where blood cells are made.
What are stem cells?
These are the “mother” cells in the bone marrow space which produce white blood cells, red blood cells, and platelets.
Why a transplant?
Bone marrow/stem cell transplants are performed for individuals who have diseased marrow or who will be receiving high doses of cancer therapy which will damage their marrow. Among the most common types of cancer treated with a transplant are testicular, lymphoma, myeloma, leukemias, and aplastic anemia. While transplants do not provide 100% assurance that the disease will not recur, it can increase the likelihood of a cure or may prolong the period of remission in many patients.
Are there different types of transplants?
Yes. Autologous transplants occur when the patient’s own stem cells are harvested and stored for re infusion after high-dose chemotherapy and/or radiation treatments.
Allogeneic transplants occur when stem cells are harvested from a sibling with matching marrow, an unrelated donor with matching marrow, a donor with mismatched marrow or umbilical cord blood, and are stored for transfusion following high-dose chemotherapy and/or radiation treatments.
What is a harvest?
Stem cells are collected by one of two methods: bone marrow harvest and aphaeresis. The highest concentration of stem cells is in the bone marrow. A bone marrow harvest is performed in the operating room under general anesthesia. Marrow with stem cells is collected from the back of the hips and, occasionally, the breast bone (sternum), or from the front of the hip bones. The collected marrow is then processed, frozen, and stored. To collect peripheral stem cells, a growth factor (such as Neupogen®) is given for four days in order to move the stem cells into the bloodstream. A special cell-separating machine is then used to collect the stem cells from the patient. This process is done on an outpatient basis over several days.
What if I can not have an autologous transplant and do not have a matching donor?
If a patient does not have a matched donor from their family, the transplant center will search for potential donors through the National Marrow Donor Program and other national and international marrow registries.
What are the risks associated with a blood or marrow transplant?
When your white blood cell count is low, your risk for infection is high. Most of the infections in transplant patients are caused by bacteria and viruses which are normally present in your body. When you receive chemotherapy, your body’s normal protective mechanisms (such as mucous membranes in your mouth and gut, and the healthy white blood cells that make up your immune system) are temporarily destroyed. When this happens, you become more likely to develop an infection. Anyone who comes into your hospital room is required to wash their hands. Person who are sick or who have been exposed to anything contagious are not allowed to visit during that time. You will shower daily with a special soap that is provided to keep your skin from germs. There are special filter systems in some room s to keep the air clean for patients at high risk of infection. While your blood cell count is low, antibiotics are given to prevent and treat any infections that might occur. Bleeding precautions are another important aspect of your care. Because your platelet count will be low, you ill bruise and bleed more easily. You will be provided a special sponge-like toothbrush to use, you be asked not to floss your teeth. You will also be asked not to use razors and/or nail clippers. These precautions are for your protection.
Why are cell and blood bone counts so important?
All mature blood cells begin as stem cells. White blood cells fight infection, while red blood cells deliver oxygen. Platelets prevent bleeding. Following high doses of chemotherapy and/or radiation, the bone marrow is damaged causing a decrease in the white and red blood cells and platelets. Blood counts are monitored daily.
What if someone wants to donate blood for my use?
Some patients have family or fiends who would like to donate blood products for their use. The contact number for South Texas Blood and Tissue Center is 210-731-5555.
Why is chemotherapy given before the transplant?
Chemotherapy drugs are given for two reasons (1) to destroy diseased cells and (2) to suppress the immune system. The immune system is the body’s mechanism for fighting off anything foreign that enters it. In an allogeneic bone marrow transplant, the immune system is suppressed so that the body will not reject the new bone marrow or stem cells. While it is undesirable to suppress the immune system in an autotologous transplant, that is a side effect of chemotherapy. Patients may have been treated with chemotherapy before and maybe familiar with its side effects. However, the chemotherapy received as part of the transplant process is given in much higher doses.
How is the transplant performed?
