Bone Marrow Transplant Treatment

Bone marrow transplant (BMT) also termed as stem cell transplant is used to treat certain cancer and blood disorders. In this surgery, unhealthy cells are replaced with healthy cells that exist in the bone marrow or stem cells. The lab filters and gives these stem cells back either to the donor (patient) or to another person. The end goal of this innovative surgery is to give healthy bone marrow cells into a person who has cancer or damaged stem cells.

BMT has successfully treated many ill-healths that include bone cancer, leukemia, and other conditions since 1968.

Types of BMT

Depending on the type of donor we have the following types:

1. Autologous BMT

• The patient uses their own cells as the donor. The surgeon takes stem cells from the patient’s bone marrow or blood. These are frozen and later returned back to the patient after treatment.

2. Allogeneic BMT

• The patient receives stem cells from a donor. This donor genetic type should match with the patient. The donor is usually a close relative, like a sibling, but can also be an unrelated adult or cord blood unit.

3. Umbilical cord blood transplant

• Stem cells are harvested from an infant’s umbilical cord shortly after birth. These stem cells grow and multiply more effectively than stem cells derived from another person’s bone marrow. The stem cells are examined, typed, numbered, and frozen until needed for transplantation.

Need for BMT

It is known that every year nearly 18,000 people in the United State come to realize that stem cell transplant can cure one or other of their ill-healths. When other forms of treatments have failed or their critical condition revives after medical surgery, then people opt for BMT.

A BMT can be utilized for:

• A diseased, non functioning bone marrow can be replaced with healthy, functional bone marrow.
• Regenerate a new immune system that is competent enough to fight existing or residual leukemia or other tumors. Chemotherapy or radiation employed during the transplant may not have destroyed these.
• After receiving large doses of chemotherapy and/or radiation to treat a tumor, the bone marrow is replaced and restored to normal function. This method is commonly referred to as rescue.

Risks and Complications

The perils depend on many factors such as age, type of transplant, overall health and include:

1. Infections

• Bacterial infections are common, particularly in patients with severe bone marrow suppression. 

2. Low platelets and red blood cells

• Low platelets can induce hazardous bleeding, whilst low red blood cells can result in anemia. 

3. Respiratory distress: 

• Your respiratory system may be weakened during the transplant.

4. Fluid overload

• This can result in pneumonia, liver damage, and elevated blood pressure. 

5. Organ injury

• The liver and heart are two vital organs and these are likely to be harmed during the surgery.
• Pain in the mouth and gastrointestinal tract is common. It can be caused by inflammation from high doses of chemotherapy or radiation. 
• Graft failure occurs when the transplant fails to take hold in the marrow.

Bone Marrow Transplant Procedure

The transplant team works in a team and best attention is given to the patient’s care. They make sure the transplant is successful. 

1) Pre-Transplant

Your healthcare practitioner will do the following tests before the transplant. It will make sure that you are physically capable of managing transplantation processes.

• Electrocardiogram
• Echocardiogram
• Computed tomography scan
• Complete blood count 
• Blood tests including liver function or kidney function
• Biopsy to study cancerous cells.

If you’re receiving your own stem cells, your doctors will draw blood from you. This will extract healthy stem cells for transplant. Here’s the steps in brief:

• Providers link veins in both arms to a cell separation machine.
• The equipment draws blood from veins in one arm.
• Blood flows into the cell separator machine, which removes stem cells.
• Blood rushes back into the veins in your other arm.
• The procedure is not painful, although it can take three to four hours.
• Your doctors may need to draw blood more than once to ensure there are enough stem cells to transplant.

2) During the Transplant

Irrespective of receiving donated stem cells or your own stem cells, the procedure may resemble getting medication or a blood transfusion with the help of an intravenous tube.

• First, your provider may administer fluids and medication to assist prevent adverse effects or lessen the likelihood that your body will reject the new stem cells. 
• Then they will begin injecting stem cells. The process could take many hours. 
• While you are receiving fresh stem cells, your doctor will monitor you for fever, chills, and other potential adverse effects.

3) After the Transplant

Your new stem cells will need time to generate new blood cells. If you got donor stem cells, they will replace harmful stem cells and begin to rebuild your immune system. This medical procedure is known as engraftment.

In either case, you may need to stay in or near the hospital for several months. It enables the healthcare specialists to monitor your recovery and ascertain how many new blood cells your stem cells are producing. 

What you may expect after a stem cell transplant:

• Pre-treatment chemotherapy impairs your immune system’s power to defend you from infection. To lessen that risk, you’ll be alone in a meticulously kept room with little physical touch with others.
• Some persons may exhibit nausea, vomiting, and diarrhea after their transplant. Your physicians will give drugs to ameliorate your symptoms. Fluid intake will replenish what you have lost.
• If you get donor cells, you will be given immunosuppressive medicine. It will lessen the probability that your body will reject them.
• You may require blood transfusions to replace red blood cells and platelets.

Recovery

After receiving a BMT, recovery is slow and gradual. It might take anything from a few months to a year. For the first 100 days following your procedure, your doctor might advise you to remain in or close to the hospital or transplant facility.

As you recover, see your healthcare professional about suggestions for returning to worksite work or school.