Bone Marrow/Stem Cell Transplant

Autologous uses your own stem cells, collected before high-dose chemotherapy and returned afterward. Lower risk since no donor matching needed, but no graft-versus-tumor effect. Used mainly for lymphoma and myeloma. Allogeneic uses stem cells from a donor (sibling, unrelated, or haploidentical family member). Higher risk of complications (GVHD) but provides a graft-versus-tumor effect that can help prevent relapse. Used mainly for leukemias and high-risk blood cancers.

GVHD occurs when donor immune cells recognize the patient's tissues as foreign and attack them. It can affect skin (rash), liver (elevated enzymes), and GI tract (diarrhea, nausea). Acute GVHD occurs in the first 100 days; chronic GVHD can occur months to years later. It's treated with steroids and other immunosuppressants. While GVHD can be serious, a mild form may indicate a beneficial graft-versus-tumor effect.

A minimum of 90 days is recommended: 30-60 days inpatient during transplant and early recovery, plus 30-60 days outpatient for close monitoring until the Day +100 milestone. This ensures you're through the highest-risk period before returning home.

Success depends on disease type, disease status at transplant, donor type, and patient fitness. Per CIBMTR registry data, engraftment success exceeds 95% for matched donors. One-year overall survival ranges from 50-90% depending on disease and patient factors, with standard-risk patients at JCI-accredited centers achieving 80-90%. Your transplant team will discuss your individual prognosis based on your specific situation.

For short flights under 4 hours, after stable engraftment and Day +30-60 minimum. For long-haul flights over 4 hours, Day +100 minimum is recommended, ideally 6 months. Your transplant team will clear you based on your recovery. Always use DVT precautions (compression stockings, hydration, movement) and wear a mask.

Yes, a 24/7 caregiver is mandatory for at least the first 100 days. The caregiver helps with transportation to appointments, medication management, meal preparation following low-microbial diet requirements, monitoring for warning signs, and emergency response. This person should plan to stay with you the entire time in Thailand.

Yes. The conditioning chemotherapy erases your immune memory, so you'll need childhood vaccines again. Inactivated vaccines start 6-12 months post-transplant. Live vaccines can be given at 24 months post-transplant if no active GVHD or immunosuppression. Your transplant team will provide a detailed vaccination schedule.

Contact your transplant team immediately for: fever 100.4F (38C) or higher, new rash, diarrhea (more than 3 loose stools per day), nausea or vomiting preventing oral intake, shortness of breath, bleeding or bruising, signs of infection at central line site, or confusion or mental status changes.

Ideal candidates are typically 18-60 years old (up to 75 for reduced-intensity conditioning), with adequate cardiac function (LVEF over 50%), pulmonary function (FEV1 and DLCO over 50%), and kidney/liver function. Disease should ideally be in complete remission. A comprehensive evaluation including cardiac, pulmonary, and psychosocial assessments determines eligibility.

Thailand offers all major transplant types: Autologous (your own cells), Allogeneic from matched sibling donors, Matched unrelated donors via international registries, Haploidentical (half-matched family donor) with PTCy protocol at Bumrungrad, and Cord blood transplants. These options significantly expand the likelihood of finding a suitable donor.