Bone marrow transplantation, also called hematopoietic stem cell transplantation is a surgical practice in which healthy cells from the marrow, are infused into another patient’s diseased or damaged bone marrow. For the patients who are suffering from some other kinds of cancer, bone marrow transplantation can be used to treat them as well.
Hematopoietic stem cell transplantation has two major types, which are:
● Autologous hematopoietic stem cell transplant – The bone marrow is harvested from the patient’s body itself and injected where the treatment is required
● Allogeneic hematopoietic stem cell transplant – In this method, from a donor, the cells are harvested
Bone marrow transplantation is usually performed for the patients who:
● Need high doses of radiation or chemotherapy
● Need to replace damaged or diseased marrow
● Need new healthy stem cells which can kill cancer cells directly, without other treatments
For the patients who are suffering from the listed conditions, bone marrow transplant practice is recommended:
● Acute leukemia
● Aplastic anemia
● Chronic leukemia
● Hodgkin's lymphoma
● Inborn errors of metabolism
● Plasma cell disorders
● Immune deficiencies
For the patients who are suffering from advanced stages of cancer, bone marrow transplantation is not suggested. For bone marrow transplant operation, the patient must be in an overall good state of health. This operation is generally performed when the disease is in remission.
A couple of days before the bone marrow transplant operation, the patient needs to stay in the hospital. To the patient’s larger veins in the chest area, a special tube is inserted. This tube is very important for the bone marrow transplant operation, which will be performed later.
With the use of the tube, blood samples would be gathered, and some drugs would be given to the patient. After, large doses of chemotherapy are administered to the patient. Occasionally radiation is used as well. To eliminate diseased or damaged stem cells in the marrow, chemotherapy is used. Also, with chemotherapy, it is ensured that the patient’s body would not reject the new stem cells when they are infused into the patient. Once these steps are completed, the real bone marrow transplant operation starts.
There are two stages of hematopoietic stem cell transplantation operation that are:
During this procedure, to the patient or donor, general anesthesia is administered. After that, the doctor would induce a needle deep into the hip bone and extract the marrow into a syringe. The sternum can also be used to harvest marrow. The doctor will proceed to repeat the process until around a liter of marrow is harvested – the marrow will then be subjected to chemotherapy if it is harvested from the patient and not a separate donor. This way, it can be ensured that the marrow is completely healthy.
The process generally takes about an hour. After, the marrow would regenerate in a couple of weeks.
The transplant stage is very similar to a blood transfusion procedure. The pre-inserted tube that is in the patient’s body is used to inject the bone marrow cells straight into the bloodstream. Once these cells are injected, they will slowly find their way to the patient's own bone marrow and begin producing platelets, white blood cells, and red blood cells.
The transplant process generally takes an hour. During this process, some patients might feel nausea or headaches.
The recovery period of bone marrow transplant is different for the donors and the recipients. On average, the donors would return to their daily activities and work in 1-7 days. The marrow would regenerate in a couple of weeks.
For the recipient, the recovery period is much longer, which is around 6-12 months. Most of the complications happen in the first 100 days after the bone marrow transplant operation.
Bone marrow transplant procedure has some complications that involve:
● Graft failure● Graft vs. host disease
● Serious infection after chemotherapy
There are several side effects of bone marrow transplant, such as:
● Intestinal cramps
● Hair loss
● Skin rashes
The average success rate of bone marrow transplant is 69% for the patients with an unrelated donor and 79% for the patients with a related donor.
Around 85% of the patients who had hematopoietic stem cell transplantation, their life expectancy is improved by 10 or more years.
– What is graft vs. host disease?
In this condition, the donor marrow cells assault the recipient’s body.
– Does a marrow donor face any risks?
Usually no, the risks are only related to the use of general anesthesia.
– What are the chances of having a donor in my family?
The rate of patients who do not have a donor in their family is around 30% - 70%.
This content is written and reviewed by our medical content team in October, 2019.