Autologous stem cells are a person’s own stem cells, collected from their body and later given back to the same person. Cells that come from someone else are allogeneic stem cells.[1] The best-established use is the autologous stem cell transplant, in which a patient’s blood-forming stem cells are collected and stored, high-dose chemotherapy (sometimes with radiation) is given, and the stored cells are returned to rebuild the blood and immune system. It is used mainly for cancers of the blood cells such as multiple myeloma and lymphoma.[1] A patient’s own cells are also the starting material for several approved cell and gene therapies, while autologous mesenchymal stromal cells (MSCs) have only narrow approvals in some countries and are otherwise investigational.
Autologous Compared With Allogeneic Cells
The main differences between the two kinds of transplant:[2][1]
| Autologous (own cells) | Allogeneic (donor cells) | |
|---|---|---|
| Donor search and tissue matching | None needed | Needed; a matched family member or registry donor must be found |
| Rejection and graft-versus-host disease | No rejection of the cells and no attack by transplanted immune cells on the body | Graft-versus-host disease is a major risk |
| Effect against remaining cancer | No graft-versus-cancer effect | Donor immune cells can attack remaining cancer cells |
| Cancer cells in the graft | A small risk that cancer cells collected with the stem cells are given back | Healthy donor cells are free of cancer cells |
| Graft failure | Possible | Possible |
Removing cancer cells from a collected graft (“purging”) can also remove some normal stem cells.[2] For MSCs the comparison is less settled: donor MSCs can provoke antibodies and be rejected, but whether that matters for any benefit is unknown, and no definite clinical advantage of a patient’s own MSCs over donor MSCs has been shown.[3]
How an Autologous Stem Cell Transplant Works
- Mobilisation. For several days the patient has injections that move stem cells out of the bone marrow into the blood,[4] usually the growth factor G-CSF (filgrastim);[5] see our page on granulocyte colony-stimulating factor.
- Collection. Blood is drawn through a vein and a machine separates the white cells that contain the stem cells (apheresis); the rest of the blood is returned.[4] Most transplants now use stem cells from the blood rather than from the marrow itself.[1] These sources are described on our pages on peripheral blood stem cells and bone marrow stem cells.
- Freezing. The collected cells are frozen and stored until the transplant.[4]
- Conditioning. High-dose chemotherapy, and sometimes radiation, is given over a week or two to treat the cancer; it also destroys the patient’s remaining blood-forming stem cells, which the stored cells will replace.[1] In myeloma the usual drug is high-dose melphalan.[6]
- Infusion. After a few days of rest the thawed cells are given through an intravenous catheter, much like a blood transfusion, over 1 to 5 hours.[1]
- Recovery. The returned stem cells begin making new blood cells, and blood counts rise. The high-dose treatment can cause problems such as bleeding and a higher risk of infection. Full recovery of the immune system after an autologous transplant takes several months, and the whole process can take a few months to complete.[1] Two autologous transplants in a row, within 6 months, is called a tandem transplant and carries a higher risk than a single one.[2]
Evidence in Myeloma and Lymphoma
Multiple myeloma. High-dose melphalan with an autologous transplant has long been the standard first treatment for adults up to 65. Two phase 3 trials tested whether it still adds benefit to modern drug combinations. In the French IFM 2009 trial (700 patients), the transplant group lived longer without disease progression (median 50 against 36 months), but survival at 4 years was the same (81 and 82 percent), and severe neutropenia, gut problems and infections were more common with transplant.[6] The American DETERMINATION trial (722 patients, with maintenance treatment until progression) found the same pattern: median progression-free survival of 67.5 against 46.2 months, no difference in survival at 5 years (80.7 and 79.2 percent), and more severe side effects with transplant (94.2 against 78.2 percent).[7]
Lymphoma. In the PARMA trial, 109 people whose non-Hodgkin lymphoma had relapsed but still responded to chemotherapy were randomly assigned to more chemotherapy or to high-dose chemotherapy with an autologous bone marrow transplant. At 5 years, 46 percent of the transplant group were alive without an event, against 12 percent, and overall survival was 53 against 32 percent.[8] For large B-cell lymphoma that relapses within a year of first treatment, this approach has since been outperformed: in the 359-patient ZUMA-7 trial, CAR T-cell therapy made from the patient’s own T cells gave a median event-free survival of 8.3 months, against 2.0 months with standard care, which was chemotherapy followed by an autologous transplant for those who responded.[9]
Autologous Transplants for Autoimmune Disease
The same procedure, used to reset the immune system, has been tested in severe autoimmune disease. In a randomized trial of 110 people with relapsing-remitting multiple sclerosis who kept relapsing on treatment, disability progressed in 3 people after a nonmyeloablative transplant and in 34 of those who switched to another disease-modifying drug (55 in each group); the authors called the study preliminary and asked for replication.[10] In 75 adults with severe scleroderma, a myeloablative autologous transplant led to better event-free survival at 72 months than monthly cyclophosphamide (74 against 47 percent), at the cost of treatment-related deaths in 6 percent of the transplant group.[11]
Other Autologous Cell Products
As of November 2026, the US Food and Drug Administration list of approved cellular and gene therapy products includes several products made from a patient’s own cells.[12] They include cartilage cells grown on a collagen membrane (MACI) for full-thickness cartilage defects of the knee in adults;[13] CAR T-cell therapies made from the patient’s T cells;[9] and gene therapies for sickle cell disease, such as CASGEVY and LYFGENIA, in which the patient’s own blood stem cells are collected, modified and given back after high-dose chemotherapy as part of a stem cell transplant.[14]
No autologous MSC product is on that list. In Japan, a patient’s own bone marrow MSCs have conditional, time-limited approval for traumatic spinal cord injury (STEMIRAC, 2018), and a patient’s own knee synovium MSCs are approved for meniscal injury repaired by suturing (Savyscus, 2026).[15] Outside such approved uses, autologous MSC treatment is investigational. Cell preparations made on the day of collection from bone marrow aspirate (bone marrow aspirate concentrate) or from fat (the stromal vascular fraction) are mixtures of cells, not MSCs grown in culture, and are not on the FDA list either. In a randomized phase 2/3 trial of cell injections for knee osteoarthritis (480 patients), neither autologous bone marrow aspirate concentrate nor autologous fat stromal vascular fraction, nor donor umbilical cord tissue MSCs, relieved pain better than a corticosteroid injection at 12 months, and none changed MRI scores.[16] Other cell types studied in the laboratory, such as Muse cells, are investigational. Umbilical cord blood stored at birth is another possible source of a child’s own stem cells; its uses are covered on our page on cord blood stem cells.
