Bone Marrow Transplant

What is a Bone Marrow Transplant?

Bone marrow transplant is another breakthrough in the field of medicine. The first ever successfully conducted bone marrow transplant dated back in 1968. There were already about 7,500 bone marrow transplants performed since 1991 and the number keeps growing. For several years now, this procedure has greatly helped thousands of lives. Though the success rate of bone marrow transplant is good, finding a donor that would match for bone marrow transplant is somewhat difficult. It is entirely impossible to find a stem cell donor who would exactly match the recipient’s.

Types

Bone marrow transplant actually has different types which include the following:

Autologous

Prior to undergoing chemo or radiation therapy, stem cell is directly harvested from you. These will then be transplanted after the aggressive therapy especially when there is bone marrow depression.

Allogenic

In an allogenic bone marrow transplant, a stem cell donor is needed. The donor can usually be the parents, siblings or relatives who would match with the recipient. These people make a perfect donor. However, in certain instances that your kin do not qualify as donors it would still be possible to search through the national bone marrow registries to look up for qualified donors.

Umbilical cord

Right when the baby is born, stem cells can directly be harvested from the umbilical cord. Umbilical cord bone marrow transplant is considered to be safer than other types of transplant owing to the fact that there is less chance that the immature stem cells would not match the recipient’s.

What is bone marrow?

Bone marrow can be abundantly found within the hips but this can also be harvested within the skull, breast bone, spine and ribs. This is a type of spongy tissue which is contained in the bones. The bone marrow produces blood cells which are responsible for doing specific functions in the body. The stem cells produced by the bone marrow include white and red blood cells and as well as platelets. The white blood cells help the body ward off pathogens and fight against potential infections; the red blood cells are responsible for circulating oxygen and nutrients in the body and the platelets for blood clotting.

Why is this indicated?

The procedure became the hope of those people who suffered from what were once considered to be incurable diseases. Nowadays, bone marrow transplant is indicated for people who are suffering from bone marrow diseases and certain types of cancer such as leukemia, Hodgkin’s lymphoma and multiple myeloma.

Whenever there is bone marrow anomaly, mature cells are being outnumbered by immature cells. The overproduction of immature cells hampers the production of mature cells. These immature cells can also get deposited within the tissues and even accumulate within the bloodstream which further causes serious problems.

During chemotherapy and intensive radiation therapy there’s a huge tendency that both mature and immature cells are destroyed. These would also destroy the bone marrow which impedes the production of mature, healthy cells. Since these therapies are indicated to treat certain types of cancer, bone marrow transplant would be the solution to the bone marrow depression after the therapy. Bone marrow transplant allows these ablative or non-ablative therapies to continue for it to be effective. It is only after these aggressive therapies that bone marrow transplant is performed to replace all the destroyed ones. It is not however a guarantee that cancer is not going to recur after bone marrow transplant.

Bone Marrow Transplant Preparation

There are several things that must be considered first before bone marrow transplant is being performed. First off, your doctor needs to obtain a thorough medical history of yours. Several tests and lab workups may also be done before you will be subjected to the procedure.

Prior to the actual bone marrow transplant, either one or two tubes need to be inserted into your neck. These catheters would help get an access to your veins so as fluids, nutrition and treatment can be instilled. Your health care provider would also discuss to you what to expect after the procedure including the risks and complications.

Bone Marrow Harvest

Once a qualified donor has been determined, a bone marrow harvest will then be performed. There is just minimal risk involved in bone marrow harvest. Typically, the donor has to be put under general anesthesia. The procedure is usually performed in an operating room. The donor cannot feel pain and discomfort during the procedure as he will be put under general anesthesia. Bone marrow is harvested in the donor’s hips while he or she is asleep.

The Bone Marrow Transplant

When the bone marrow has already been harvested from a qualified donor, this will then be transplanted to the recipient. Bone marrow transplant is performed around 2 days after radiation or chemotherapy. The bone marrow recipient gets the bone marrow and stem cells in the same way that he or she receives blood transfusion. Bone marrow transplant does not require a surgery and this does not need to be performed in the operating room. This can just be done within the patient’s room and may even be performed on an out-patient basis so one doesn’t need to stay overnight in the hospital just to get bone marrow transplant. This is considered a critical procedure. Thus, the recipient must be watched for signs of transplant reaction which include fever, chills, chest pains, difficulty of breathing and hives.

What to expect after the procedure?

Bone marrow transplant may suck the energy out of the patient. This is an entirely exhausting procedure. The patient may suffer from fever, flu, nausea and vomiting and body malaise. These symptoms may not only last for days but may extend up to weeks.

Survival Rate

The survival rate of patients who undergo bone marrow transplant depends on certain factors and these include the following:

• Age
• General health condition
• Donor stem cell compatibility
• Type of bone transplant
• Type of cancer
• Genetic makeup

There are only two things that could happen after a bone marrow transplant. If the procedure is totally successful, you would eventually survive but when complications occur, it could be life-threatening and death is impending. It usually takes about a year to fully recover from a bone marrow transplant.

Bone Marrow Transplant Cost

Bone marrow transplant is considered to be a potentially life-threatening condition. This is an expensive procedure but since this has been commonly performed nowadays, the cost has eventually decreased over time. Bone marrow transplant cost would usually depend on its type and the institution where it is performed. To give you an idea of the cost of bone marrow transplant, here’s a price range:

• Autologous bone marrow transplant- $50,000- $100,000
• Allogenic bone marrow transplant- $150,000-$200,000

Bone Marrow Transplant Complications

There are several complications which may occur during and even after a bone marrow transplant because this is a risky procedure. The common complications of bone marrow transplant include the following:

• Anemia
• Bleeding in the different parts of the body including the brain, lungs and intestine
• Cataracts
• Graft failure- After a successfully conducted bone marrow transplant, the donor cells do not settle into the recipient’s body and fail to produce new cells.
• Graft versus host disease- This is a potentially life-threatening complication in which the donor cells would attack the recipient’s cells.
• Infections
• Pain