Bone Marrow Transplant: A Comprehensive Guide
Bone marrow
transplantation, also known as a stem cell transplant, is a medical procedure
that replaces damaged or diseased bone marrow with healthy bone marrow cells,
also known as stem cells. Bone marrow is the soft and spongy tissue located in
the center of bones that produces blood cells, including red and white blood
cells, and platelets.
Indications for Bone Marrow
Transplant
Bone marrow
transplants are used to treat a variety of conditions that affect the blood and
immune system, including:
Blood cancers: Leukemia, lymphoma, and multiple myeloma.
Inherited blood disorders: Sickle cell anemia, thalassemia, and aplastic
anemia.
Immune system disorders: Severe combined immunodeficiency (SCID) and
Wiskott-Aldrich syndrome.
Genetic disorders: Fanconi anemia and Diamond-Blackfan anemia.
Types of Bone Marrow Transplants
There are two main types of bone
marrow transplants:
Autologous Bone Marrow Transplant: In this procedure, the patient's own
bone marrow/stem cells are collected and stored prior to receiving high-dose
chemotherapy or radiation therapy. After the therapy, the stored bone marrow/stem cells are returned to the patient.
Allogeneic Bone Marrow Transplant: In this procedure, the patient
receives bone marrow/stem cells from a donor. The donor must be a close match
to the patient, usually a sibling, to minimize the risk of rejection.
Preparation for Bone Marrow
Transplant
Before the
procedure, the patient needs to undergo a series of tests to determine if they
are a good candidate for a bone marrow transplant.
These tests include:
Blood tests: to determine the type and extent of
the disease, and to check for any infections.
Imaging studies: such as X-rays, CT scans, and MRI to
get a better understanding of the disease and to determine the best approach
for treatment.
Bone marrow biopsy: a sample of bone marrow is taken to
determine if there are any abnormal cells present.
Donor
matching: if an allogeneic transplant is being performed, the patient will
undergo tissue typing to determine if the donor is a good match.
Procedure
The bone
marrow transplant procedure can take place in several stages:
Collection of bone marrow or stem
cells: this can be
done through a procedure called apheresis or by taking a bone marrow sample
directly from the hip bone.
Conditioning treatment: prior to the transplant, the patient
may undergo high-dose chemotherapy or radiation therapy to destroy any
remaining diseased cells.
Transplant: the collected bone marrow or stem
cells are infused into the patient's bloodstream through an IV.
Recovery and Aftercare
After the
transplant, the patient will be closely monitored for any complications. This
may include:
Graft-versus-host disease (GVHD): a condition that occurs when the
donor's immune cells attack the recipient's healthy cells.
Infections: the patient is at a higher risk of
infections due to a weakened immune system.
Organ damage: high-dose
chemotherapy or radiation therapy can cause damage to the liver, heart, and
lungs.
Bleeding and clotting: due to a lack of platelets, the
patient may experience bleeding or clotting.
The recovery
time after a bone marrow transplant can vary, but most patients are able to
return to their normal activities within a.
By
Dr. R K Choudhary
Director & Head Medical Oncology
Metro Cancer Institute, Noida
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