Bone Marrow Transplant

Bone marrow is a spongy tissue found inside the bones and bone marrow present in the breast bone, skull bone, hip bone, ribs and spine produces stem cells. These stem cells eventually develop into blood cells. Since bone marrow acts as an important source for the production of blood cells, if something is wrong with the marrow then a person can become very ill or even might die. Certain types of cancers may cause serious problem to the bone marrow. Diseases such as leukemia and aplastic anemia, can cause serious damage to bone marrow. When the problem becomes very serious then bone marrow transplant procedure  becomes an important treatment option. In a bone marrow transplant healthy stem cells are put in place of the unhealthy ones. This can treat or even cure the disease.

Bone Marrow Transplant (BMT) Procedure
In a bone marrow transplant the stem cells that are normally found in the bone marrow are taken out, filtered, and given back either to the same person or to another person. Bone marrow transplant is a relatively new medical procedure being used to treat diseases once thought incurable. The  first successful Bone Marrow Transplant was done in the year  1968. Bone Marrow Transplant procedures have been used to treat patients diagnosed with following diseases.

  • Aplastic anemia,
  • Leukemia,
  • Lymphomas such as Hodgkin’s disease,
  • Multiple myeloma,
  • Immune deficiency disorders and
  • Some solid tumors such as breast and ovarian cancer.

In patients suffering with leukemia, aplastic anemia, and some immune deficiency diseases, the stem cells in the bone marrow start behaving abnormally. They produce excessive number of defective or immature blood cells or low blood cell counts. These defective blood cells interfere with the production of normal blood cells, accumulate in the bloodstream and may invade other tissues. In order to destroy such cells large doses of chemotherapy and/or radiation are required .These therapies, however, not only kill the abnormal cells but can destroy normal cells found in the bone marrow as well. A bone marrow transplant helps the doctors to treat these diseases with aggressive chemotherapy and/or radiation by allowing replacement of the diseased or damaged bone marrow after the chemotherapy/radiation treatment.

TYPES OF BONE MARROW TRANSPLANTS
The new bone marrow which is infused into the patient’s blood-stream during a successful Bone Marrow Transplant Procedure, migrates to the cavities of the large bones, engrafts and begins producing normal blood cells. The patient’s diseased bone marrow is replaced  by new bone marrow.

There are two major types of Bone Marrow Transplant Procedures

1) Autologous bone marrow transplant
2) Allogenic bone marrow transplant

In an Autologous bone marrow transplant the donor is the person him/herself. The bone marrow is extracted from the patient prior to transplant and may be cleaned to remove malignant cells in case if the disease has afflicted the bone marrow. Stem cells are taken from the patient before the patient gets chemotherapy or radiation treatment. When chemotherapy or radiation is done, the patient gets their stem cells back. This is called a “rescue” transplant. It allows the patient to receive high doses of chemotherapy and radiation.

In an Allogenic bone marrow transplant procedure the stem cells come from another person, who is called a donor. The healthy stem cells are taken from the bone marrow of the donor. It is very important that a donor must have the same genetic typing as the patient, so that their blood “matches” the patient’s blood. Hence special blood tests are conducted to determine whether or not the donor’s bone marrow matches the patient’s bone marrow. If the donor’s bone marrow is not a good genetic match, it will perceive the patient’s body as foreign material to be attacked and destroyed.  Such a situation if arises, may be life threatening. There are high chances that a patient will have a sibling whose bone marrow is a perfect match.

Some of the important sources of Bone Marrow Stem Cells are, Bone marrow harvest(Stem cells directly collected out of the bone), Apheresis (stem cells are collected by filtering the blood for circulating blood cells  and Umbilical cord blood ( stem cells are filtered from blood in the umbilical cord after a baby is born).The majority of bone  marrow transplants are made using stem cells collected by apheresis, since this method has better results for both the donor and the recipient.

PREPARING FOR THE TRANSPLANT
There are certain important factors to be considered before a patient undergoes a Bone Marrow Transplant. Some of the important factors are:

  • Age,
  • General physical condition,
  • Patient’s diagnosis and
  • Stage of the disease

The patient needs to be healthy enough to face the rigours of such a major procedure. Post Bone Marrow Transplant procedure, a battery of tests is carried out to ensure the patient is physically capable of undergoing a transplant. A thorough physical examination and history taking is done by the treating doctor and tests of the patient’s vital organ functions are carried out.

A successful bone marrow transplant requires a multi-disciplinary approach and expert medical team. Some of the hospitals in India have world-class facilities, most advanced technology, experienced medical team and affordable treatment packages.  These hospitals treat a large number of patients from all over the world.