Published Clinical Citations
[1] ^ National Cancer Institute. Stem Cell Transplants in Cancer Treatment. Updated 5 October 2023. https://www.cancer.gov/about-cancer/treatment/types/stem-cell-transplant
[2] ^ American Cancer Society. Types of stem cell and bone marrow transplants. Last revised 10 July 2025. https://www.cancer.org/cancer/managing-cancer/treatment-types/stem-cell-transplant/types-of-transplants.html
[3] ^ Ankrum JA, Ong JF, Karp JM. Mesenchymal stem cells: immune evasive, not immune privileged. Nature Biotechnology. 2014;32(3):252-260. https://doi.org/10.1038/nbt.2816
[4] ^ MedlinePlus Medical Encyclopedia. Bone marrow transplant. Review date 3 February 2025. https://medlineplus.gov/ency/article/003009.htm
[5] ^ Anasetti C, Logan BR, Lee SJ, et al. Peripheral-blood stem cells versus bone marrow from unrelated donors. New England Journal of Medicine. 2012;367(16):1487-1496. https://doi.org/10.1056/NEJMoa1203517
[6] ^ Attal M, Lauwers-Cances V, Hulin C, et al. Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma. New England Journal of Medicine. 2017;376(14):1311-1320. https://doi.org/10.1056/NEJMoa1611750
[7] ^ Richardson PG, Jacobus SJ, Weller EA, et al. Triplet therapy, transplantation, and maintenance until progression in myeloma. New England Journal of Medicine. 2022;387(2):132-147. https://doi.org/10.1056/NEJMoa2204925
[8] ^ Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. New England Journal of Medicine. 1995;333(23):1540-1545. https://doi.org/10.1056/NEJM199512073332305
[9] ^ Locke FL, Miklos DB, Jacobson CA, et al. Axicabtagene ciloleucel as second-line therapy for large B-cell lymphoma. New England Journal of Medicine. 2022;386(7):640-654. https://doi.org/10.1056/NEJMoa2116133
[10] ^ Burt RK, Balabanov R, Burman J, et al. Effect of nonmyeloablative hematopoietic stem cell transplantation vs continued disease-modifying therapy on disease progression in patients with relapsing-remitting multiple sclerosis: a randomized clinical trial. JAMA. 2019;321(2):165-174. https://doi.org/10.1001/jama.2018.18743
[11] ^ Sullivan KM, Goldmuntz EA, Keyes-Elstein L, et al. Myeloablative autologous stem-cell transplantation for severe scleroderma. New England Journal of Medicine. 2018;378(1):35-47. https://doi.org/10.1056/NEJMoa1703327
[12] ^ US Food and Drug Administration. Approved Cellular and Gene Therapy Products. Content current as of 30 October 2026. https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/approved-cellular-and-gene-therapy-products
[13] ^ US Food and Drug Administration. MACI (autologous cultured chondrocytes on porcine collagen membrane). BL 125603. Content current as of 26 August 2024. https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/maci-autologous-cultured-chondrocytes-porcine-collagen-membrane
[14] ^ US Food and Drug Administration. FDA approves first gene therapies to treat patients with sickle cell disease. Press announcement, 8 December 2023. https://www.fda.gov/news-events/press-announcements/fda-approves-first-gene-therapies-treat-patients-sickle-cell-disease
[15] ^ Pharmaceuticals and Medical Devices Agency (Japan). List of Approved Regenerative Medical Products, April 2015 to July 2026. https://www.pmda.go.jp/files/000283257.pdf
[16] ^ Mautner K, Gottschalk M, Boden SD, et al. Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nature Medicine. 2023;29(12):3120-3126. https://doi.org/10.1038/s41591-023-02632-w