Bone marrow transplant

Bone marrow transplant, how much do you know?

A bone marrow transplant is a procedure that transplants healthy bone marrow into a patient whose bone marrow is not working properly, usually due to diseases of the blood, bone marrow, or certain types of cancer. Bone marrow is a spongy tissue found inside bones, like the breast bone, skull, hips, ribs, and spine. It contains stem cells that produce the body's blood cells, including leukocytes or white blood cells, which fight infection, and erythrocytes or red blood cells, which carry oxygen to and remove waste products from organs and tissues, and platelets which enable the blood to clot.

According to reliable online sources, bone marrow transplants do not provide 100% assurance that the disease will not recur, a transplant can increase the likelihood of a cure, or at least prolong the period of disease-free survival for many patients.

A bone marrow transplant enables physicians to treat diseases of the blood and bone marrow with aggressive chemotherapy and/or radiation, by allowing replacement of the diseased or damaged bone marrow after the treatments are completed. This procedure uses high doses of chemotherapy and/or radiation to eradicate the patient’s malignant cell population and return them to their body, as an autologous donor. The advantages of this method include lower risk of graft rejection and infection, and no graft-versus-host disease since donor and recipient are the same individual.
Allogenic involves a donor and recipient whose tissue type matches the recipient’s. The donor can be a relative, like a sibling, or an unrelated volunteer. The procedure uses the donor’s umbilical cord blood as the source of stem cells, and requires the recipient’s own bone marrow to be destroyed prior to the graft to decrease the possibility of rejection or severe graft-versus-host disease.

Prior to a bone marrow transplant patients with diseases such as leukemia, aplastic anemia, sickle-cell disease, lymphoma, and Hodgkin’s may go for several weeks without adequate numbers of white blood cells, which puts patient at risk for infection, sepsis, and septic shock despite prophylactic antibiotics. Immunosuppressive agents further increase the risk of opportunistic infection, which are used to prevent rejection or graft-versus-host disease.

Transplant patients also lose their acquired immunity so they must repeat childhood vaccinations like measles, polio, tetanus, etc. after they have completed treatment with immunosuppressive medications.
For more information on bone marrow transplant, visit the National Cancer Institute at http://www.cancer.gov/ for a fact sheet that explains the step-by-step procedures of the two types of transplantations used including the risks and benefits of each.