The bone marrow transplant is a major clinical procedure, used to rectify unhealthy stem cells. It is also known as stem cell transplant. This transplant procedure is very effective as well as very useful to replace faulty stem cells with healthy ones.
What is bone marrow?
Bone marrow is soft, spongy, and fatty tissue. It is mainly located in the medullary cavities of the long bones like hip and thigh bone. Also, bone marrow acts as the origin of red blood cells, white blood cells, and platelets.
Some immature hematopoietic stem cells are produced from it. When these hematopoietic cells become mature, they flow in your blood.
Why do we need a bone marrow transplant?
Bone marrow transplant is done when the person’s marrow doesn’t work properly. It means the marrow is unable to produce healthy stem cells. This may give you an impaired immune system and be susceptible to various infections.
Behind the transplantation, there are several reasons such as,
- Sickle cell anemia
- Severe blood disease such as thalassemia, aplastic anemia
- Damaged bone marrow due to congenital neutropenia
- Some types of cancer like leukemia, lymphoma, multiple myeloma, sarcoma
- Germ cell tumor
- Hodgkin’s or non-Hodgkin’s lymphoma
- Waldenstrom macroglobulinemia
What does transplantation do to your body?
The main role of bone marrow transplantation is quite different from others. It is a critical procedure. but, the results are very satisfactory and provide you a permanent cure.
Its functions are like;
- Replace the damaged stem cells that are destroyed by chemotherapy.
- It replaces the diseased bone marrow that is unable to produce its own stem cells.
- The transplantation helps to detect and kill cancerous cells.
Types of a bone marrow transplant
It is of two types;
Umbilical cord transplant
Parent-child transplant and haplotype mismatched transplant
In an autologous transplant, the stem cells are collected from your own body.it is very necessary after cancer treatment. The high dose of chemotherapy and radiation therapy damaged the cells.
So, doctors reserve your stem cells from blood or bone marrow. They are restored before the chemotherapy begins.
After chemotherapy, the stem cells are inserted into the body. These stem cells help your body to enhance your immunity and produce normal blood cells. That’s why the process is called autotransplant stem cell rescue.
In an allogeneic transplant, the stem cells are collected from a person other than himself. Here the donor plays a vital role in this procedure.
The donor stem cells are inserted inside the patient after the patient received a high dose of chemotherapy or radiation therapy. This is also called an allo transplant.
Points to be noted,
The donor cells are mainly taken from the siblings from the same parents. Other family members and unrelated volunteers can be a match too.
If the donor stem cells are not matched with the patient then it shows graft versus host disease.in this condition, the healthy transplant cells attack your cells.
What are other types of bone marrow transplant?
The allogeneic transplant are also various types
Umbilical cord transplant
In this type of transplant, stem cells are collected from umbilical cord blood. Cancer centers around the world used this umbilical cord blood for later use.
parent-child transplant and haplotype mismatched bone marrow transplant
Parents have 50% matched blood protein with the child. It is used more often when the siblings don’t have a similar match. It is a more effective bone marrow transplant to treat cancer.
How to prepare for a bone marrow transplant?
Before you undergo a bone marrow transplant, you have to do several tests. Here the tests help you to find out the type of marrow your body needs.
Also, take chemotherapy or radiation therapy before the transplant to kill all the cancer cells. This procedure takes up to a week. Therefore, make some steps like;
- Complete an advance care directive
- Take care of bank and financial treatment
- Arrange for care of your children
- Arranging travel to and from the hospital
- Packing clothes and other necessities
- Insurance coverage, payment of bills, and other financial concern
- Housing near the hospital for your loved ones
How are the stem cells collected?
The stem cells are collected in two ways from the donor. These are,
Bone marrow harvest
It is a minor surgery. It is done by giving general anesthesia to the donor. After that bone marrow is removed from the donor’s hip bone. Here the amount of bone marrow removal is dependent upon the marrow receiver (patient) weight.
In leukapheresis, stem cells are collected from the donor intravenously. It is the collection of donor white blood cells that contain stem cells. they are separated in a machine and given to the patient. Lastly, the red blood cells are returned to the blood.
How does it perform?
Bone marrow transplant is a procedure similar to blood transfusion. So, when you’re ready for transplant, a small tube is inserted into the patient’s chest. It is called a catheter.
If you are having an allogeneic transplant then bone marrow is harvested then inserted into your body. This procedure takes a day or two. But, in the case of autologous transplants, they will be collected from the stem cell bank.
What to do after the procedure?
After the transplant, you have to go under close observation. And you will have to stay in a special bone marrow transplant unit. This may help to reduce your chance of getting infections.
In an allogeneic and autologous transplant as an outpatient, you don’t have to stay in the hospital overnight. But, your stay depends on the complications related to transplant, types of transplant, and your medical center’s procedures.
What do health care members do after bone transplantation?
They closely monitor your blood count and vital signs. They give medicine to prevent GVHD and various infections. The medications are antibiotics, antifungal, antiviral, etc.
Also, they will observe if you need a blood transfusion or not. And give intravenous fluid until you eat by mouth.
Some short–lived complications are like,
- A sudden decrease in blood pressure
- Mild headache
- Shortness of breath
Mild to the severe complication is
- Graft-versus-host disease
- Graft failure
- Bleeding in lungs, liver, and brain