You need healthy blood and bone marrow cells to live. If you have a condition that affects your bone marrow or blood, then a stem cell transplant could be the best treatment option for you. For some people, a transplant offers hope of a potential cure.
A bone marrow or stem cell transplant means that doctors or nurses will put new, healthy stem cells into your bloodstream. These cells make their way to your bone marrow, where they begin to grow and make healthy red blood cells (which carry oxygen around the body), white blood cells (which prevent and fight infections) and platelets (which stop you bleeding).
If you're receiving stem cells donated from someone else, doctors need to find a donor whose tissue type matches yours. We explain how they do this on our Finding a Donor for Your Stem Cell Transplant page.
A sibling transplant means that you will have a transplant using stem cells donated from your brother or sister.
Brothers or sisters have a 25% chance of having the same tissue type as you. So if you do have any siblings, your transplant team will normally ask if your brother(s) or sister(s) would like to be tested first.
Who can have a sibling transplant?
A sibling transplant could be a treatment option for you if you have a brother or sister whose tissue type matches yours, and you have:
- A condition that means that you’re not able to make your own healthy blood cells, for example aplastic anaemia, or a genetic condition affecting your blood, bone marrow or immune system
- blood cancer that is unlikely to be cured by having chemotherapy alone.
How does your brother or sister donate their stem cells?
If your brother or sister is a match and they want to donate, your transplant centre will arrange a ‘donor assessment’ and medical screening to make sure they are fit and well enough to donate. This is voluntary and it’s up to them if they want to donate. You can find out more in our webpage Donating Your Stem Cells to a Relative.
Unfortunately, there are certain medical conditions that could mean your sibling won’t be able to donate to you. However, in this scenario, there are other options for finding you another donor.
If your sibling is a match and can donate, the next step will be to book a date for the donation and transplant process. Most siblings donate their stem cells in a process called peripheral blood stem cell collection (PBSC). Some donate their bone marrow; this means they will need to have a small operation and a general anaesthetic to minimise discomfort during the procedure.
What will happen before the transplant?
You will have conditioning therapy to prepare your bone marrow and immune system for the new cells. This is done with chemotherapy, sometimes in combination with a type of radiotherapy called total body irradiation (TBI). This also helps to get rid of any abnormal cells if you have them.
You then receive the cells from your sibling to help you form a new blood and immune system. Your new immune system recognises any remaining abnormal cells in your body as foreign and attacks them. You might hear this called ‘graft versus tumour’ effect.
What will happen during the transplant?
Your transplant normally takes place the day after the conditioning therapy has finished.
The transplant itself involves having the donor stem cells passed through a thin tube into your bloodstream, a bit like having a blood transfusion. The transplant isn’t painful, is not an operation and you’ll be awake the whole time.
After your transplant, the stem cells make their way to your bone marrow. Once there they will start to grow into normal blood cells – this is called engraftment.
Recovering from a sibling stem cell transplant
The length of time spent in recovery is different for every patient. After your transplant you’ll probably be in hospital for about three to four weeks in protective isolation. You’ll usually be in a single hospital room with precautions taken to protect you from infection. For more information about how to cope during this time see our webpage Your Stay in Protective Isolation.
After you go home, it usually takes at least six months before your level of activity starts to get back to normal.
What side effects can I expect?
Having a transplant is a very intensive treatment that has a big physical and emotional impact on your life. Your transplant team will talk to you about the risk of complications and side effects so you can make the best decisions for your care.
Side effects of a sibling transplant vary from person to person and can be short term or long term. They are often caused by the conditioning therapy you have before the transplant, as well as the effect of the transplant itself.
Short-term side effects include:
- need for blood and platelet transfusions
- increased risk of infections
- sore mouth (mucositis)
- liver and kidney problems
- diarrhoea and feeling or being sick
- loss of appetite.
It’s also common to feel a bit down or anxious during the early stages of recovery. We have further information on this in our Recovery: Mind section.
Your transplant team will be monitoring you closely, and there will be treatment and support available.
Long-term side effects include:
When you’ve had a stem cell transplant, there are still small differences between your new developing immune system and other cells in your body. As a result, your growing immune system may harm some of the cells in your own body because it sees them as ‘different’. This is called graft versus host disease (GvHD). It can affect different parts of your body but commonly affects your skin, gut and liver. It can be short or long term, and mild or severe. Your transplant team will be monitoring you closely for signs of GvHD and will offer you treatment that can help.
Information published: 04/08/21
Next review due: 04/08/24