Bone marrow transplant

bone marrow transplant is a treatment that replaces the diseased or damaged bone marrow with healthy blood manufacturing stem cells. A bone marrow transplant is also known as a stem cell transplant. 

Bone marrow refers to the spongy and soft tissue in some of the bones, such as those in the thighs and hips. A transplant to replace the damaged cells with the healthy ones, probably from a donor, is beneficial to people with some blood-related diseases. For instance, bone marrow transplants can save a person's life if they have lymphoma or leukemia or if their blood cells have been destroyed by cancer treatment.

 

Types of Bone Marrow Transplant 

A bone marrow transplant can be divided into two categories. The underlying reason for your need will determine the form of transplant you undergo. 

  • Autologous transplants

This is a type of transplant that uses the patient's stem cells. It usually entails extracting your cells prior to starting a cell-damaging therapy like chemotherapy and radiation treatment. The patient’s cells are restored to the body once the treatment is complete.

Autologous transplant is not frequently available and can only be utilized whenever your bone marrow is in good shape. It does, however, lower the chance of some major problems, such as GVHD.

  • Allogeneic transplant 

Allogeneic transplant uses the stem cells obtained from the donor. A close genetic match between the donor and the recipient is required. A suitable relative is often the greatest option, but a donor registry can also help you find genetic matches. 

If you have a disorder that has damaged the bone marrow cells, you will need an allogeneic transplant. They do, however, have a high risk of problems, including GVHD. You will very certainly need to take medications to restrain the immune system, so the body does not react and attack the new cells. You may become susceptible to sickness as a result of this. An allogeneic bone marrow transplant success rate is determined by how well the donor cells match with your own.

 

Why Bone Marrow Transplant is done?

A bone marrow transplant is usually recommended if a person's bone marrow is not healthy enough to work normally. This might occur as a result of long-term diseases, infections, and cancer treatments. 

The following are some of the common reasons for performing a bone marrow transplant: 

  • Aplastic anemia; this is a condition in which the bone marrow ceases producing new blood cells.
  • Malignancies that attack the bone marrow, including lymphoma, leukemia, and multiple myeloma
  • Congenital neutropenia, a genetic condition that leads to recurrent infections.
  • Bone marrow damage following a chemotherapy transplant 
  • The genetic blood condition sickle cell anemia which creates malformed red blood cells.
  • Thalassemia, an inheritable blood illness in which the body produces an aberrant type of hemoglobin. This is an essential component of red blood cells.

 

How to Prepare for a Bone Marrow Transplant?

Bone marrow transplant

The physician will conduct some testing to evaluate the optimum form of the procedure before performing a bone marrow transplant. If necessary, they can as well seek out a suitable bone marrow transplant donor. But if the patient's cells are to be used, the doctor will obtain the cells in advance and properly keep them in a freezer till the scheduled day. 

Following that, the patient will receive additional treatment, which could include radiation therapy, chemotherapy, or sometimes a combination. These modes of treatment help kill the bone marrow cells and the cancerous cells. Furthermore, chemotherapy and radiation restrain the body's immune system. This helps to avoid a bone marrow transplant rejection. 

The patient might have to remain in the hospital setting for one to two weeks as they prepare for the transplant. A healthcare expert will implant a tiny tube into one of the major veins of the patient during this period.

The patient will also get some drugs through the tube that eliminates any present abnormal stem cells. It can as well trigger the immune system to stop the new healthy transplanted cells from rejection. 

It's a good initiative to make the following arrangements before going to the hospital:

  • Take leave from work or school for such medical reasons
  • Provide the necessary care if there are any children or pets to look after
  • Transportation to and from the hospital
  • Clothing and other essentials
  • If necessary, find a family member who will stay with you while in the hospital 

 

How a Bone Marrow Transplant is done?

