What is Bone Marrow?
It is the soft tissue inside the bones that produces new blood cells. The new blood cells may grow into Red Blood Cells, White Blood Cells or Platelets.
What is Bone Marrow Transplantation?
It is the procedure in which unhealthy or diseased bone marrow is replaced with healthy bone marrow. Blood Cells and healthy Marrow are needed to live. Bone marrow is ideally extracted from the pelvis bone through a large needle that reaches the center of the bone. This process is done under general anesthesia.
Who Needs Bone marrow transplant?
Bone Marrow Transplant is referred to those people who have bone marrow disease and blood cancer or other types of cancer. The functions of RBC, WBC and platelets are disturbed due to improper development of the blood cells. BMT can be used to treat patients with some of the following conditions:
- Leukemia (blood cancer disease) and also other type of cancer
- Aplastic anaemia (bone marrow failure)
- Other Genetic diseases (that involve the blood) or immune system diseases
- Sickle Cell disease
What are the types of Bone Marrow Transplants?
- Autologous Bone Marrow Transplant: As the name suggests “AUTO” means “SELF”. In this process, the bone marrow of the patient is removed before the patient is treated with high dose of Chemotherapy or Radiations that destroys the bone marrow as a side effect. The bone marrow is stored in a freezer or Cryopreserved. After the Chemotherapy or Radiation treatment the bone marrow is transfused back to the bloodstream, where it replaces the damaged tissues and regenerates the new blood cells. This procedure has lower risk of infection and graft rejection is very rare as the donor and the recipient are the same person. This process is common for diseases like lymphoma.
- Allogeneic Bone Marrow Transplant:In this process the bone marrow is received from a donor. A specific protein called Human Leukocyte Antigens (HLA), found on the surface of the WBC makes each person’s tissue unique. HLA of the donor must be matched with HLA of the recipient. Donor may be sister, brother, parents or other relatives. There is a chance of rejection. This recreates the immune system that continues to attack any remaining cancer cells after the completion of the chemotherapy.
- Umblical Cord / Cord Blood Transplant:The immature Marrow Cells recovered from the Umblical Cord of the new born baby after birth is stored and cryopreserved until they are needed for transplant. This is highly beneficial as chances of mismatch are seldom.
Factors to Choose transplant type
- Type of disease being treated
- The extent of bone marrow damage
- Age and health of the patient
Bone Marrow Transplant Procedure
- Step 1- Extraction:The bone marrow from the patient (in case of autologous transplant) or from the donor (in case of allogeneic transplant) is extracted from the Pelvic Bone through injection under general anesthesia.
- Step 2- Conditioning: High dose of chemotherapy or radiation is given to patient to kill the cancer cell and also suppressed the immune system of the patients to lower the risk of graft rejection.
- Steps 3- Transplant: After the chemotherapy or radiation, Bone Marrow is transfused into the vein of the patient. Simultaneously the patient needs lots of blood and platelets transfusion. To avoid infection the patient is kept in a clean room.
- Step 4- Engraftment and early recovery: After BMT the patient’s blood cells start responding and the count of blood cells gradually increases, showing improvement of the patient.
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