Bone marrow transplant is a vital procedure performed on patients whose bone marrow has been damaged or exhausted due to an underlying disease, infection or treatments like chemotherapy and radiation therapy. The procedure was developed nearly half a century ago, yet it continues to be a gold standard option for treating a wide gamut of blood-related malignancies. The procedure is also known as stem cell transplant as it is not the bone marrow, but rather the stem cells that are collected and transplanted into the body of the recipient to facilitate the growth of new blood cells and platelets.
Bone marrow transplant is broadly classified into two types – Autologous transplant and Allogeneic transplant. The former procedure involves the collection of the patient’s stem cells and preserving them to be used later whereas the latter involves the collection of stem cells from a suitable donor.
Major indications of Bone Marrow Transplant
Bone marrow transplant is performed to treat a broad spectrum of malignant as well as benign medical conditions. Here are some major indications that might call for the need of a bone marrow transplant:
Bone marrow failure syndromes
Inborn errors of metabolism
Plasma cell disorders
Apart from all these conditions, a bone marrow transplant is also performed on patients who are undergoing chemotherapy, radiation therapy or any other drug therapy that destroys the healthy cells and tissues along with the malignant ones.
How to prepare for the procedure?
Before undergoing the procedure, you will be required to undergo certain tests and screenings so as to assess and evaluate your overall health. This is important to ensure that you are physically prepared for the procedure. An intravenous catheter (central line) will also be introduced in a large vein of your neck. This is used later on for infusing the new stem cells and medicines into the patient’s body.
How is the procedure performed?
The procedure starts with the collection of healthy stem cells
Autologous transplant –The procedure is usually performed on patients undergoing high dose chemotherapy. The patient is given regular injections of growth factor to enhance stem cell production and move these cells into your bloodline so that these can be easily collected. The patient is then required to undergo a procedure known as apheresis in which the blood is drawn out from the patient’s body and circulated to separate the stem cells from the other components. These stem cells are preserved to be returned to the patient’s body post-chemotherapy.
Allogeneic transplant –In this case, there is a need for b a suitable donor who is willing to donate his/her stem cells. These can be collected either from the donor’s blood or bone marrow. Cord blood transplant may also be performed in which the stem cells are taken from the umbilical cord of babies right after birth and then stored to be used later. The baby’s mother can choose to donate the umbilical cords right after their delivery.
This is then followed by the conditioning process
The patient is subjected to chemo or radiation therapy
To kill all the malignant cell
To suppress the patient’s immune system
Prepare the bone marrow for the transplant of new stem cells.
The intensity of the conditioning therapy varies from one patient to another depending upon their health history and age.
The final step is the transplant
The collected stem cells are infused into the patient’s body via the intravenous catheter or central line. These stem cells travel to the bone marrow via the bloodline and gradually multiply to facilitate the production of healthy blood cells. This process is known as engraftment. It may take a few weeks for your blood count to return back to normal.
What follows after Bone Marrow Transplant?
After the bone marrow transplant, the patient will be kept under keen medical supervision and may be discharged within a few days or even a week depending upon how well he/she is responding to the treatment. In certain case, the patient might require periodic transfusion of red blood cells and platelets until the bone marrow starts producing these on its own.
Also, it is pertinent to understand that the immunity of the recipient is significantly compromised for the first few months following the transplant, hence it is important to take extra precautions.
The patient is required to make certain healthy lifestyle and dietary changes and restrict alcohol intake.
What are the benefits of Bone Marrow Transplant?
The goal of the bone marrow transplant depends upon the condition of the individual but there are certain benefits that are common to all. These include:
Better quality of life
Longer life span
Relief from symptoms
Are there any risks involved?
Some of the major risks associated with bone marrow transplant include: