Bone marrow transplantation, also known as hematopoietic stem cell transplantation is a surgical procedure where healthy cells from the marrow,
Bone marrow transplantation, also known as hematopoietic stem cell transplantation is a surgical procedure where healthy cells from the marrow, are infused into another patient’s diseased or damaged bone marrow. Bone marrow transplantation can also be used to treat patients suffering from certain types of cancer.
There are two main types of hematopoietic stem cell transplantation:
● Autologous hematopoietic stem cell transplant – The bone marrow is harvested from the patient’s own body and injected where it is needed
● Allogeneic hematopoietic stem cell transplant – The cells are harvested from a donor
Bone marrow transplantation is mainly used to help patients that:
● 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
A bone marrow transplant procedure is recommended for patients suffering from:
● Acute leukemia
● Aplastic anemia
● Chronic leukemia
● Hodgkin's lymphoma
● Inborn errors of metabolism
● Plasma cell disorders
● Immune deficiencies
● And others
Bone marrow transplantation is not recommended for patients in the final stages of cancer. The patient needs to be in a good state of health for this procedure. The bone marrow transplant procedure is usually performed when the disease is in remission.
The patient will need to be submitted to hospital a few days before the bone marrow transplant is set to begin. A special tube is inserted into one of the patient’s larger veins in the chest area. This tube is essential for the bone marrow transplant procedure, which will be performed later.
Blood samples are collected through the tube and the patient will be administered certain necessary drugs. Large doses of Chemotherapy are then administered to the patient. Sometimes radiation is also used. Chemotherapy is used to destroy diseased or damaged stem cells in the marrow. The chemotherapy also ensures that the patient won’t reject the new stem cells when they are infused into the body. Once these steps are performed, the actual bone marrow transplant procedure can begin.
The hematopoietic stem cell transplantation procedure can be divided into two separate stages:
General anaesthesia is administered to the patient or donor. The doctor will then introduce 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 litre 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 will ensure that the marrow is fully healthy.
The procedure usually lasts about an hour. The marrow will then regenerate in a few weeks.
The transplant stage of the bone marrow transplant procedure is very similar to a blood transfusion. The patient’s pre-inserted tube is used to inject the bone marrow cells directly 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 usually lasts about an hour. Some patients may feel nausea or headaches during this stage of the bone marrow transplant.
The bone marrow transplant recovery period is different for donors and recipients. The average donor can return to normal activities and work in 1 to 7 days. The marrow will regenerate in a few weeks.
The recovery time for the recipient is much longer, between 6 and 12 months. Most complications occur in the first 100 days after the bone marrow transplant procedure.
Bone marrow transplant complications can include:
● Graft failure
● Graft vs host disease
● Serious infection following chemotherapy
Bone marrow transplant side effects can include:
● Intestinal cramps
● Hair loss
● Skin rashes
The average bone marrow transplant success rate is 69% for patients with an unrelated donor and 79% for patients with a related donor.
Around 85% of patients that underwent hematopoietic stem cell transplantation improve their life expectancy by 10 or more years.