Procedure for Allogenic Bone Marrow Transplant

What is Bone Marrow Transplant?

Bone marrow transplant is a procedure done for replacing a diseased or unhealthy bone marrow with a normal or healthy bone marrow. These stem cells segregate and create newer stem cells. These cells multiply speedily to produce millions of blood cells daily.

Why is a Bone Marrow Transplant Needed?

Bone marrow transplant procedure is required in the following instances:

• For regenerating the immune system with the objective of fighting off the existing or residual leukaemia or other cancers not killed by the chemotherapy or radiation used in the transplant
• For replacement of diseased, unhealthy bone marrow with healthy functioning bone marrow in conditions like:
  • Leukaemia
  • Aplastic anaemia
  • Sickle cell anaemia
• The genetically healthy functioning bone marrow is used to avoid the further deterioration from a genetic disease

Indicated Diseases in which Bone Marrow Transplant is Useful

Some of the diseases in which the bone marrow transplant is beneficial are:

• Leukaemia
• Thalassemia
• Anaemia types:
  • Aplastic anaemia (severe)
  • Sickle cell anaemia
• Lymphomas
• Multiple myeloma
• Immune deficiency disorders

Types of Bone Marrow Transplant

There are three main types of bone marrow transplant.

1. Allogeneic bone marrow transplant
2. Autologous bone marrow transplan
3. Umbilical cord blood transplant

Allogeneic Bone Marrow Transplant

The term “allo” in Allogeneic means “other”. In allogeneic transplant, the stem cells are removed from “other” people, these are called donors. Usually, these “donor's genes” need to match atleast partially.

Bone Marrow Transplant Procedure

A bone marrow transplant procedure mainly involves 5 stages, which are as follows:

1. Test & Examination:

   Prior to the procedure, various evaluations and tests are conducted for assuring the health and fitness and eliminating bone marrow transplant donor risks. This evaluations help in determining if the bone marrow transplant is safe and helpful for the patient. Also bone marrow transplant risks are evaluated.

2. Harvesting:

   The collection of the stem cells for the transplant usually depends on where the stem cells are taken. The stem cells are usually sourced from the bone marrow, peripheral blood or the blood from the umbilical cord. This is often conducted in an operation theatre setting.

3. Conditioning:

   In conditioning, a high dose of chemotherapy/radiotherapy is given for destructing the existing diseased bone marrow for preparing the donor stem cells to initiate their function.

4. Stem Cell Transplant:

   After the conditioning is done, the patients are rested for a couple of days for allowing the chemo and other drugs to go out of the body. In the transplantation process, the healthy stem cells taken during harvesting are implanted into the body by a central line for regenerating or repairing the tissue.

5. Recovery Phase

   After the completion of the transplant process, hospitalization is required for a few weeks for allowing the stem cells to be accepted and settled in the bone marrow and for initiating the new blood cells production. The patient is monitored regularly for the vitals and blood counts.

   When the patient is being discharged following things are assessed and ensured:

   The transplanted bone marrow is producing sufficient and healthy blood cells

   The absence of serious complications

Risk Involved in Bone Marrow Transplantation

Some of the Bone marrow transplant risks include:

• Graft-versus-host disease (only in case allogeneic transplant)
• Failure of Graft/Stem cell
• Damage to the organ
• Infertility
• Infections
• Cataracts
• Death

Graft-versus-host Disease

In some instances, the recipient's cells are not accepted by the body as a normal reflex fight them back. This condition is called Graft Versus Host Disease (GVHD). This might be beneficial in a few cases, when these cells also happen to attack the cancerous cells left even after the chemotherapy.

Symptoms of GVHD

Some symptoms seen in GVHD are:

• Itching and rash
• Diarrhoea
• Nausea
• Sensitive/dry mouth
• Dry eyes
• Skin dryness
• Shortness of breath
• Joint pain
• Jaundice
• Frequent infections