Chemotherapy treatments reduce the production of blood cells by the bone marrow. The rest periods between courses of chemotherapy allow your bone marrow to recover. However, there is a limit to how much chemotherapy you can have without it causing permanent damage to your bone marrow.

Bone marrow and stem cell transplants are a way of allowing much higher doses of chemotherapy to be given, to improve the chances of completely curing the leukaemia. They are not suitable treatments for everyone with acute myeloid leukaemia. If your doctor thinks that a transplant is necessary or possible for you, they will discuss it with you in detail.

Very high doses of chemotherapy, with or without radiotherapy, are given, which destroy all the cells in your bone marrow. Soon afterwards, stem cells (the immature blood cells which develop into red cells, white cells and platelets) are given back into your blood through your central or PICC line. These cells make their way into the bone marrow and start to make healthy blood cells.

The stem cells may be your own (taken before your high dose treatment), or donated by someone else (usually a brother or sister). The new stem cells take a few weeks to settle in your bone marrow and produce the blood cells that you need. During this time you will have very low immunity. You will probably need to stay in hospital and be nursed in isolation. This is done to reduce your risk from infection until your white blood cell count has recovered.

Stem cell transplants use stem cells which are taken from the blood. This is collected through a small tube (cannula) which is put into a vein. The stem cells are then removed, and the blood is then returned through another cannula.

For a bone marrow transplant, some of the bone marrow is taken from the bones under general anaesthetic. The bone marrow contains stem cells.

Stem cell and bone marrow transplants carry some risk, and are generally carried out in major cancer treatment hospitals, so you may have to be treated at a hospital some distance from your home.

Autologous transplants use your own stem cells. They are collected from your blood while you are free of any signs of leukaemia (in remission).

To collect the stem cells from the blood, you will be given daily injections of a growth factor - a protein that stimulates the bone marrow to produce lots of stem cells. These 'spill over' into the blood and can then be collected. This growth factor will be given immediately following a course of chemotherapy, which is the time when it is most effective.

This type of transplant uses stem cells or bone marrow donated by someone else. Usually, you can only have this type of transplant if you have a brother or sister whose bone marrow is a close match to your own.

Sometimes it is possible to use an unrelated donor for a stem cell transplant if tests have shown that their white blood cells are a good match with yours. This type of transplant is called a MUD (Matched Unrelated Donor) transplant.

We have a section on stem cell and bone marrow transplants which describes these treatments in detail.