BALTIMORE -- A school bus, blocks away from its first stop Tuesday morning, rear-ended a car, then ricocheted off a roadside pillar into an oncoming commuter bus in a crash that killed at least six people and injured 10, authorities said.

The school bus driver was killed, along with at least five people on the Maryland Transit Administration bus, Baltimore Police spokesman T.J. Smith said.

"It literally looks like a bomb exploded in the bus. It's catastrophic damage," Smith said.

The only other occupant of the school bus, an aide, was taken to a hospital, as were the car driver and eight people from the commuter bus, Smith told a news conference.

He said one survivor was in critical condition, one was in serious condition and eight had injuries that were not considered serious.

The National Transportation Safety Board is sending a team to investigate, spokesman Keith Holloway said.

Baltimore Police Commissioner Kevin Davis characterized riders on the No. 10 MTA bus as workers travelling on a route from Dundalk, a largely blue-collar community southeast of Baltimore, toward Catonsville, a western suburb.

"They're on their way to make a living, they're on their way to the job and they're on their way to support their families," Davis said, "Our hearts and prayers go out to them, to their families, to their co-workers as well."

The school bus first hit a silver Ford Mustang, crushing its rear and forcing its nose into the pavement. Then it hit a pillar at a cemetery entrance hundreds of feet down the street. Veering across the centre line, the yellow school bus slammed into the front driver side of the MTA bus, ending about 100 yards from the pillar.

The school bus raked the side of the commuter bus, ending with its front end buried toward the back of the MTA vehicle.

The wreck peeled back metal and exposed a tangle of metal and human limbs, according to a passing motorist who stopped to help, Michael Feldman. He told WJZ-TV that the MTA driver appeared to be in very bad shape; authorities have not said if that driver survived.

Smith noted a lack of skid marks at the crash scene on Frederick Avenue near Loudon Park Cemetery, leading to what he called a working theory that the school bus driver had suffered a medical emergency.

Firefighters were still working their way through the wreckage of the commuter bus more than two hours after the crash, which was reported at about 7 a.m., Baltimore Fire Chief Niles Ford said.

"This was a significant, significant wreck, so there are still portions of the bus that our people have not been able to fully access," Ford told a morning news conference.

He said firefighters had to enter the school bus from the rear and cut out the seats to reach the driver and aide.

Some of the survivors suffered facial bone injuries and spinal injuries, said Dr. Deborah Stein at the University of University of Maryland Medical Center's shock trauma unit in Baltimore.

The Rev. Mike Murphy said the crash sounded like "one loud thump" from his room in the rectory of nearby St. Joseph's Monastery, a Catholic facility.

Murphy said the busy thoroughfare "gets kind of crazy at times."

Doreen Downs, who lives nearby, heard the crash and saw the wreckage.

"It's just horrible," she said.

Smith characterized it as an accident investigation, not a crime-scene investigation, despite the presence of homicide detectives. Smith said they were called because they are accustomed to conducting death investigations.