Question 1

Which types of blood cancer most commonly require a bone marrow transplant?

Accepted Answer

AML, ALL, multiple myeloma, Hodgkin and non-Hodgkin lymphoma, MDS, and CML (in TKI-resistant cases) are the most common indications. The specific recommendation depends on disease risk, remission status, and patient fitness.

Question 2

What is the difference between autologous and allogeneic BMT?

Accepted Answer

Autologous BMT uses the patient's own stem cells to rescue the bone marrow after high-dose chemotherapy. Allogeneic BMT uses stem cells from a matched donor, whose immune system can attack residual cancer cells through the graft-versus-leukaemia (GvL) effect. Allogeneic BMT carries higher risks but offers greater curative potential for many blood cancers.

Question 3

Is bone marrow transplant the only cure for blood cancer?

Accepted Answer

For certain high-risk blood cancers such as AML and MDS, allogeneic BMT is currently the only proven curative option. However, newer therapies including CAR-T cell therapy, targeted agents, and bispecific antibodies are changing the landscape.

Question 4

How do doctors decide if a patient needs a bone marrow transplant?

Accepted Answer

The decision involves disease type and molecular risk, response to initial chemotherapy, patient age and organ function, donor availability, and patient preference. A multidisciplinary haematology team reviews all these factors before recommending transplant.

Question 5

Can older patients undergo a bone marrow transplant?

Accepted Answer

Age alone is not a barrier. Reduced-intensity conditioning (RIC) regimens have made allogeneic BMT feasible for patients in their 60s and 70s who are otherwise fit. The transplant team assesses each patient's biological age and organ function rather than chronological age.

Question 6

What happens if no matched donor is found?

Accepted Answer

Haploidentical (half-matched) transplants from parents, children, or siblings are now a well-established alternative. Cord blood transplants are another option. Advances in post-transplant cyclophosphamide protocols have made haploidentical BMT outcomes comparable to matched unrelated donor transplants in many centres.

Types of Blood Cancer That Require a Bone Marrow Transplant

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