What is Bone marrow transplant?
Bone marrow transplant surgery, also known as stem cell transplant and hematopoietic stem cell transplant, is a surgical procedure that helps restore the blood and immune systems to normal using healthy stem cells. These stem cells are known to be master builders of blood. The cells are the ones that eventually grow into white blood cells, red blood cells, and platelets. In patients where the bone marrow becomes weak, damaged, or infected by a disease, a bone marrow transplant surgery helps restore the ability to produce these vital blood cells.
It is important first to understand what bone marrow actually does. Bone marrow is a soft, sponge-like tissue inside human bones that functions as part of the body that produces new blood cells to replace old and damaged ones. When the original bone marrow stops producing healthy cells or produces abnormal cells, the entire body suffers. This is where a bone marrow transplant surgery steps in as a way to support the body with new, healthy stem cells.
A bone marrow transplant is considered by a doctor when they suspect a serious issue with how natural bone marrow works. Disturbances in the normal functioning of bone marrow are usually due to blood cancers, immune disorders, genetic conditions, or disease conditions that affect the normal functioning of bone marrow, thereby producing abnormal blood cells and stopping the production of healthy cells. These complications in health cannot be regulated by using normal treatment techniques.
Bone marrow transplant is required in conditions like leukemia, lymphoma, multiple myeloma, aplastic anemia, thalassemia, sickle cell disease, and some immune deficiencies. Though all these conditions affect the body in a different way, the root cause of the problem remains the same that is bone marrow fails to supply healthy functioning blood cells. A transplant then acts as a support system to this vital process in the body to be restored to normalcy.
Types of Bone Marrow Transplants
Bone marrow transplant surgery is not a single method. It is made up of different methods, depending on where the stem cells actually originate from. The choice of bone marrow transplant depends on the medical condition of the patient, the availability of doctors, the availability of donors, and the health conditions of the donor’s bone marrow itself. The types of bone marrow transplants are given in detail below:
- An autologous transplant is where the patient himself acts as a donor of stem cells. Healthy stem cells are collected from the patient’s own peripheral blood or bone marrow before the patient is subjected to high-dose chemotherapy or radiation to kill the cells of cancer cells. After the chemotherapy or radiation treatment, the healthy stem cells that were extracted are reinfused into the blood of the patient.
- An allogenic transplant is where the stem cells are obtained from another donor. This technique is utilised when the patient’s own bone marrow is diseased or when an autologous transplant itself is at risk of relapse. The donor must have a closely matching tissue type (human leukocyte antigen or HLA) for the patient to reduce the risk of the body rejecting the donor cells (graft vs host disease or GVHD).
- Allogenic bone marrow transplants are of various subtypes depending on the relationship and genetic match of the donor, namely, they are
- Matched related donor transplant (MRD) is where the donor is a close blood relative of the patient, typically a brother or sister, who is most normally a very close genetic match.
- Matched unrelated donor transplant (MUD) is a donor other than a closely related family member, who has a closely matching human leukocyte antigen marker.
- Haplocidentical transplant (Half-matched) is a bone marrow transplant surgery option for a patient who cannot find a fully matched donor. A half-matched donor, such as a parent, child, or half-sibling, is normally utilized as a donor. Modern developments in medical care and the availability of immunosuppressive drugs have made this option possible in recent times.
- Umbilical cord blood transplant is a bone marrow transplant technique, where the stem cells are collected from newborns’ umbilical cord and placenta immediately after birth. The stem cells are then frozen and stored in a cord blood bank. Cord blood cells are less mature, and therefore make a less perfect match acceptable. But this technique usually makes recovery of blood count a lengthy process.
- Tandem (Double-Auto) transplants are a process where, patient is subjected to repeated sequences of high-dose autologous transplantation.
- Other variations of bone marrow transplant include reduced intensity conditioning (RIC) transplant, also known as mini transplant is a variation of allogenic bone marrow transplant, where a lesser and lower amount of toxic radiation is utilized to overpower the immune system’s power of bone marrow rather than destroy it.
| Procedure Name | Bone Marrow Transplant |
|---|---|
| Type of Surgery | Infusion of stem cells is similar to a blood transfusion |
| Type of Anesthesia | No anesthesia, stem cell transplantation is done while the patient is awake |
| Procedure Duration | The patient first receives a high dose of radiation for 5 to 10 days to prepare the body, and after that, stem cells are infused into blood bloodstream. Patients are usually awake. Donor stem cells are collected by subjecting them to local or general anesthesia or from the blood through a process called apheresis. The infused blood cell multiplication takes 2 to 4 weeks |
| Recovery Duration | Initial recovery takes 2 to 6 weeks, and full recovery in an autologous transplant takes several months, whereas in the case of an Allogeneic transplant, it can take 1 to 2 years. |
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