During a bone marrow transplant, a patient receives healthy stem cells (blood-forming cells) to replace their stem cells that have been destroyed by treatment with radiation or high doses of chemotherapy. The healthy stem cells may come from the bone marrow of the patient or a related or unrelated donor. An autologous bone marrow transplant is when they use the patient’s stem cells that were collected and saved before treatment, an allogeneic bone marrow transplant is when stem cells from a related or unrelated donor are used, and syngeneic bone marrow transplant is when stem cells are donated by an identical twin.
What is Bone Marrow?
Bone marrow is the soft, spongy tissue found inside bones. It is where most of the body's blood cells develop and are stored. The blood cells that make other blood cells are called stem cells. It is the stem cells that are needed in bone marrow transplants.
Why is a Bone Marrow Transplant needed?
The goal of a bone marrow transplant is to cure many diseases and types of cancer. When the doses of chemotherapy or radiation needed to cure a cancer are so high that a person's bone marrow stem cells will be permanently damaged or destroyed by the treatment, a bone marrow transplant may be needed. Bone marrow transplants may also be needed if the bone marrow has been destroyed by a disease.
A bone marrow transplant can be used to:
Replace diseased, nonfunctioning bone marrow with healthy functioning bone marrow.
Regenerate a new immune system that will fight existing or residual leukemia or other cancers not killed by the chemotherapy or radiation used in the transplant.
Replace the bone marrow and restore its normal function after high doses of chemotherapy and/or radiation are given to treat a malignancy.
Replace bone marrow with genetically healthy functioning bone marrow to prevent more damage from a genetic disease process.
What are some diseases that may benefit from bone marrow transplants?
Severe aplastic anemia
Lymphomas
Multiple myeloma
Immune deficiency disorders
Some solid-tumor cancers (in rare circumstances)
Why is a bone marrow transplant done?
A bone marrow transplant may be used to:
Safely allow treatment with high doses of chemotherapy or radiation by replacing or rescuing the bone marrow damaged by the treatment
Replace bone marrow that's not working properly with new stem cells
Provide new stem cells, which can help kill cancer cells directly
Bone marrow transplants can benefit people with a variety of both cancerous and noncancerous diseases, including:
Acute leukemia
Adrenoleukodystrophy
Aplastic anemia
Bone marrow failure syndromes
Chronic leukemia
Hemoglobinopathies
Hodgkin's lymphoma
Immune deficiencies
Inborn errors of metabolism
Multiple myeloma
Myelodysplastic syndromes
Neuroblastoma
Non-Hodgkin's lymphoma
Plasma cell disorders
POEMS syndrome
Primary amyloidosis
What are the risks of a bone marrow transplant?
A bone marrow transplant can pose numerous risks. Some people experience minimal problems with a bone marrow transplant, while others can have serious complications that require treatment or hospitalization. Your risks depend on many factors, including the disease or condition that caused you to need a transplant, the type of transplant, your age, and your overall health. Possible complications from a bone marrow transplant include:
Graft-versus-host disease (a complication of allogeneic transplant only)
Stem cell (graft) failure
Organ damage
Infections
Cataracts
Infertility
New cancers
Death
What happens during a bone marrow transplant?
Your bone marrow transplant occurs after you complete the conditioning process. On the day of your transplant, stem cells are infused into your body through your central line. The transplant infusion is painless. You'll be awake during the procedure.
What to expect after receiving a bone marrow transplant?
The success of a bone marrow transplant is primarily dependent on how closely the donor and recipient genetically match. Sometimes, it can be very difficult to find a good match among unrelated donors. When the new stem cells enter your body, they travel through your blood to your bone marrow. There they multiply and begin to make new, healthy blood cells. It takes several weeks before the number of blood cells in your body starts to return to the standard range. You may be at greater risk of infections or other complications for months to years after your transplant. For the rest of your life, you'll meet regularly with your healthcare provider to check for late complications. The typical recovery time for a bone marrow transplant is about three months. However, it may take up to a year for you to recover fully. Recovery depends on numerous factors, including:
the condition being treated
chemotherapy
radiation
donor match
where the transplant is performed
There’s a possibility that some of the symptoms you experience after the transplant will remain with you for the rest of your life.
Conclusion
A bone marrow transplant, also known as a stem cell transplant, is a significant medical procedure used to replace bone marrow that’s not producing enough healthy blood cells. This procedure can be a potential cure for certain diseases or types of cancer. However, it comes with its own set of risks, including graft-versus-host disease, stem cell failure, organ damage, infections, cataracts, infertility, and even the possibility of new cancers. The risk of complications varies depending on many factors, including the disease or condition that led to the need for a transplant, the type of transplant, the patient’s age, and their overall health. Despite these risks, a bone marrow transplant can offer a chance at improved health or even a cure for patients with serious illnesses. Patients must have a thorough discussion with their healthcare provider about the potential risks and benefits before deciding to undergo this procedure.
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