Bone Marrow transplant

Introduction

Bone marrow that lies within the long bones of the body is the manufacturing unit of many of the blood cells. The bone marrow cells exist as stem cells that have the potential to become any cell desired. In patients with certain blood cancers like leukemia, myelomas or lymphomas transplant of bone marrow may help in therapy. Usually these patients are treated with high doses of chemotherapy and radiation which kill the cancer cells but also destroy the bone marrow, where new blood cells are made. Thus these patients then need stem cell transplant or a bone marrow transplant to replenish the body with healthy cells and bone marrow after a rigorous round of chemo and radiation therapy.

Procedure and considerations

Patients below 55 to 60 years of age are most likely to benefit from a bone marrow transplant. Only patients with a good general physical condition and favorable diagnosis or stage of disease benefit from the process. Since the procedure may be painful and sometimes long, candidates are selected carefully. Once the chemotherapy and radiation therapy is completed the patient remains vulnerable to infections due to a very low blood cell level.

Bone marrow transplants may be of two broad types – Autologous or Allogenic. Autologous transplants usually involve bone marrow or stem cells taken from the patient’s own body and frozen during the chemotherapy and radiation courses. These are reintroduced after the rounds of chemo and radiation therapy. Allogenic transplants involve stem cells that come from another person whose stem cells match the patient’s own genetically. These commonly come from siblings or relatives. A test called the Human Leukocyte Antigen testing (HLA testing) is commonly employed to check a potential donor.

Once the type of transplant is identified the bone marrow may be collected from blood by a special procedure called harvesting. Before collection the doctors prescribe a drug to augment the bone marrow. This may cause some bone pain. The whole process usually takes two to four hours. The other process is taking bone marrow cells from a bone – usually in the hip. The surgeon inserts a needle into the bone to withdraw the bone marrow. The donor is usually given spinal or epidural anesthesia that makes them numb below waist. This takes around an hour or two in the operating room.

Once the chemotherapy and radiation therapy is completed the patient remains vulnerable to infections due to a very low blood cell level. They may need to be kept isolated in hospital cabins to prevent any infections that could be life threatening during this stage. Now the harvested cells from their own body or from the donor would be thawed and injected into them. Within some days to a few weeks the bone marrow cells will multiply to bring the blood counts to near normal. Levels would be monitored closely till then. Complete achievement of normal blood levels of blood cells may take a few months.

Bone marrow transplant is not a cure for the cancer. It is basically a method to cope with the severe shortage of white blood cells after chemotherapy and radiation treatments of various blood cancers.