Bone Marrow Transplant Center

Free consultation

Learn which donor route is realistic for you before anyone travels

The assessment is free of charge and places you under no obligation. Send your diagnosis reports, the most recent bone marrow biopsy report, blood counts with their dates, HLA typing results if any have been done, a list of the treatment lines you have already received, and the number and ages of your full brothers and sisters. A transplant haematologist replies in writing with whether a transplant is indicated now, which donor option to pursue first, and which tests should be done at home before any ticket is bought.

How the Bone Marrow Transplant Center is organised

Biruni Hospital runs two dedicated transplant units in Istanbul, one for adults and one for children, inside a single programme. A bone marrow transplant replaces diseased or destroyed blood-forming stem cells with healthy ones, either the patient's own cells collected in advance or cells from a donor, and the unit exists because that replacement needs infrastructure a general haematology ward does not have: sterile isolation rooms for the weeks when the patient has almost no immune system, daily engraftment monitoring, round-the-clock transfusion and infection support, and a follow-up clinic that watches for graft-versus-host disease long after discharge.

The split between adult and paediatric units matters more than it may look. A two-year-old with an inherited immune deficiency and a sixty-year-old with acute myeloid leukaemia need different conditioning drugs, different donor strategies and differently trained nurses, and keeping the two services separate means neither is treated as a smaller version of the other.

For a reader outside Turkey, one fact frames the rest of this page. Transplant is the only treatment in this hospital where a second person, the donor, may need testing, clearance and sometimes a plane ticket of their own, so planning starts with the donor question and works backwards.

The four transplant types, and where the cells come from

Four transplant types cover nearly every situation in which a transplant is considered, and they differ mainly in one variable: whose cells are used. An autologous transplant uses your own stem cells, collected and frozen before high-dose chemotherapy, so no donor is needed at all. An allogeneic transplant uses cells from another person whose tissue type matches yours, most often a fully matched sibling or a matched unrelated volunteer from a registry. A haploidentical transplant uses a half-matched family member, which is what every biological parent and every child of the patient automatically is. A cord blood transplant uses stem cells from a banked umbilical cord unit, so there is no living adult donor anywhere in the process.

Engraftment, the point at which the new cells start producing blood, arrives at different speeds. The centre monitors it daily, and typically sees engraftment at two to three weeks after an allogeneic transplant and three to five weeks after a cord blood transplant. Autologous grafts are generally the quickest to recover. Slower engraftment means more days in isolation, more transfusions and a higher infection window, which is why the timing column in the table below is worth reading twice.

No table decides a case. Disease, remission status, age, organ function and the donors actually available all pull on the choice, and two patients with the same diagnosis can leave the same clinic with two different plans.

Which diseases are treated with a bone marrow transplant here

Leukaemias come first on the list: acute myeloid leukaemia, acute lymphoblastic leukaemia, and chronic myeloid or chronic lymphocytic leukaemia when drug treatment stops holding the disease. Hodgkin and non-Hodgkin lymphoma and multiple myeloma are treated mainly with autologous transplants, where high-dose chemotherapy does the therapeutic work and the returned cells rescue the marrow afterwards. That same marrow rescue is also used on its own for patients whose bone marrow has been damaged by intensive chemotherapy or radiation given for another cancer.

The non-malignant list is long, and it is where the paediatric unit does much of its work. Severe aplastic anaemia. Inherited blood disorders, including beta-thalassaemia major, sickle cell disease and Fanconi anaemia. Immune deficiencies such as severe combined immunodeficiency and Wiskott-Aldrich syndrome, where a transplant can be curative in early childhood. Rare metabolic diseases including Hurler syndrome, adrenoleukodystrophy, Krabbe disease and metachromatic leukodystrophy, where the timing of transplant against the pace of the disease is the entire clinical decision.

Families of thalassaemia and sickle cell patients should note a particular donor consequence: these are inherited diseases, so a brother or sister who carries the same condition may not be usable as a donor, and the family typing round has to check for the disease as well as the tissue match.

Can my brother or sister donate? How family typing works from abroad

Each full sibling has a one in four chance of being a complete HLA match. HLA stands for human leukocyte antigen, the set of protein markers your immune system uses to tell self from non-self, and a transplant works best when donor and recipient carry the same markers at the key positions. Two full siblings inherited their markers from the same two parents, which is why the odds are 25 percent per sibling and why a patient with four brothers and sisters has a reasonable chance that at least one matches fully.

