What is Bone Marrow Transplant?
A bone marrow transplant is a medical procedure that replaces damaged or diseased bone marrow with healthy marrow. Bone marrow, the spongy tissue found in the center of bones, is crucial for producing blood cells, including red blood cells, white blood cells, and platelets. When bone marrow fails due to conditions such as leukemia, lymphoma, or certain genetic disorders, a transplant may be necessary to restore normal function.
The procedure can be life-saving and is often a treatment option for patients whose bone marrow is unable to produce healthy blood cells due to disease, chemotherapy, or radiation. A successful transplant can provide a new source of healthy blood cells, helping to rebuild the immune system and enhance the patient’s overall health.
Indications for a Bone Marrow Transplant
splants are indicated for a variety of medical conditions, including:
- Leukemia: A cancer of the blood and bone marrow that affects white blood cells.
- Lymphoma: Cancer of the lymphatic system, which can involve bone marrow.
- Aplastic Anemia: A condition where the bone marrow does not produce enough blood cells.
- Myelodysplastic Syndromes: Disorders caused by poorly formed or dysfunctional blood cells.
- Inherited Blood Disorders: Such as thalassemia or sickle cell disease.
Types of Bone Marrow Transplant
There are two main types of bone marrow transplants:
Autologous Transplant: In this procedure, the patient’s own bone marrow or blood cells are collected, processed, and then returned to the patient after intensive treatment. This is often used for patients with certain blood cancers or disorders.
Allogeneic Transplant: This involves using bone marrow or blood cells from a donor. The donor can be a relative or an unrelated individual who matches the patient’s tissue type. This type is often used for patients with conditions that have a genetic component.
- Umbilical cord blood transplant:
The Umbilical cord blood transplant is a type of allogeneic transplant where the stem cells are extracted from a newborn baby’s umbilical cord right after his/her birth. The stem cells are then frozen and stored until a transplant is required.
Pre-Transplant Evaluation
Before undergoing a transplant, patients go through a thorough evaluation:
Medical History: A detailed history of the patient’s health, including previous treatments and current health conditions.
Physical Examination: A comprehensive exam to assess overall health and identify any potential risks.
Laboratory Tests: Blood tests are conducted to evaluate organ function, blood cell counts, and tissue typing.
Imaging Studies: X-rays or other imaging techniques may be used to assess the condition of the bones and overall body.
Finding a Donor
Bone Transplant is quite an extensive procedure that takes almost a month. Here is how the procedure flows.
For allogeneic transplants, finding a suitable donor is crucial. The donor’s tissue type must closely match that of the patient to reduce the risk of complications. This can involve:
- Family Members: Siblings or parents are often the best matches.
- National Registries: If a family member is not available, registries can be accessed to find an unrelated donor with a matching tissue type.
The Transplant Procedure
The actual transplant procedure is relatively straightforward and can be broken down into two parts:
Infusion: The collected bone marrow or blood cells are infused into the patient’s bloodstream through an intravenous line. This process is similar to a blood transfusion and typically takes a few hours.
Engraftment: After infusion, the new cells travel to the bone marrow, where they begin to grow and produce healthy blood cells. This process can take several weeks.
General Bone Marrow Transplant side-effects
Patients might experience mild to moderate side-effects that show up a few days from the day of the transplant or the conditioning. These can be in the form of,
- Diarrhea
- Mouth ulcers and sores
- Sudden Bleeding problems
- Fatigue and nausea
- In case your getting cells from a different donor, you might be prone to GVHD or Graft-versus-host disease where the new stem cells treat your body like a foreign antibody and attack.
Post-transplant care
What patients need the most after their bone marrow transplant is the love, care and support from close family members and friends. Here’re a few home care pointers to keep in mind-
- Ask your doctor for a detailed diet chart along with restrictions such as no smoking or drinking alcohol clearly mentioned.
- Avoid weight gain after your transplant procedure
- Exercise regularly to maintain your weight but make sure you do it in moderation.
- Make sure you take doctor follow-ups seriously
Complications
While bone marrow transplants can be life-saving, they also carry potential risks and complications:
- Graft-versus-Host Disease (GVHD): In allogeneic transplants, the donor’s immune cells may attack the recipient’s tissues, leading to complications.
- Infections: Due to a weakened immune system, patients are at higher risk for infections during recovery.
- Organ Damage: Chemothe*rapy and radiation can affect other organs, potentially leading to long-term complications.
FAQs on Bone Marrow Transplant
Bone Marrow Transplant requires about 3-4 weeks’ stay in hospital and about 2 months stay in India for routine follow-ups.
Only 2-4% of bone marrow donors are known to face complications after donation. However, very rare cases of long-term complications have been recorded.
Bone marrow transplant is usually done under local or full anaesthesia and hence, the procedure will be completely painless for you. However, side effects after the transplant can affect the patient and hence precautionary measures should be taken.
Only 4-6% of the donor’s bone marrow is extracted for the procedure and the body regenerates the lost amount within 4-6 weeks. The donor’s immune system is often unaffected which means your recovery rate as a donor will depend on your immune system.
The whole point of getting a bone marrow transplant is to eliminate the cancer cells (for cancer cases) or to prolong life. However, in some cases, cancer may come back and a second transplant may be recommended in such cases.
In rare cases, the patient’s immune system may reject the new stem cells which will result in transplant failure. In such cases, more donor stem cells are required for a second shot at transplant.
The donor match process is quite detailed with additional testing done to ensure the best match of the lot is selected for the procedure. The chances of finding the right match cannot be predicted as such.