The frozen marrow and/or peripheral stem cells are thawed in a warm water bath at the bed side. It looks like blood as it is injected into the patient’s central venous catheter. The cells find their way back into the bone marrow and in approximately seven to ten days begin to grow.
Why is there so much emphasis on nutrition?
Good nutrition will be especially important for the patient throughout the transplant process. A high-calorie, high-protein diet is encouraged. This diet will help withstand the side effects from treatments, help maintain strength, and prevent muscle and other body tissues from breaking down while rebuilding normal tissue affected by the treatment.
What kind of support can I expect from the transplant team?
Our approach is a team approach. During the transplant process the patient will have abundant access to the following resources: professional individual and/or family support counseling, volunteer peer counseling from other transplant recipients, support groups, resource books, video and audio tapes.
How do I know if I am a candidate for transplant?
Whether or not you are a transplant candidate requires a process involving very detailed information about your disease, what therapies you have received and how your disease has responded to previous treatments. The patient’s personal physician is required to play an important role in their care before and after transplantation. Their doctor will discuss your disease history with the transplant doctor before the patient’s initial visit.
Will my insurance pay for a bone marrow or stem cell transplant?
At the time that the patient is referred to the transplant program, a financial coordinator will verify the patient’s transplant benefits with their insurance company. Confirmation of the patient’s insurance is essential and must be completed prior to beginning the transplant process. Insurance coverage for the transplant and related services is dependent on the patient’s individual insurance policy. The financial coordinator will work closely with the patient to ensure that all transplant benefits are maximized. The insurance clearance process typically happens quickly upon referral, but in some instances could take a couple of weeks depending on the responsiveness of the insurance company to the requests for information. Do not assume that the insurance company will pay for a transplant. Also, if the insurance company initially denies coverage for any reason, there may be an appeal process available to overrule the initial decision.
What kinds of insurance does Methodist accept?
The transplant program is a Medicare and Medicaid provider. In addition, it is contracted for transplant services with almost every major insurance carrier. If Methodist is not contracted with a particular insurance company, they will work quickly to try and put an arrangement together in order for the patient to be treated in the clinic.
What types of charges should I expect?
You will incur separate bills for hospital and physician services. All of the doctors who treat you are independent contractors who bill for their services separately from the hospital. The transplant clinic is a hospital-based clinic; therefore you will receive a hospital outpatient bill for each time you are seen in the clinic. The financial coordinator and social worker will help the patient and their family becomes aware of what charges to expect and at what time during the process.
What is a clinical trial?
A clinical trial is a research study which involves cancer patients. Each study is specially designed to answer specific questions or to find new and better ways to help cancer patients. Advances in the treatment of cancer are the result of the new ideas developed from research. Many of the standard treatments used today are the result of clinical trials conducted years ago.
Are clinical trials safe?
Extensive testing is completed before a drug is used in a clinical trial. This testing happens in laboratories and in animal studies. The best results from this testing are then tried in patients before these drugs are available for use outside the clinical trial setting. Each clinical trial is carefully supervised, monitored and documented by both physicians and nurses involved in the trial. Each clinical trial is also supervised by the Institutional Review Board whose membership consists of clinical experts and laypersons.
Are there risks associated with clinical trials?
Yes. There are risks and potential side effects. Cancer treatment is particularly powerful because it is designed to destroy cancer cells. A clinical trial is a tool used to investigate new areas of cancer treatment. The risks and side effects are not always known ahead of time. Researchers are continually trying to develop treatments that destroy cancer cells but do not harm healthy cells and which may have few side effects. Although every effort has been made to identify the potential risks and side effects prior to a patient’s participation, the possibility of unknown danger, side effects and still remain.
Who is eligible to participate in a clinical trial?
Each study has its own guidelines for who can participate. Generally, participants are alike in key ways such as the type and stage of cancer. The patient’s physician will determine whether or not they are a candidate for a research trial.
Helpful Links... (Printable PDF)
The following links are provided for additional research on blood and marrow transplant and/or cancer topics. The Texas Transplant Institute does not take any responsibility for the accuracy or reliability of these sites.