A bone marrow transplant (BMT) is needed when the bone marrow stops working or doesn’t produce enough healthy blood cells. Bone Marrow is the spongy tissue present in the cavities created by the cancellous arrangement of the core of our bones. They are responsible for the production of various blood cells and platelets.
Bone Marrow is found in the large bones of the body such as the hip, thigh, shoulder blade, and breast bone. They are also found in the skull, spine, and ribs. It plays a vital role in the body’s immune response and blood cell production.
When the bone marrow gets damaged or diseased, it results in low blood cell production and a weak immune response. To treat the issue, a bone marrow transplant is carried out in which healthy stem cells from a donor are infused into the patient’s body. For this reason, it is also called a stem-cell transplant.
The main objective of bone marrow transplant is to transfer hematopoietic cells from a healthy donor by extraction or harvesting, and infusion into a diseased person. The process though sounds simple, in reality, is complex. To carry out the process, the patient is first admitted to a special aseptic area in the hospital which is HEPA (high-efficiency particulate air) filtered. The area is a highly sterilized environment where the patient is kept for 3-4 weeks.
The different types of bone marrow/stem cell transplants are:
Autologous transplantation. Stem cells for this transplant come from the patient’s body. Cancer is sometimes treated with high-dose, intensive chemotherapy, or radiation therapy. This type of treatment can damage your stem cells and immune system. Therefore, before starting cancer treatment, doctors remove or preserve stem cells from your blood or bone marrow.
Allogeneic bone marrow transplant. The donor and patient have the same genetic profile. Stem cells can be collected through bone marrow extraction or apheresis, typically from a sibling who matches the patient genetically. Other donors may include parents, unrelated bone marrow transplants (UBMT), or (MUD)for a matched unrelated donor.
Cord blood transfusion. Stem cells are taken from the umbilical cord immediately after birth. Compared to stem cells extracted from the bone marrow of another child or adult, these stem cells develop into mature, functioning blood cells more quickly and effectively. When necessary for transplantation, stem cells are counted, typed, and tested before being frozen.
The stem cell transplant procedure usually involves several steps, including:
The bone marrow transplant procedure can cause side effects and it can take several weeks or months for the patient to fully recover. The success of a stem cell transplant depends on several factors, including the general health of the patient, the stage of the disease, and the type of stem cells used.
Bone marrow transplantation is used to treat many diseases and cancers. If the doses of chemotherapy or radiation therapy is given to treat cancer are so high that a person's bone marrow stem cells are prominently damaged or destroyed as a result of the treatment, a bone marrow transplant may be required. A bone marrow transplant may also be necessary if some disease has killed the bone marrow.
A stem cell transplant is used:
Peripheral blood stem cell donation and bone marrow donation are the two basic ways to donate bone marrow.
The most frequent type of donation is peripheral blood stem cell donation (PBSC). Giving a donor a drug that raises the quantity of blood-forming cells in their bloodstream is a non-surgical approach. Then, similar to donating blood, these cells are harvested via a procedure called apheresis.
In bone marrow donation, a needle and syringe are used to extract bone marrow straight from the donor's hip bone. Under general anaesthesia, the treatment is carried out, and the donor often stays in the hospital for one or two days to recover. Compared to PBSC, this technique is less popular. The bone marrow transplant cost is not fixed and varies from country to country and also on health providers.
Complications may vary depending on the following factors:
These complications can also occur alone or together: