Bone Marrow Transplant

Bone Marrow Transplant

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Bone Marrow Transplant

What is Bone Marrow?

Bone marrow is spongy tissue found within the centre of the bones. In birds and mammals, bone marrow acts as the primary source of new blood cell production. In adult humans, bone marrow is primarily located in the ribs, vertebrae, sternum, and bones of the pelvis. This sponge tissue produces immature blood forming cells; called as stem cells, which rapidly multiply through constant division and mature into red blood cells (carry oxygen and nutrients), white blood cells (fight infection) and platelets (clot formation).

What is Bone Marrow Transplant?

Bone Marrow Transplant is a medical treatment procedure wherein the doctors replace the damaged or destroyed bone marrow due to infection, disease or any other cause. The procedure involves the harvesting of healthy stem cells and transplanting them in the damaged / destroyed bone marrow which promotes formation of blood cells and growth of bone marrow.

 

Bone Marrow Transplant may be done in three ways:

  1. Autologous Bone Marrow Transplant- The term auto implies self. Stem cells are removed from the patient himself followed by high-dose chemotherapy or radiation treatment to kill any cancer cells or remaining healthy bone marrow thereby allowing the new bone marrow to grow through transplanted stem cells.
  2. Allogeneic Bone Marrow Transplant- The term auto implies other. Stem cells are removed from another person, called a donor. However, the donor's genes must at least partly match patient’s genes. Generally a brother or sister is more likely to be a good match. Parents, children, and other relatives of patients also turn out to be good matches.
  3. Umbilical Cord Blood Transplant- In this kind of transplant, stem cells are taken from a new born baby's umbilical cord right after birth. Thereafter the stem cells so harvested are frozen and stored till such a time when they would be required for transplant. Umbilical cord blood cells beingvery immature don’t require perfect matching. However, due to the lesser number of stem cells, in this type of transplant blood counts take much longer to recover.

 

A patient may require a bone marrow transplant if he/she has:

  1. Cancers; such as leukemia, lymphoma, myelodysplasia, or multiple myeloma.
  2. Any disease that adversely affects the production of bone marrow cells; such as aplastic anemia, congenital neutropenia, severe immune system illnesses, sickle cell anemia, or thalassemia.

Donor Stem Cells can be harvested in two ways:

  1. Bone Marrow Harvest- It requires a minor surgery and is done under anesthesia. The donor shall remain asleep during procedure and shall not feel any pain. The bone marrow is removed from the back of both the hips and the amount of bone marrow required to be extracted from the donor, it depends of the weight of the patient requiring the bone marrow.

 

  1. Leukapheresis- under the procedure, the donor is kept under medication to shot up the level of stem cells from bone marrow to the stream. Thereafter, blood is removed from the donor through IV line and part of the white blood cells containing stem cells is separated in a machine and the red blood cell is returned to through the IV line simultaneously.

 

Bone Marrow Transplant may cause any of the following symptoms:

  • Pain in chest.
  • Fall in blood pressure.
  • Fever, flushing chills.
  • Funny taste in the mouth.
  • Headache.
  • Hives
  • Nausea.
  • Shortness of breath.

 

Pre-Procedure

You would be asked about your medical history and would have to undergo physical exam. You will have many tests as under:

  • Electrocardiogram (ECG) – to check your heart's rhythm and electrical activity.
  •  Echocardiogram – to look at the heart and nearby blood vessels.
  •  X-ray or  CT scan- to check the condition of organs such as the lungs and liver.
  • Pulmonary Function Test- to determine if there is any problem with patient’s lungs. The quantity of air inhaled and exhaled by patient is measured along with how quickly it’s exhaled.
  • Blood Tests -to check the level of various blood cells and assess the wellness of the liver and kidneys patient.
  • Biopsy- to evaluate the present condition of patient’s bone marrow.
  • Before transplant, you will have 1 to 2 tubes, called catheters, inserted into patient’s blood vessel in the neck or arms. This tube allows the patient to receive treatments, fluids, and sometimes nutrition. It is also used to draw blood.

 

Post-Procedure

Bone Marrow Transplant is usually done in a hospital or medical center that specializes in such treatment. You would be required to stay in a special bone marrow transplant unit in the center. This is to limit your chance of getting an infection. Depending on the treatment and where it is done, all or part of an autologous or allogeneic transplant may be done as an outpatient. This means you do not have to stay in the hospital overnight.

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