Bone marrow transplant

A bone marrow transplant is aimed at delivering healthy bone marrow stem cells into a patient. Should somebody have bone marrow that is either not working or that has been destroyed by radiation or chemotherapy, this can be replaced via a transplant. Bone marrow can best be described as the soft, fatty tissue that is found inside your bones. The stem cells are the immature cells that are contained within your bone marrow and are able to give rise to all your blood cells. Your blood is actually made from red blood cells, which will carry oxygen directly to your tissues, white blood cells, which are intended to fight against infection, and platelets which will help your blood to clot.

For someone who is undergoing a bone marrow transplant, they will typically receive healthy stem cells after their own (damaged) bone marrow has been destroyed. Bone marrow transplants come in three separate forms and these are:

  • Autologous bone marrow transplant – this form of transplant will remove a patient’s stem cells prior to chemotherapy or radiation treatment. Once the chemotherapy or radiation treatment is completed, the stem cells will be returned to the body. This will typically allow a person to receive extremely high doses of both chemotherapy and radiation.
  • Allogeneic bone marrow transplant – this is where stem cells are given to a patient from a donor. The majority of the time a donor should have the exact same genetic typing as the patient as this will allow their blood to match. This will involve sample blood tests and typically a patient’s siblings will have the best chance of being a good match. However, you may find that other members of the family can also be a good match. There are, of course, donors who are not related to a patient and these people will usually be found through a bone marrow register.
  • Umbilical cord blood transplant – this will involve removing the stem cells from an umbilical cord immediately after a baby has been delivered. The stem cells will then need to be tested, counted and frozen until they are required for transplant purposes. This form of bone marrow transplant is far less complicated when it comes to matching as the stem cells are extremely immature.

You will actually find that many patients receive an extremely high dose of chemotherapy or radiation prior to a bone marrow transplant. This is often referred to as ablative treatment. It is typically used to kill any remaining cancer cells and can therefore make room for new stem cells to grow inside the bone marrow. There are even certain patients who receive less chemotherapy and radiation prior to transplant and this is referred to as reduced intensity transplant. Once chemotherapy and radiation has been completed and a stem cell transplant will involve adding cells via a tube called a central venous catheter. The process is actually extremely similar to receiving a blood transfusion as the cells go directly into the bloodstream and then make their own way to the bone marrow. In these circumstances, surgery will not be required.

A patient will display certain symptoms when they are receiving stem cells and these will include pain, chest pain, a drop in blood pressure, chills, fevers, nausea, flushing, headache, shortness of breath and a funny taste in the mouth. Bone marrow or stem cell transplants are typically recommended for certain cancers such as leukaemia, multiple myeloma and lymphoma. There are also certain illnesses where the bone marrow is unable to produce the correct kind of cells and these include sickle cell anaemia, thalassaemia, severe immunodeficiency syndromes, Aplastic anaemia and congenital neutropenia.

There are, of course, certain risks from having a bone marrow transplant and these are affected by certain factors. These factors include the actual disease that you have, how old you are, how healthy you are, what type of treatment you have undergone prior to bone marrow transplant, how good a match your donor is and the exact type of bone marrow transplant you will be having. Complications that may arise from a bone marrow transplant include bleeding, infections, anaemia, pain, diarrhoea, vomiting, nausea, damage to the heart, liver, kidneys and lungs, cataracts and early menopause. You will also find that children who undergo bone marrow transplants may suffer from delayed growth.

Prior to undergoing a bone marrow transplant you will require a physical examination and your health care provider is likely to ask many questions about your health. You also need certain tests to be carried out before your course of treatment begins. It is extremely important that you discuss the emotional stress of a bone marrow transplant with either your doctor or nurse. You may often be referred to a mental health counsellor and it is advisable to discuss the procedure with your family. A bone marrow transplant will usually be conducted in a hospital or a specialised medical centre. The majority of patients will be hospitalised for at least 4 to 6 weeks and you will be closely monitored during this time.

Last updated on Feb 13th, 2011 and filed under Other Conditions & Diseases. Both comments and pings are currently closed.

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