Bone Marrow Transplant

Bone marrow is the soft, fatty tissue inside your bones. The bone marrow produces blood cells. Stem cells are immature cells in the bone marrow that give rise to all of your different blood cells. A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Doctors perform bone marrow transplants from healthy, matching marrow to treat this disease; this is done so that new stem cells may be cultivated. Marrow is extracted from the breast bone, or the hip, skull, spine or rib – these are found to contain stem cells that produce leukocytes, erythrocytes and platelets.
The procedure is required for treating several cancerous and non-cancerous conditions like leukemia, multiple myeloma, thalassemia and several others.

There are 3 kinds of bone marrow transplants:
Autologous bone marrow transplant: The term auto means self. Stem cells are removed from you before you receive high-dose chemotherapy or radiation treatment. The stem cells are stored in a freezer. After high-dose chemotherapy or radiation treatments, your stems cells are put back in your body to make normal blood cells. This is called a rescue transplant.
Allogeneic bone marrow transplant: The term allo means other. Stem cells are removed from another person, called a donor. Most times, the donor’s genes must at least partly match your genes. Special tests are done to see if a donor is a good match for you. A brother or sister is most likely to be a good match. Sometimes parents, children, and other relatives are good matches. Donors who are not related to you, yet still match, may be found through national bone marrow registries.
Umbilical cord blood transplant: This is a type of allogeneic transplant. Stem cells are removed from a newborn baby’s umbilical cord right after birth. The stem cells are frozen and stored until they are needed for a transplant. Umbilical cord blood cells are very immature so there is less of a need for perfect matching. Due to the smaller number of stem cells, blood counts take much longer to recover.

BMT is required for following conditions-
Blood cancers-

  • Acute Lymphoblastic leukemia (ALL)
  • Chronic Myeloid Leukemia (CML)
  • Acute Myeloid Leukemia (AML)
  • Multiple Myeloma
  • Hodgkin Lymphoma
  • Non-Hodgkin Lymphoma
  • Myelodysplastic syndrome

Non Cancerous Conditions-

  • Thalassemia, sickle cell anemia, transfusion dependent anemia
  • Aplastic anemia
  • Fanconi anemia, pure red cell aplasia
  • Metabolic disorders
  • Immunodeficiency states

Risk involved in the procedure-
Bone marrow transplant is a complex procedure that carries significant risks of serious complications.

The risks are reduced:

  • If patient is young – studies have shown the younger you are, the more likely the treatment is to succeed.
  • If patient receive stem cell donation from a sibling (brother or sister).
  • If patient have no serious health conditions (apart from the condition you’re being treated for).

The major problem with stem cell transplants is the recipient’s ability to withstand high doses of chemotherapy (and sometimes radiotherapy), which are often needed before the transplant.