Bone Marrow Transplant

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A bone marrow transplant is a procedure to replace impaired or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fatty tissue inside your bones. Stem cells are immature cells in the bone marrow that give rise to all of your blood cells.

Autologous bone marrow transplant: "Auto" means "self." Stem cells are removed from you before you take high-dose chemotherapy or radiation treatment and stored in a freezer (cryopreservation). After high-dose chemotherapy or radiation treatments are done, your stems cells are put back in your body to add to your normal blood cells. This is called a "rescue" transplant.

Allogeneic bone marrow transplant: "Allo" means "other." Stem cells are removed from another person, called a donor. Most times, the donor must at least partly match you genetically. Special blood tests are done to determine if a donor is a good match for you. A brother or sister is most likely to be a good match. However, sometimes parents, children, and other relatives may be good matches. Donors who are not related to you may be found through national bone marrow registries.

Umbilical cord blood transplant: Stem cells are removed from a newborn baby's umbilical cord immediately after birth. The stem cells are stored until they are needed for a transplant. Umbilical cord blood cells are so immature; there is less of a need for matching.

Before the transplant, chemotherapy, radiation, or both may be given. This may be done in two ways:

Ablative (myeloablative) treatment: High-dose chemotherapy, radiation, or both are given to destroy any cancer cells. This also kills all healthy bone marrow that remains, and allows new stem cells to grow in the bone marrow.

Reduced amount (nonmyeloablative) treatment, also called a mini transplant: Patients receive lower doses of chemotherapy and radiation before a transplant. This has allowed older patients, and patients with other health problems to have a transplant.

A stem cell transplant is done after chemotherapy and radiation is complete. The stem cells are delivered into your bloodstream through a tube called a central venous catheter. The process is similar to getting a blood transfusion. The stem cells travel through the blood into the bone marrow. Usually, no surgery is desirable.

Donor stem cells can be composed in two ways:

Bone marrow harvest: This minor surgery is performed under general anaesthesia meaning the donor will be asleep and pain-free during the procedure.

The bone marrow is removed from the back of both hip bones. The amount of marrow removed depends on the weight of the person who is receiving it.

Leukapheresis. First, the donor is given 5 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 in a vein. The part of white blood cells that contains stem cells is then separated in a machine before being returned to the donor.

Risks and complications involved in bone marrow transplant: