Bone Marrow Transplant is the procedure of replacing damaged bone marrow with healthy tissues. The damage can be from diseases, infection, or Chemotherapy that is undertaken to combat cancer. The transplanted marrow cells help produce new healthy red blood cells and promote the growth of the marrow.
Bone marrow is the spongy fatty tissue found inside the bone cavities, which helps create red blood cells, white blood cells, and platelets. Stem cells for transplantation can be harvested if taken from the patient’s own body before proceeding with the Chemotherapy or radiation sessions.
Reasons for Bone Marrow Transplant
The following diseases necessitate replacing the unhealthy tissues with new ones-
Aplastic Anaemia – Disorder in which the bone marrow stops making new blood cells
Cancer – Conditions when the marrow replicates too fast, and the new cells are ill. These include Leukaemia, Lymphoma, and Multiple myelomas.
Damaged Marrow – Often, the diseases or Chemotherapy for cancer treatment can leave the marrow damaged and incapable of producing new cells.
Inherited Diseases –
- Congenital Neutropenia: Causes recurring infections
- Sickle Cell Anaemia: Inherited blood disorder that causes red blood cells to be produced misshapen and dysfunctional.
- Thalassemia: Here the body makes an abnormal form of hemoglobin which then aberrates normal oxygenation of the body.
Diagnosis
A final diagnosis consists of the following:
A. Personal and family history check by the doctor. The current symptoms need to corroborate with disease development.
B. Laboratory tests to detect cancerous cells. These include –
- Blood or Urine Tests
Multiple Myeloma causes a specific protein to enter into the circulation. Blood tests also help get information on kidney function, electrolyte levels, and blood cell count. - Bone Marrow Aspiration
A specialized needle is used to puncture and aspirate marrow from the bones, with the patient under Anesthesia. This small sample of bone marrow, if detected with cancerous cells when put under the microscope, helps confirm the disease diagnosis.
3. Imaging Tests
Abnormal or damaged bones can be detected with the help of
- X-ray
- CT Scan
- MRI Scan
- PET Scan
Procedure
If you are asking how is bone marrow transplant done, the following steps help understand the procedure.
- Collecting stem cells
- Conditioning the patient
- Transplant of the cells
- Postprocedural recovery
Success Rate
It depends on a number of factors.
Genetic match of the donor and the recipient
It is very difficult to get matching donors, especially from unrelated donors.
State of the engraftment
The graft needs to be regularly monitored; the engraftment usually gets complete between 10 to 28 days from the day of the transplant. A rising white blood cell count is the first sign of engraftment.
Recovery time
The typical recovery time of a bone marrow transplant is about 3 months but can take up to a year to fully recover. The recovery factors include:
- The condition/ disease that is being treated
- Chemotherapy and the extent of damage it has done to the immune system
- Radiation effects
- Donor match rate
- Postprocedural symptoms often remain with the patient for the rest of their life.
Post graft complications
Temporary Complaints:
- A drop in blood pressure
- Headache, nausea, diarrhea, vomiting
- Chills, fever
- Shortness of breath
Serious complaints:
GVHD- If the stem cells were taken from a donor, one possible risk is Graft-Versus-Host Disease.
GVHD occurs only when bone marrow from a donor is transplanted into the patient’s body. The patient’s immune system attacks the new cells since it is foreign. The reaction can be either mild or life-threatening, and complete rejection of cells is not uncommon. The after-effects can start showing up right after transplant, or for months afterward.
- Graft Failure – Transplanted cells don’t produce new cells as planned
2. Bleeding – In lungs, brain, etc.
3. Cataracts – Clouding of the lens in the eyes
4. Early Menopause
5. Damage to Vital Organs
Immunosuppressive drugs are used to combat this situation.
Outlook
The outlook varies according to what disease you are battling, what your age is, and your current state of health. People who detect cancer at the initial stages, before the disease spreads to too many organs, have a higher chance of complete cure without future remission.
Despite the best treatment and early detection, in some, the cancer is just too aggressive to control effectively; in such cases, treatment might not be as effective. Additionally, the treatments such as Chemotherapy and some of the drastic drug trials can themselves lead to serious side effects, for example, severe cases of infection or kidney failure. Thus, you need to have a comprehensive knowledge of all the treatment options available and be in sync with their treatment plan, along with their medical team.