Typically, a bone marrow transplant isn't a surgical procedure. It's comparable to receiving a blood transfusion. If the transplant involves the use of donor stem cells, they will be obtained before the procedure. If the patient’s own cells are to be used in the transplant, the medical facility will store the cells.

The transplant is usually done in a series of procedures for a few days. This method of staggering cell entry offers them the highest opportunity of merging with the body. 

The doctor can use the tube to infuse liquids like nutrients, blood, and drugs to help in fighting infection or promote bone marrow growth. The exact combination is determined by the body's reaction to the treatment.

The operation will temporarily weaken the patient's immune system, leaving them vulnerable to infection. To assist limit this danger of infection, most medical facilities maintain a separate, isolation area for persons undergoing a bone marrow transplant.

 

Bone Marrow Transplant Recovery 

The genetic compatibility of the donor and recipient is crucial to the success and recovery of a bone marrow transplant. However, finding a suitable match among the available unrelated donors might be difficult at times. 

The engraftment will be checked on a regular basis. It usually takes between 10 and 28 days to complete following the first transplant. An increase in the white blood cell count is the first indicator of engraftment. This indicates that the transplant is producing new blood cells. 

A bone marrow transplant usually takes three months to recover from. It might, however, take up to one year for one to completely recover. Some of the factors that can influence recovery include;

  • The underlying health condition 
  • Chemotherapy 
  • Radiation therapy 
  • A match of donors
  • The area in which the transplant will take place

There is a chance that some of the side effects you'll have following the transplant will last for your entire life.

Medications:

The doctor can recommend some drugs to help avoid graft-versus-host disease and minimize the immune system's reactivity (immunosuppressive medications). This is usually if your bone marrow transplant uses stem cells obtained from the donor (allogeneic transplant).

It generally takes some time before the immune system recovers after a transplant. Therefore, medications to help prevent infections may be necessary to you at this period. 

 

Bone Marrow Transplant Results 

Physicians can treat some health conditions using a bone marrow transplant, where others can go into remission. A bone marrow transplant goal varies depending on your situation. However, they commonly involve controlling or treating the disease, prolonging your life, and enhancing your general quality of life.

Some patients are able to complete their bone marrow transplant procedure with few difficulties and side effects. On the other hand, others face a variety of challenges, both short-term and long-term. The seriousness of adverse effects and the transplant's success varies from one patient to another. It’s sometimes hard to predict prior to the procedure.

 

Risks of Bone Marrow Transplant 

Risks of Bone Marrow Transplant

The transplantation of bone marrow is generally a major treatment procedure. Due to this, there is a significant risk of problems that can occur both during and after the procedure. The possibility of complications occurring is determined by a number of factors, such as;

  • The age of the patient 
  • General health and well-being
  • The form for transplantation
  • The underlying reason for the treatment 

The following are some of the most prevalent problems and bone marrow transplant side effects:

  • Infections
  • Nausea and vomiting, or a combination of the two
  • Diarrhea 
  • Mucositis, a condition that causes inflammation and pain in the mouth, throat, and stomach.
  • Graft failure that occurs when the cells that were transplanted fail to create new blood cells.
  • Anemia 
  • Early menopause onset 
  • Infertility
  • Cataracts 
  • Damage to the organ
  • Graft-versus-host disease, a condition where the donor cells attack the recipient's body
  • Bleeding inside the lungs, brain, or other organs.
  • Sometimes, the complications from the bone marrow transplant lead to death. 

The patient who undergoes a bone marrow transplant might also have the usual side effects that come with any medical treatment. They include:

  • Breathing problems
  • Reduced blood pressure
  • Headaches 
  • Pain 
  • Fever and chills 

 

Conclusion 

A bone marrow transplant is one of the major medical treatment procedures that necessitate extensive planning. This entails deciding on the best form of transplant, locating a donor where necessary, and preparing for an extended stay in the hospital.

The length of time it takes for the body to recover from a transplant fully depends on a number of factors. They can include the patient's age, overall health, and the purpose of the transplant.