Bone marrow transplantation is a procedure that has become popular over the past decades, primarily with the advent of technology and excellent success rayes. Bone marrow transplantation has been instrumental in transforming lives across the world for patient suffering from blood and bone marrow conditions. The stem cell transplantation technique has been giving hope and a second chance in life to critically ill cancer people. If you are wondering what bone marrow transplants is and how it works, what is BMT treatment cost in India, this article is for you.
Defining bone marrow transplantation
Bone marrow transplant is a hematology procedure that involves replacing the hematopoietic or the blood forming stem cells of the body with new healthy stem cells. It can be a life-saving procedure for certain people who have conditions such as lymphoma, myeloma, leukemia, and other cancers and blood related immune disorders affecting the bone marrow. The bone marrow transplant is also referred to as a stem cell transplant or hematopoietic stem cell transplant for this reason. The definition of bone marrow transplantation leads us to the next question: what is bone marrow?
What is bone marrow?
The bone marrow is the soft and spongy tissues found within some large bones of the body such as in the thighs and hips. The bone marrow contains the hematopoietic stem cells that can differentiate and form different types of blood cells in the body. In a healthy individual, a stem cell differentiates into the following cells:
- Red blood cells: carry oxygen to various parts of the body
- White blood cells: fight infection and improve immunity
- Platelets: cause blood clotting and stop excessive bleeding.
When a medical condition such as those mentioned above affects the bone marrow or the immune system, the ability to produce blood cells is compromised. In that case, the patient needs a bone marrow transplant to continue adequate blood cell production.
An ideal candidate for bone marrow transplant
A patient with any of the following condition may qualify as a candidate for bone marrow transplant
- A severe form of cancers such as lymphoma or leukemia
- Genetic immune disorders like sickle cell disease or thalassemia
- Aplastic anemia – a bone marrow disease
- Damage of the bone marrow due to cancer treatments such as chemotherapy or radiation therapy
Types of bone marrow transplants
The bone marrow transplant is of three types based on the source of healthy donor cells.
Allogeneic transplant: In allogeneic or allo transplant, the donor cells are taken from a donor who is typically a close family relative such as a parent or sibling. The stem cells are taken from a close family relative because the genetic makeup is similar. Donor cells from a close family relative reduce the risk of rejection. If a close family relative is not available, the doctor will find search for another donor with a high degree of match. In this procedure, the donor cells are transplanted after session chemotherapy and radiation therapy in some patients. To prevent the “graft-versus-host” effect, finding the perfect match is highly crucial.
Autologous transplant: In this procedure, the source of healthy donor cells is the patient itself. The doctor will carefully remove the affected area and replace it with stem cells from the patient.
Cord transplant: the cord or umbilical cord transplant is a type of bone marrow transplant where the stem cells are taken from the umbilical cord which is preserved after the birth of the baby. The umbilical cord stem cells need not be an exact match like the adult stem cells.
The procedure starts with an examination of the patient’s health. For both the allogeneic transplant and autologous transplant, the procedure starts with the selection of donor cells and the collection of stem cells. If a donor is involved, the stem cells are acquired well in advance of the transplant to test the suitability to the patient. In an autologous transplant, the cells are recovered a few days before and kept in cold storage.
The transplantation procedure typically takes place over several days. The body is prepared for the uptake of new cells. In an auto transplant, several sessions of high dose chemotherapy are given to the patients. The pre-transplant treatment step takes place for 5 to 10 days. Followed by pre-transplant treatment, the stem cells are infused into the bloodstream via the catheter. Infusion of stem cells takes about 30 minutes.
In allo transplant, the donor cells collected from the close relative by HLA testing is examined by the doctors. The collection procedure is known as a bone marrow harvest. Once matching cells are collected, the same procedure as in autologous transplant is done.
Once the final session of infusion is complete, doctors will check your blood each day to determine the success rate of the procedure. It is done by checking whether there is a growth of new cells in the bone marrow. An increase in the concentration of white blood cells indicates that blood production has started which means the transplant is successful. In the case of a bone marrow transplant, recovery is a long process. The pace of recovery depends on various factors such as:
- The type of bone marrow transplant
- The recovery rate of the immune system
- Acceptance of the new and healthy cells by the body.
The doctor will examine the patients for several weeks to months for signs of infection or GVHD. Some can discharge soon after the bone marrow transplant while some need to stay in the hospital for several weeks to months.
Risks associated with bone marrow transplant
Though bone marrow transplant extends life and gives a second chance, some risks are associated with the procedure. Following are some risks that a person undergone a bone marrow transplant might experience:
- mucositis, inflammation, and soreness in the throat, mouth, and stomach
- graft failure
- early menopause
- organ damage
- graft-versus-host disease, the attack of body cells by the donor
- bleeding in various parts such as brain and lungs
- In severe cases, bone marrow complications might lead to the death of the patient.
Bottom line: Bone marrow transplant is a complex and expensive procedure. The affordable range of bone marrow transplant cost in India offers a ray of hope for people who may otherwise be not able to afford it. The success rate depends on various factors such as the type of bone marrow transplant and the clinic at which the procedure is done. So opt for the best transplant hospital after careful consideration.