Typing does not require anyone to fly. A blood sample, or in many laboratories a cheek swab, is enough for HLA typing, and it can be done in your home country with the report sent to the transplant team alongside your own results. The centre confirms any promising match with its own high-resolution typing before a transplant is scheduled, because a donor chosen on a low-resolution report can turn out to be less matched than the paperwork suggested.

What happens when the siblings all test negative, or there are none? Look at your own family tree again. Every biological parent is a half-match to their child, and every child is a half-match to their parent, with no testing lottery involved. Siblings have a further 50 percent chance of being half-matched. This is the haploidentical route, and since post-transplant cyclophosphamide made half-matched transplants safe enough for routine use, it has meant that almost every patient with living first-degree relatives has at least one possible donor inside their own family.

Matching is only half of a donor work-up. The chosen relative is examined as a patient in their own right: screening for hepatitis, HIV and other transmissible infections, a cardiovascular and general fitness review, and a check for conditions that would make donation risky for the donor themselves. Pregnancy defers donation. Some chronic illnesses rule it out. A willing donor who fails medical clearance is one of the most common late surprises in cross-border cases, which is why the team asks about all potential family donors at the file stage instead of pinning the plan to one person.

When no relative matches: the worldwide unrelated donor search

Around 42.7 million potential donors and cord blood units are listed in the World Marrow Donor Association's global database, according to a 2025 analysis published in the journal HLA. A search is not a physical hunt; your high-resolution HLA type is queried against that database through the registry network, and candidate donors anywhere in the world appear within days. Confirming one takes longer. The candidate must be contacted, re-typed, medically cleared and scheduled, and the realistic span from starting a search to having cleared cells runs from several weeks to a few months.

Whether a match exists at all depends heavily on ancestry. A New England Journal of Medicine analysis of the US registry found that the likelihood of an optimally matched adult donor ranged from 75 percent for patients of white European descent down to 16 percent for some patient groups with African ancestry, because registries still hold far fewer donors from some populations than from others. The same 2025 WMDA study adds a detail that matters to anyone searching from a smaller country: when a new match is eventually found for a hard-to-match patient, it is typically found outside the country where the search began. An international search is the normal case, not the exception.

So which is better when both exist, a half-matched relative or a matched stranger? A 2021 analysis in Blood compared 2036 haploidentical with 284 matched unrelated donor transplants, all using the same modern cyclophosphamide-based protection. After reduced-intensity conditioning the matched unrelated donors did clearly better, with graft failure at 3 percent against 11 percent and two-year overall survival of 67 percent against 54 percent. After full-intensity conditioning, survival was equivalent. The practical reading for a patient abroad: a family half-match that is available immediately is sometimes chosen over a distant registry donor that would take three more months, and sometimes the reverse, and this is exactly the judgement the transplant team makes case by case.

Cord blood sits behind both options as a further reserve. Banked units tolerate looser matching, and the same US registry analysis found a usable unit for almost every patient under 20 and for more than 80 percent of older patients, whatever their ancestry. Slower engraftment and limited cell doses for larger adults are the price of that availability.

Does the donor travel with me? What donation actually involves

An unrelated registry donor never travels with you, and you will never meet them. Their cells are collected at a centre in their own country and flown to Istanbul by medical courier, under rules that keep both of you anonymous to each other. Nothing about that donor's journey is yours to arrange or pay for directly; it is handled between the registries and billed as part of the procurement cost described further down.

A family donor is different. They travel, because their work-up, clearance and collection happen where the transplant happens.

Donation today rarely means an operation on the hip bone. For most adult donors the cells are collected from circulating blood: the donor receives growth factor injections for four to five days to move stem cells out of the marrow into the bloodstream, then sits through one or two apheresis sessions of a few hours each, connected to a machine that filters stem cells out and returns everything else. Donors tend to describe the session itself as a long blood donation, tedious more than painful. No anaesthesia, no overnight stay in most cases, and the commonest complaints are bone ache and fatigue during the injection days. A classical marrow harvest under general anaesthesia is still used when the recipient is a small child or the graft composition calls for it; that donor usually goes home the next day with hip soreness that fades over the following days, and the donated marrow replaces itself within a few weeks, so donation costs the donor nothing permanent.

