Bone Marrow Transplant: A Comprehensive Guide

By Dr. R K Choudhary in Cancer Haematology & BMT Bone Marrow Transplant (BMT)

Feb 2, 2023

Bone marrow transplantation, also known as a stem cell transplant, is a medical procedure that replaces damaged or diseased bone marrow with healthy bone marrow cells, also known as stem cells. Bone marrow is the soft and spongy tissue located in the center of bones that produces blood cells, including red and white blood cells, and platelets.

Indications for Bone Marrow Transplant

Bone marrow transplants are used to treat a variety of conditions that affect the blood and immune system, including:

• Blood cancers: Leukemia, lymphoma, and multiple myeloma.
• Inherited blood disorders: Sickle cell anemia, thalassemia, and aplastic anemia.
• Immune system disorders: Severe combined immunodeficiency (SCID) and Wiskott-Aldrich syndrome.
• Genetic disorders: Fanconi anemia and Diamond-Blackfan anemia.

Types of Bone Marrow Transplants

There are two main types of bone marrow transplants:

1. Autologous Bone Marrow Transplant: In this procedure, the patient’s own bone marrow/stem cells are collected and stored prior to receiving high-dose chemotherapy or radiation therapy. After the therapy, the stored bone marrow/stem cells are returned to the patient.
2. Allogeneic Bone Marrow Transplant: In this procedure, the patient receives bone marrow/stem cells from a donor. The donor must be a close match to the patient, usually a sibling, to minimize the risk of rejection.

Preparation for Bone Marrow Transplant

Before the procedure, the patient needs to undergo a series of tests to determine if they are a good candidate for a bone marrow transplant.

These tests include:

• Blood tests: to determine the type and extent of the disease, and to check for any infections.
• Imaging studies: such as X-rays, CT scans, and MRI to get a better understanding of the disease and to determine the best approach for treatment.
• Bone marrow biopsy: a sample of bone marrow is taken to determine if there are any abnormal cells present.
• Donor matching: if an allogeneic transplant is being performed, the patient will undergo tissue typing to determine if the donor is a good match.

Procedure

The bone marrow transplant procedure can take place in several stages:

• Collection of bone marrow or stem cells: this can be done through a procedure called apheresis or by taking a bone marrow sample directly from the hip bone.
• Conditioning treatment: prior to the transplant, the patient may undergo high-dose chemotherapy or radiation therapy to destroy any remaining diseased cells.
• Transplant: the collected bone marrow or stem cells are infused into the patient’s bloodstream through an IV.

Recovery and Aftercare

After the transplant, the patient will be closely monitored for any complications. This may include:

• Graft-versus-host disease (GVHD): a condition that occurs when the donor’s immune cells attack the recipient’s healthy cells.
• Infections: the patient is at a higher risk of infections due to a weakened immune system.
• Organ damage: high-dose chemotherapy or radiation therapy can cause damage to the liver, heart, and lungs.
• Bleeding and clotting: due to a lack of platelets, the patient may experience bleeding or clotting.

The recovery time after a bone marrow transplant can vary, but most patients are able to return to their normal activities within a.