How transplants actually work
Not every stem cell transplant needs a donor
This is the thing people are most often surprised by, and the reason we put it on its own page. For several of the commonest conditions treated with a transplant, the cells being transplanted are the patient’s own.
The two kinds
Your own cells
Autologous
Your blood stem cells are collected and frozen before treatment. You are then given high-dose chemotherapy, which is effective against the disease but also wipes out your bone marrow. Your own stored cells are given back to rebuild it.
No donor is involved at any point. Nobody is searched for, and there is no question of a match, because the cells are already yours.
Someone else’s cells
Allogeneic
The blood-forming system is replaced with cells from another person — a matched brother or sister, or a stranger found through a registry.
This is the kind that needs a donor, and the kind our work is about. It also does something an autologous transplant cannot: the donor’s immune cells can recognise and attack disease that survived treatment.
Why this gets confused so often
Both are called a stem cell transplant, and often just “a transplant”. Both involve high-dose chemotherapy, weeks in hospital, and a wait for blood counts to recover. From the outside they look alike.
But one is a rescue and the other is a replacement, and that difference decides whether anyone needs to be found. Charity fundraising has not always been careful about it, and we would rather be.
Multiple myeloma is the clearest example. It is the single largest reason people have a stem cell transplant in Europe — and almost none of those transplants involve a donor.
Which conditions use which
Usually the person’s own cells
11 conditions in our library. If you have one of these, a transplant would not normally involve a donor.
- ALK-negative anaplastic large cell lymphoma
- ALK-positive anaplastic large cell lymphoma
- Angioimmunoblastic T-cell lymphoma
- Classic Hodgkin lymphoma
- Early diffuse cutaneous systemic sclerosis
- Highly active relapsing multiple sclerosis
- Immunoglobulin-related amyloidosis (AL amyloidosis)
- Peripheral T-cell lymphoma, not otherwise specified
- POEMS syndrome
- Primary CNS lymphoma
- Primary plasma cell leukemia
A donor is a genuine route
46 conditions in our library, some from a family member and some from a stranger on a registry.
- Acquired severe aplastic anemia
- Acute myeloid leukemia
- Adult T-cell leukemia/lymphoma
- Autosomal recessive malignant osteopetrosis
- B-cell acute lymphoblastic leukemia (B-ALL)
- Blastic plasmacytoid dendritic cell neoplasm
- CD40 ligand deficiency
- Chronic granulomatous disease
- Chronic myelomonocytic leukemia
- Chronic neutrophilic leukemia
- Combined immunodeficiency due to DOCK8 deficiency
- Congenital amegakaryocytic thrombocytopenia
These lists are shortened. The full library states, on every page, what part a donor plays in that particular condition.
The conditions that do need donors, still need them
Leukemia, aplastic anemia, the inherited marrow failure syndromes and the inherited immune disorders all depend on someone else’s cells — and for most people who need them, no one in the family matches.