Plan for the family donor to be in Istanbul across the clearance and collection window, and ask the coordinators to align the donor's dates with the conditioning schedule, since the graft is timed to the day the patient is ready to receive it. Where the donor genuinely cannot travel in the same window, collecting and freezing the graft in advance can be discussed, with trade-offs the team will explain against your specific disease.

From conditioning to engraftment: what the weeks in hospital hold

Conditioning opens the transplant itself: several days of chemotherapy, sometimes with radiation, that clears the diseased marrow and switches off the immune system so the graft will not be rejected. Its intensity is a decision, not a default. Full myeloablative conditioning gives the strongest anti-disease effect and demands the most from the heart, lungs, liver and kidneys; reduced-intensity regimens opened transplant to older patients and to those with other illnesses, at the cost of leaning more on the graft's own immune effect against the disease.

The infusion that follows looks almost disappointing after all that. Cells run in through a central line like a blood transfusion, over an hour or so, and the infused stem cells find their own way to the marrow space.

Then comes the part the isolation rooms were built for. Between infusion and engraftment the patient produces almost no white cells, and the team bridges that window with sterile isolation, filtered air, transfusions and rapid antibiotic response to any fever. Blood counts are checked daily for the first signs of the graft working. At two to three weeks after an allogeneic transplant, and three to five weeks after cord blood, rising neutrophil counts usually announce engraftment, and the strictest phase of isolation begins to ease. Discharge from the ward is not discharge from Istanbul, a distinction the section on length of stay explains.

Engraftment also produces one of the strangest facts in medicine. From that point on your blood is being made by the donor's cells, which means your blood group can convert to the donor's over time and a DNA test run on your blood would show the donor's profile, even though every other tissue in your body remains entirely your own. The team tracks this deliberately. Chimerism monitoring measures what share of your blood is donor-derived, and it is the standard way of confirming, check after check, that the graft is holding and the original marrow is not creeping back.

Graft-versus-host disease and the other risks that deserve numbers

Acute graft-versus-host disease affects roughly 30 to 50 percent of allogeneic transplant recipients, with severe forms in about 14 percent, according to a 2017 review in the New England Journal of Medicine. GVHD is the mirror image of rejection: the donor's immune cells recognise the patient's skin, gut or liver as foreign and attack, producing rashes, diarrhoea or liver test abnormalities in the early months. Preventive immunosuppression starts before it can, every allogeneic patient at the centre is monitored for it as a matter of routine, and most cases respond to corticosteroids. A chronic form can surface months later in the skin, eyes, mouth or lungs.

The same donor immune reaction has a beneficial twin. Transplant physicians call it the graft-versus-leukaemia effect: the new immune system recognises residual leukaemia cells as foreign and destroys them, and that ongoing surveillance is a large part of why an allogeneic transplant can cure diseases that chemotherapy alone could not. Suppressing GVHD too completely can blunt this effect, so several decisions in transplant, from donor choice to how fast immunosuppression is tapered, are weighed as trade-offs between the two faces of one reaction. Managing GVHD is therefore a balance rather than an eradication.

Two other risks belong in any honest account. Graft failure, where the new cells never take hold, occurred in 3 to 11 percent of patients in the Blood comparison cited above, depending on donor type and conditioning intensity. Infection remains the constant background threat from conditioning until immune recovery, which takes months.

Who is not a candidate, and what a file review cannot settle

Honesty is cheaper for you than optimism, so here are the situations in which this team will advise against travelling, or against transplant altogether.

A reply that says do not come, or not yet, is a real outcome of the review, and it is given when staying near your current team, or waiting for deeper remission, serves you better than a transplant admission would.

How long you stay in Istanbul, and when flying home is safe

Plan in months, not weeks. An autologous patient typically spends several weeks in the country across work-up, collection, the transplant admission and the first recovery checks. Allogeneic patients stay longer, because transplant units everywhere keep patients near the hospital through the first roughly one hundred days after infusion, the period in which acute GVHD, infections and graft problems are most likely and most treatable if caught within hours. During the outpatient part of that period you live near the hospital and attend frequent clinic checks, which is where a companion becomes a practical necessity, watching for fever at night and managing a strict medication list with you.

