A bone marrow transplant is a procedure to replace damaged or damaged bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fatty tissue inside your bones. The bone marrow produces blood cells. Stem cells are immature cells in the bone marrow that generate all your different blood cells.
Before the transplant, chemotherapy, radiation, or both may be given. This might be done in 2 methods:
- Ablative (myeloablative) treatment: High-dose chemotherapy, radiation, or both are given to eliminate any cancer cells. This likewise eliminates all healthy bone marrow that stays, and allows new stem cells to grow in the bone marrow.
- Decreased strength treatment, likewise called a tiny transplant: People get lower doses of chemotherapy and radiation prior to a transplant. This permits older people, and those with other health issue to have a transplant.
There are 3 type of bone marrow transplants:
- Autologous bone marrow transplant: The term auto suggests self. Stem cells are removed from you before you get high-dose chemotherapy or radiation treatment. The stem cells are kept in a freezer. After high-dose chemotherapy or radiation treatments, your stems cells are put back in your body to make normal blood cells. This is called a rescue transplant.
- Allogeneic bone marrow transplant: The term allo indicates other. Stem cells are removed from another person, called a donor. The majority of times, the donor’s genes must at least partly match your genes. Unique tests are done to see if a donor is a good match for you. A sibling or sis is probably to be a good match. Sometimes parents, children, and other loved ones ready matches. Donors who are not associated with you, yet still match, might be found through national bone marrow computer registries.
- Umbilical cable blood transplant: This is a kind of allogeneic transplant. Stem cells are removed from a newborn baby’s umbilical cord right after birth. The stem cells are frozen and stored until they are needed for a transplant. Umbilical cord blood cells are really immature so there is less of a need for ideal matching. Due to the smaller sized number of stem cells, blood counts take a lot longer to recover.
A stem cell transplant is typically done after chemotherapy and radiation is complete. The stem cells are delivered into your bloodstream normally through a tube called a central venous catheter. The process resembles getting a blood transfusion. The stem cells take a trip through the blood into the bone marrow. Most times, no surgery is needed.
Donor stem cells can be collected in 2 methods:
- Bone marrow harvest: This minor surgery is done under basic anesthesia. This implies the donor will be asleep and pain-free during the procedure. The bone marrow is removed from the back of both hip bones. The quantity of marrow eliminated depends on the weight of the individual who is getting it.
- Leukapheresis: First, the donor is provided numerous days of shots to help stem cells move from the bone marrow into the blood. During leukapheresis, blood is removed from the donor through an IV line. The part of white blood cells that contains stem cells is then separated in a machine and got rid of to be later offered to the recipient. The red blood cells are returned to the donor.
Why the Procedure is Performed
A bone marrow transplant replaces bone marrow that is either not working effectively or has been damaged (ablated) by chemotherapy or radiation. Physicians believe that for many cancers, the donor’s white blood cells might attack any staying cancer cells, much like when white blood cells attack bacteria or viruses when fighting an infection.
Your doctor may advise a bone marrow transplant if you have:
- Particular cancers, such as leukemia, lymphoma, myelodysplasia, and multiple myeloma
- A disease that impacts the production of bone marrow cells, such as aplastic anemia, genetic neutropenia, severe body immune system diseases, sickle cell anemia, and thalassemia
- Had chemotherapy that ruined your bone marrow
Does Bone Marrow Transplant Dangerous
A bone marrow transplant may cause the following symptoms:
- Chest pain
- Drop in high blood pressure
- Fever, chills, flushing
- Amusing taste in the mouth
- Shortness of breath
Possible complications of a bone marrow transplant depend upon lots of things, consisting of:
- The disease you are being treated for
- Whether you had chemotherapy or radiation before the bone marrow transplant and the dosages of such treatments
- Your age
- Your general health
- How good of a match your donor was
- The kind of bone marrow transplant you got (autologous, allogeneic, or umbilical cable blood).
Complications might include:
- Early menopause.
- Damage to the kidneys, liver, lungs, and heart.
- Graft failure, which suggests that the new cells do not settle into the body and start producing stem cells.
- Thickening in the little veins of the liver.
- Bleeding in the lungs, intestines, brain, and other areas of the body.
- Infections, which can be very serious.
- Stomach issues, consisting of diarrhea, nausea, and vomiting.
- Inflammation and soreness in the mouth, throat, esophagus, and stomach, called mucositis.
- Graft-versus-host disease (GVHD), a condition where the donor cells attack your own body.
- Delayed growth in children who get a bone marrow transplant.
Preparation for Bone Marrow Transplant Procedure
Your health care service provider will ask about your case history and do a physical exam. You will have many tests before treatment begins.
Before transplant, you will have 1 or 2 tubes, called catheters, placed into a blood vessel in your neck or arms. This tube permits you to get treatments, fluids, and often nutrition. It is also used to draw blood.
Your provider will likely discuss the emotional stress of having a bone marrow transplant. You might want to consult with a counselor. It is necessary to speak to your household and children to help them comprehend what to expect.
You will have to make plans to assist you prepare for the procedure and deal with tasks after your transplant:
- Arrange for care of your children.
- Look after bank or financial declarations.
- Arrange for someone to assist with family chores.
- Find housing on your own or your family near the medical facility, if required.
- Pay bills.
- Organize care of pets.
- Validate medical insurance coverage.
- Organize medical leave from work.
- Total an advance care directive.
After the Procedure
A bone marrow transplant is typically carried out in a health center or medical center that specializes in such treatment. Most of the time, you stay in an unique bone marrow transplant system in the center. This is to limit your chance of getting an infection.
Depending on the treatment and where it is done, all or part of an autologous or allogeneic transplant might be done as an outpatient. This suggests you do not need to remain in the hospital overnight.
The length of time you stay in the healthcare facility depends upon:
- How much chemotherapy or radiation you got.
- The kind of transplant.
- Your medical center’s treatments.
While you are in the hospital, you will be separated due to the fact that of the increased risk of infection. The health care team will closely monitor your blood count and vital signs.
While you remain in the medical facility you may:
- Get medications to prevent or treat infections, including antibiotics, antifungals, and antiviral medicine.
- Need lots of blood transfusions.
- Be fed through a vein (IV) up until you can eat by mouth and stomach side effects and mouth sores have actually gone away.
- Be given medicines to prevent GVHD.
After you leave the hospital, make sure to follow directions on how to look after yourself at home.
What to Expect After the Transplantation?
How well you do after the transplant depends upon:
- The type of bone marrow transplant.
- How well the donor’s cells match yours.
- What kind of cancer or disease you have.
- Your age and overall health.
- The type and dose of chemotherapy or radiation therapy you had before your transplant.
- Any complications you may have.
- A bone marrow transplant may completely or partially treat your health problem. If the transplant is a success, you can go back to most of your normal activities as quickly as you feel all right. Normally it takes up to 1 year to recover totally, depending on what complications take place.
Complications or failure of the bone marrow transplant can result in death.
Other names of the procedure are: Transplant – bone marrow; Stem cell transplant; Hematopoietic stem cell transplant; Reduced strength nonmyeloablative transplant; Mini transplant; Allogenic bone marrow transplant; Autologous bone marrow transplant; Umbilical cord blood transplant; Aplastic anemia – bone marrow transplant; Leukemia – bone marrow transplant; Lymphoma – bone marrow transplant; Multiple myeloma – bone marrow transplant.