Table of Contents
About Bone Marrow
Bone marrow is the soft and spongy tissue found inside bones and is responsible for the creation of red blood cells, white blood cells, platelets, and hematopoietic stem cells.
Hematopoietic stem cells are immature & pluripotent stem cells that can produce any cell or tissue. These cells either remain stem cells or develop into different blood cells (red, white, or platelet). These stem cells are the mainstay of bone marrow transplantation, also known as hematopoietic stem cell transplant (HSCT).
A bone marrow transplant is a medical procedure or treatment that is done to replace unhealthy bone marrow with healthy cells. There may be various conditions that affect bone marrow function, including chronic infections, certain diseases, or cancer treatment. The Department of BM and Stem Cell Transplant can offer patients the most advanced treatment for cancer and blood-related disorders, including blood and marrow stem cell transplants.
Types Of BMT
Bone Marrow Transplant (BMT) : This is a medical treatment that replaces diseased or destroyed bone marrow with healthy cells. Replacement cells used for transplantation can be taken from the patient’s own body or from a matched donor.
Autologous BMT: In this type, the patient’s own stem cells are used for the transplant. Stem cells are harvested (collecting peripheral blood stem cells) before chemotherapy or radiation therapy and then e-injected into the patient’s body.
Allogeneic BMT: In this type of BMT, stem cells are received from a healthy and genetically closely matched donor. The donor can be A genetically matched related donor, such as a sibling.
Allogeneic Transplants Are Of The Following Types Based On The Source And Type Of Stem Cells:
- A matched related donor transplant is a matched unrelated donor transplant.
- Haploidentical exchange
- Umbilical cord transplant
- Conditions treated with bone marrow transplantation in adults and children.
Conditions Treated With BMT In Adults And Children.
Cancer Conditions
- Lymphomas Hodgkin’s and non-Hodgkin’s lymphoma (DLBCL,PTCL,MCL)
- Multiple myeloma
- Acute lymphoblastic leukemia is acute myeloid leukemia.
- Chronic myeloid leukemia
- Myelodysplastic syndrome is a myeloproliferative neoplasm-myelofibrosis
- Neuroblastoma Ewing’s sarcoma
Non-Cancerous Conditions
Hemoglobinopathies – Thalassemia And Sickle Cell Anemia
- Bone marrow failure syndromes
- Acute aplastic anemia
- Fool anemia
- Dyskeratosis congenita Diamond Blackden syndrome
Primary Immunodeficiency Diseases
- Severe combined immunodeficiency
- Wiskott-Aldrich syndrome
- Hyper IgE syndrome
Congenital Metabolic Diseases
- Metachromatic leukodystrophy
- Adrenoleukodystrophy
Stages Of Bone Marrow Transplant
Undergoing a Bone Marrow Transplant is a five-stage process. This includes:
1. Preparation
This step involves medical assessment, which includes different medical tests such as
- Complete blood tests
- Chest X-ray and CT scans
- Kidney Function Test (FT) Tests evaluate the health of the heart and lungs.
- HLA-typing to assess donor-recipient compatibility
A Central Venous Cacher (CVC) will be guided and inserted into a large vein in your chest, usually done as an outpatient surgery and under local anesthesia. This catheter helps draw blood from your vein and administer the medicines to you. Once your transplanted stem cells are engrafted, and your blood counts are back to normal, the CVC is removed.
2.Conditioning
Also known as pre-transplant treatment or bone marrow preparation, This process involves the administration of chemotherapy and/or radiation therapy and takes about one or two weeks.
Conditioning Serves The Following Purposes:
- Destruction of cancerous cells present in patient’s BM.
- Suppression of the patient’s immune system to lessen the chances of graft rejection.
- Creating space for new stem cells.
3. Stem Cell Harvesting
This is the process of obtaining stem cells to be used in the transplant. Depending on the type of donor, harvesting is done either from the patient, him or herself, or from a genetically-matched donor, usually a brother or sister, or an unrelated genetically-matched donor.
Stem Cell Harvest Is of Two Types:
- Peripheral blood stem cell harvest.
- Bone marrow harvest.
4. Infusion
In this stage, the infusion or the actual transplant of donor bone marrow or stem cells takes place, given a single-day infusion of stem cells after conditioning chemotherapy is completed. This process is like a blood transfusion, where the harvested cells are administered via a Central Venous Catheter (CVC) Into the bloodstream.
5. Recovery
The patient needs to be kept in a BMT unit in isolation for observation and to ensure a complete recovery.
Engraftment and Early Recovery: Signs that fresh bone marrow or stem cells are developing can be anticipated in about 2 to 3 weeks after the transplantation.
Long-Term Recovery: This stage involves the discharge of the patient from the center, discussing follow-ups and precautions to avoid any long-term complications.