Daily life in that period follows rules that surprise many patients. The kitchen becomes a clinical matter: raw or undercooked meat, fish and eggs, unpasteurised milk and cheese, and unwashed salads are all avoided early on, because a gut with no immune defence turns a trivial food germ into a hospital admission. Crowded indoor spaces are kept to a minimum while counts recover. Some of the drugs on the post-transplant list make skin burn unusually fast in the sun, so covering up outdoors becomes routine. Before discharge the team also asks detailed questions about where you will be staying and who lives there, down to pets and recent illness in the household, since the safety of the graft depends as much on the room you sleep in as on the ward you left.

Clearance to fly is a medical decision made against your counts, your immunosuppression and any GVHD activity, not a fixed date on a booking. A long flight in a sealed cabin, away from transplant-capable care, is a meaningful exposure for someone whose immune system is months from recovered, and the team will tell you plainly when the risk has fallen far enough. Before departure you receive a written handover for your haematologist at home covering the transplant details, current drugs, tapering plans and the warning signs, fever above 38 degrees first among them, that should send you to a hospital the same day.

Where the money goes in a transplant quote

Five factors move the price more than anything else, and understanding them explains why two quotes for the same diagnosis can sit far apart. Transplant type comes first: an autologous case has no donor work-up, no donor collection and no registry involvement, while an allogeneic case carries all three. Second is the donor route itself, since an unrelated search adds registry fees and a procurement charge for collecting and couriering the graft that varies with the donor's country, whereas a family donor adds work-up, collection and that person's travel instead. Conditioning intensity is third, through drug and radiation costs. Fourth, the number of inpatient isolation days, which differs by transplant type and by how quickly engraftment arrives. Fifth, complications: a course of GVHD treatment or a serious infection can extend an admission well past any estimate, and a serious quote will say how such events are billed.

Aggregator sites give a first sense of scale. Public medical tourism platforms commonly quote allogeneic transplant in Turkey at roughly 60,000 to 80,000 US dollars, while the same sites quote 450,000 to 550,000 dollars for the United States. Those are indicative marketing figures compiled for comparison shopping, not clinical data, and they move with the transplant type and with what each package actually includes, which is exactly why the five-part breakdown above tells you more than any headline number.

Ask any centre you compare, this one included, to break a quote into those five parts and to state which of them are capped. A single round figure with no structure behind it is the least trustworthy number in medical travel.

Coordinating a transplant from another country, step by step

Everything begins with documents, not travel. You send the file listed at the top of this page, a transplant haematologist reviews it, and the written reply states whether transplant is indicated, which donor route to start with, and what to do in your home country first, most often HLA typing of the patient and every willing sibling. If the family round fails, the registry search starts while you are still at home, since search weeks cost nothing extra when they run in parallel with your remaining treatment.

Travel is booked only once the donor plan is concrete: a cleared relative flying with you, a registry donor with a confirmed collection date, or a reserved cord unit. On arrival both patient and family donor go through the in-person work-up, the conditioning calendar is fixed, and the admission proceeds as described above. After discharge come the outpatient months near the hospital, then the flight home with the handover letter. Once you are back home, follow-up runs on two tracks: your local haematologist handles blood checks and day-to-day questions, while the transplant team stays reachable by remote follow-up for the decisions that need transplant experience, tapering immunosuppression and judging possible GVHD chief among them.

Returning to work is a question of immune recovery as much as of energy. Patients commonly go back some months after an autologous transplant and later still after an allogeneic one, and the kind of work matters: a desk reached by car comes back sooner than a classroom, a clinic or a crowded workshop, and your haematologist judges the point at which your counts and your medication make it reasonable.

Questions international patients ask about donors and travel

References

1. Gragert L, Eapen M, Williams E, et al. HLA match likelihoods for hematopoietic stem-cell grafts in the U.S. registry. New England Journal of Medicine. 2014;371(4):339-348.
2. Maiers M, Greco-Stewart V, Madbouly A, et al. The Registry of Unmet Need: a World Marrow Donor Association analysis of patients without an HLA match. HLA. 2025;105(5):e70255.
3. Gooptu M, Romee R, St Martin A, et al. HLA-haploidentical vs matched unrelated donor transplants with posttransplant cyclophosphamide-based prophylaxis. Blood. 2021;138(3):273-282.
4. Zeiser R, Blazar BR. Acute graft-versus-host disease: biologic process, prevention, and therapy. New England Journal of Medicine. 2017;377(22):2167-2179.
5. Sorror ML, Maris MB, Storb R, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106(8):2912-2919.