What is Bone Marrow Transplant or BMT?
To understand BMT, we have to first know what is bone marrow. Bone marrow is the spongy tissue inside few bones of the body, such as hip and thigh bones. This spongy tissue creates the parts of the blood- namely Red Blood Corpuscles (RBC), White Blood Corpuscles (RBC) and Blood Platelets. When these get diseased thereby unable to produce healthy blood cells, then the only way to cure it is by infusing it with healthy blood stem cells. The marrow transplant is also called Bone Marrow Transplant (BMT) or called stem transplant or stem cell transplant
Who needs Bone Marrow Transplant?
-Those who suffer from Sickle cell anemia.
-A few types of cancer like Leukemia, Multiple Myeloma or Hodgins Lymphoma.
-Non Hodgins Lymphoma
-Aplastic anemia, which is a disorder in which the marrow stops making new blood cells
-Due to chemotherapy the bone marrow is damaged.
-Congenital neutropenia, which is a genetic disorder that causes recurring infections
-Thalassemia, which is another genetic blood disorder where the body makes an abnormal form of hemoglobin which is in RBC.
-Rare diseases like Krabbe disease, Hurler Syndrome, Adrenoleukodystrophy, and metachromatic Leukodytrphy
What are the types of Bone Marrow Transplant?
There are 2 types of BMT – One using your own stem cells (autologous) or using stem cell from a donor (Allogenic). Both are fairly successful but the former is usually preferred to the later.
Autologous Transplants - Autologous transplants is a form of BMT using a person’s own stem cells. This involves harvesting the cells, preserving it before beginning a therapy to cells like chemotherapy or radiation. After the treatment is done, the same cells are infused into the person. While this method is highly preferable, it is not always possible. This method reduces many complications including the serious one like Graft Vs Host Disease (GVHD)
Allogeneic Transplants - Allogeneic transplants involve the use of cells from a donor having a very close genetic match. While close relatives or siblings are best choice, sometimes they do not match, in which case you can go to a blood donor registry. The match testing is called Human Leucocytes Antigens (HLA) type testing. It i
Allogeneic transplants have a higher risk of complications, such as GVHD. The success of an allogeneic transplant depends on how closely the donor cells match the recipient.
What is the process of Bone Marrow Transplant?
Patient will undergo a series of tests and procedures to assess general health and the status of their condition, and to ensure that they are physically prepared for the transplant. This evaluation which takes several days or more.
The conditioning process:
After completion of pretransplant tests and procedures, a process known as conditioning is started. During conditioning, patient will undergo chemotherapy and possibly radiation to:
Destroy cancer cells if being treated for a malignancy
Suppress the immune system
Prepare the bone marrow for the new stem cells
The type of conditioning process provided depends on a number of factors, including the disease, overall health and the type of transplant planned. Both chemotherapy and radiation or just one of these treatments may be given as part of the conditioning treatment.
Leukapheresis for the Donor:
During leukapheresis, a donor is given upto five shots to help the stem cells move from the bone marrow and into the bloodstream. Blood is then drawn through an intravenous (IV) line, and a machine separates out the white blood cells that contain stem cells. These stem cells are implanted into the donor.
A long thin tube (intravenous catheter) will be implanted into a large vein in the chest or neck. The catheter, often called a central line, normally remains in place for the entire duration of your treatment as the doctors will use the central line to infuse the transplanted stem cells and other medications and blood products into the body of the treated patient.
Multiple sessions give the new stem cells the best chance to integrate themselves into your body. That process is known as engraftment.
Through this port, the patient will also receive blood transfusions, liquids, and possibly nutrients. Medications to fight off infections and help the new marrow grow are also injected.
Who can be a donor for BMT and an Ideal donor?
An ideal donor is between 18 to 44 years of age. The reason is usually the stem cells harvested from younger donors lead to long term survival rates. Doctors require 8 – 10 HLA matches to engage in BMT. In case of cord cell blood even 4- 6 matches are accepted by Doctors.
What is the duration and outcome of BMT?
Duration of BMT normally depends on the condition of the patient, and the type of treatment provided, and complications which may arise. Engraftment is complete between 10 – 28 days. The success of the engraftment is the increase of the WBC count. Recovery may take 3 months to upto 1 year and depends on a host of factors. There are chances that the condition may last for the entire life, though modern medicine has increased the success rate of BMT substantially
What are the complications arising from BMT?
A BMT involves several risks, some potentially fatal. The complications depend on many factors, including the type of disease or condition, the type of transplant, and the age and health of the person.
Some people experience few problems with a transplant, while others may develop serious complications that may require hospitalization. The following are some complications that may occur with a BMT. However, each individual may experience symptoms differently. These complications may also occur alone, or in combination:
-Low platelets and low red blood cells
-Organ damage – The liver and heart are important organs that may be damaged during the transplantation process. -Temporary or permanent damage to the liver and heart may be caused by infection, graft-versus-host disease, high doses of chemotherapy and radiation, or fluid overload
-Graft failure – Failure of the graft (transplant) taking hold in the marrow
-Graft-versus-host disease – Graft-versus-host disease (GVHD) can be a serious and life-threatening complication of a BMT. GVHD occurs when the donor’s immune system reacts against the recipient’s tissue. It typically affects skin, digestive tract or liver
-Pain in the form of mouth sores and gastrointestinal irritability
-Fluid overload – Fluid overload is a complication that can lead to pneumonia and high blood pressure
Anavara has tied up with more than 350 + hospitals around the globe and can take excellent care of you in your journey to undergo BMT. Please search from the home-page search-box.