Bone Marrow Transplant

Overview

Bone marrow transplant is the procedure that involves replacement of the damaged stem cells due to infection, disease or chemotherapy with the healthy stem cells from a donor or from the patient’s own body. It is the best option for patients whose bone marrow is not healthy enough to perform its various functions properly.

Let’s first understand little bit about bone marrow and its functioning before moving to bone marrow transplant.

What is Bone Marrow?

Bone marrow is the spongy, soft and fatty tissue inside the bones that is responsible for making and storing of blood cells including RBCs, WBCs and platelets. These components of blood have life-maintaining functions and are important to avoid any sort of infections, bleeding disorders, or anemia.

Why is Bone Marrow Transplant required?

A bone marrow transplant is required in patients whose bone marrow is damaged and could not make normal blood cells like RBC, WBC and platelet. RBCs are important as they carry oxygen to the tissues in the body. WBCs are responsible to fight against any infection while platelets are important for blood clotting. Inability of the bone marrow to form normal blood cells can lead to various life-threatening disorders. In such conditions, it becomes necessary to transplant the bone marrow so that healthy cells can be formed for proper body functioning.

What conditions require Bone Marrow Transplant?

Bone marrow transplant is required if the bone marrow becomes diseased and could not perform its function of making blood cells. This can occur due to various reasons like cancer or cancer treatment, chronic infection or disorders. There are a variety of bone marrow disorders that may require a bone marrow transplant, like:

- Aplastic anemia
- Sickle cell anemia
- Thalassemia
- Bone marrow damage due to chemotherapy
- Some bone marrow affecting cancers like lymphoma, leukemia, neuroblastoma and multiple myeloma
- Congenital neutropenia
- Other immune system or genetic diseases

The procedure

Bone marrow transplant is done by a team of expert surgeons and specialist doctors. The stem cells from transplant can come from the patient itself or from the donor who is a close match of the patient.

Transplant Evaluation Process

Once the patient decides to undergo bone marrow transplant, various tests are done before transplant to ensure the safety of the procedure and find out the eligibility of the patient for the transplant. These tests are also required to find out the type of bone marrow transplant the patient can undergo. Some of the major tests done are:

- Chest X-ray
- Computed tomography (CT scan) of the chest
- Spirometry
- Pulmonary function tests
- Coronary artery catheterization
- Electrocardiogram
- General metabolic laboratory tests
- Coagulation studies
- Complete blood count
- Bone mineral density test
- Colonoscopy
- Pap smear and mammogram (women) etc.

Transplant Surgery

The bone marrow transplant is a procedure that is like blood transfusion. It may be required to give chemotherapy, radiotherapy or both before the transplant to kill any remaining bone marrow cells, so that new cells can grow easily.

Depending upon the donor, the bone marrow transplant is of following three types:

Autologous bone marrow transplant: Auto means self and in autologous bone marrow transplant, stem cells from patient’s own body are removed and stored in a freezer. The patient is given high-dose of chemotherapy or radiotherapy. After this, patient’s stored stems cells are placed back in his body so that new normal blood cells can be formed. This is also called a rescue transplant.
Allogeneic bone marrow transplant: Allo means other and in allogenic bone marrow transplant, stem cells from another person (donor) are transplanted to the recipient. In most of the cases, the donor is brother/sister/parent/children/family member of the recipient. This is because the donor’s genes must at least partly match with the genes of the recipient. However, the donor can be any person who is not part of the family of recipient but matching of genes (partly) is important for successful transplant. Once donor decides to donate stem cells, special tests are done to find out if the donor is a good match for transplant. This requires following tests
Blood Type Testing
Tissue Typing
Crossmatch
Serology

These tests are required to match a donor to the recipient and transplant is planned only after confirming the match. Donor stem cells can be collected in the following two ways:

- Bone marrow harvest: This a minor surgery in which donor is given general anesthesia and his bone marrow from the back of both hip bones is removed for transplantation into the recipient.
- Leukapheresis: In this method, donor is given shots for several days so that the stem cells move to blood from bone marrow. Then, through an IV line, blood is removed from the donor. This is followed by separation of part of WBCs that contain stem cells from the collected blood. The left out blood containing RBCs is returned to the donor
- Umbilical cord blood transplant: Umbilical cord blood transplant is a type of allogeneic transplant. In this transplant, the stem cells from the newborn baby’s umbilical cord are removed and saved soon after the birth. These stem cells are frozen and stored till the time they may be required for transplant.

Post-transplant care

Recovery of patient after bone marrow transplant may take few weeks
Patient is given antibiotics and other antirejection medications for several weeks to prevent any kind of infection or graft-versus-host disease
Blood transfusion can also be done if required
Patient is given IV feeding for few days
Patient can move around some time after the procedure
If everything goes well, recipient can go home in about one week after the procedure

Benefits of Bone Marrow Transplant

A successful bone marrow transplant is defined by increase in the blood count levels or control of disease/cancer. In most of the cases, transplant can increase the survival of the patient. It can partially or in some cases completely cure the illness of the patient. Within one year after transplant, patient can resume all the major daily activities and feels far better than before.

Complete or partial cure of the illness
Increased chances of survival and adds years to the life of sufferer
After bone marrow transplant, patient can usually go back to normal activities within one year
Improved quality of life of the person

Results of Bone Marrow Transplant

Why NICE ?

We are associated with the best hospitals globally having the emergency infrastructure, fully equipped with the latest technologies and techniques to overcome from every emergency condition.
Our team of doctors are highly experienced in ‘Emergency Patient Management’ and work together to save the patient.
Consultation from doctors through e-mail, phone, and video calling.
Rehabilitation programs are organized to assist complex surgery patients.
Complete support and assistance being given before and after treatment.
Cost of treatment is quite less as compared to other service providers.
We are always ready to offer our helping hand and our services are available 24/7.