What is a Bone Marrow Transplant?
Bone marrow is a fatty, spongy tissue that exists inside your bones. Bone marrow has important functions such as creating red blood cells, platelets, and white blood cells. The function of the red blood cells is to transport nutrients and oxygen throughout the body. White blood cells combat the infection that invades your body. Platelets participate in the clotting of blood. An important constituent of your bone marrow is immature stem cells. Hematopoietic stem cells (HSCs) have the potential to differentiate into other forms of mature cells. They multiply through cell division. These HSCs are responsible for producing blood cells throughout your life.
Damage and destruction to your bone marrow happen after you experience a severe infection or disease. Sometimes, your bone marrow is adversely affected after several chemotherapy sessions. In these instances, physicians may advise you to have your bone marrow transplanted. Bone marrow transplant involves transplanting stem cells of the blood. These cells travel to the bone marrow to produce new cells that help grow the new bone marrow. Bone marrow transplant causes your body to produce enough red blood cells, platelets, and white blood cells. This means your body can fight bleeding disorders, infection, and anemia.
When you Need a Bone Marrow Transplant
Your physician may choose to either get the bone marrow cells from a donor or harvest them from your body. The latter happens when you need chemotherapy for cancer. When cells are harvested from your body, they need to be stored and transplanted after your treatment. The most common reasons for having your bone marrow transplanted are cancer. This procedure can improve outcomes in many cancer types including congenital neutropenia, aplastic anemia, thalassemia, and sickle cell anemia. Besides chemotherapy, you may also require bone marrow donation and transplantation when you have other forms of bone marrow cancer. These may be lymphoma, multiple myeloma, and leukemia.
Types of Bone Marrow Transplant
The types of bone marrow transplants may be classified as allogeneic or autologous transplants. In autologous transplants, physicians use the bone marrow of the person undergoing the transplant process. Autologous transplants are generally related to radiation therapy or chemotherapy. In an autologous transplant, doctors harvest stem cells before treatment and return them afterward. The limitation of the autologous bone marrow transplant is that it is only possible when the individual has healthy bone marrow.
The other type of bone marrow transplant process is the allogeneic transplant. Allogeneic transplants require another donor who has a close genetic match with the patient. The patient’s relative is generally the allogeneic donor. In other cases, physicians consult the donor registry to treat a severe underlying condition damaging the bone marrow. Infections are a common occurrence following allogeneic transplants. Patients are administered immunosuppressants before the procedure. This ensures the patient’s immune system cells do not attack the cells of the transplanted bone marrow.
Bone Marrow Donation
Many people have the misconception that bone marrow donation is a painful process. However, this is a common myth. The process of bone marrow donation is only associated with slight discomfort and a few side effects. The donor may sometimes experience headaches, fatigue, back pain, and bruising lasting a few days or weeks.
The common method to donate stem cells is the traditional bone marrow donation process. Another process is the peripheral blood stem cells (PBSC) donation. Bone marrow donation is a surgical process in an outpatient setting. Patients are given anesthesia to carry it out. Physicians extract liquid marrow from two punctures at the back of the pelvic bone. A non-surgical procedure is used to draw peripheral blood stem cells.
A bone marrow transplant donor can return to work after about a week following the bone marrow donation. This is true when the marrow is donated non-surgically from the peripheral blood (PBSC). When the marrow is donated surgically, the patient may require about 20 days to recover fully. The bone marrow of a donor returns to normal levels after a week.
Bone Marrow Transplant Process
The process of bone marrow transplant starts with several tests required for the purpose. These tests determine the type of bone marrow cells you will require. Thereafter, it may take about a week to perform the transplant. During this time you can plan your medical insurance, travel, housing, medical leave, and the like. Before you consult with your physician, it is good to prepare a set of relevant questions. Talking to professionals in the field or counselors may also prove useful.
Immunosuppression during the bone transplant process is a significant concern. You may be required to stay in a special section of the hospital to carry out the procedure. These measures are in place to ensure that your risk of infection is reduced.
The bone marrow transplant is similar to blood transfusion. To collect the bone marrow cells, the doctor anesthetizes the bone marrow transplant donor. Bone marrow cells are collected from the hip bones using a needle. This harvesting of the cells is done a day or two before the surgery.
Another method of bone marrow transplant is leukapheresis. Leukapheresis is a process that causes the stem cells in the bone marrow to move to the bloodstream. Physicians draw blood intravenously. A machine separates white blood cells containing stem cells. The physician places a central venous catheter, a special type of needle in the upper part of the chest.
The purpose of the needle is to allow a fluid with the new stem cells to flow into the heart. Thereafter, stem cells reach all parts of the body when the heart pumps out the blood. The stem cells start growing afterward. Physicians repeat this process over several days. The catheter stays in place for that period. This process of assisting stem cells to grow inside the body is known as engraftment. Liquids, nutrients, and blood transfusions are also supplied through this catheter. The catheter is also used to monitor infections and subsequent complications.
The process of engraftment takes anywhere between 10 and 28 days following a transplant. Patients experience a rise in white blood cells. This happens because the transplant leads to the production of new red blood cells. Patients can recover three months after the transplant. Sometimes, it may take up to a year to recover completely. The differences in the recovery process are due to the type of your condition and the nature of the transplant. Other factors that affect recovery time include donor match, radiation, and chemotherapy.
Bone Marrow Transplant Risks
The bone marrow donation process and subsequent transplantation have several risks. You may experience a headache, pain, nausea, fever, chills, low blood pressure, and shortness of breath. These complications are subject to several other factors. These may be your health status, age, disease type, and transplant type. In more severe cases bone marrow transplant risks may also include the development of mucositis. In some cases, inflammation of the throat, mouth, and stomach, cataracts, or anemia may occur. You may also experience graft-versus-host-disease, early menopause, or damage to vital organs. Some individuals may also experience bleeding in the brain, lungs, and other parts of the body. Diarrhea, nausea, and vomiting are also common complications.
Bone marrow transplant is a recommended process and the only treatment for certain conditions. Replacing your damaged bone marrow cells with healthy stem cells can save lives. Bone marrow donors are integral to the success of this process. In many cases, they may have to be educated so that they understand the risks and facts. When the protocol for bone marrow transplant is followed, it can address many types of cancers and conditions that are otherwise extremely hard to treat through traditional and pharmacological means.
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