What is Bone Marrow Transplant? Describe in Detail Types, Procedure and Risk
Introduction to Bone Marrow Transplant:
Bone-marrow is the spongy tissue present in the bones in the human body. It is responsible for the formation of blood cells. The blood cell components formed by the Bone-Marrow are Hematopoietic Stem Cells or HSCs. The Hematopoietic cells are further responsible for the creation of red blood cells, white blood cells and platelets.
In short, it is the life forming unit of the body. So, for healthy existence, it is essential that the Bone-Marrow of a person is in perfect condition. In case there is any damage to the bone marrow, it calls for Bone-Marrow Transplant. Now, the question arises what a Bone-Marrow Transplant is?
A medical procedure that is carried out to replace the original bone-marrow in the body that is either destroyed or damaged. The bone marrow may be destroyed because of any disease, specific infection or as a result of chemotherapy.
The process involves the transplantation of blood stem cells. These blood stem cells travel to Bone-Marrow and produce new blood cells. Apart from that, the transplanted stem cells also help in the growth of the bone marrow. Based on the procedures, Bone-Marrow Transplant is of three different types, let us check all the classes in brief.
Types of Bone-Marrow Transplant:
Different types of BMT are:
Autologous Bone-Marrow Transplant:
In this type of transplant, the patient does not require the donor. The surgeon makes use of the patient’s stem cells for the transplantation. He first removes the stem cells from the body of the patient before carrying out any medical procedure. Then preserves these healthy stem cells and lastly eliminates the damaged or diseased part of the stem cell.
It is possible for a surgeon to collect healthy bone-marrow or stem cells by using bone-marrow harvesting or stem-cell mobilisation.
Allogeneic Bone-Marrow Transplant:
This type of transplant is not possible without a donor. In this type of Bone-Marrow Transplantation, the essential requirement is the close match of the stem cells. In most of the cases, the preferred option is a blood-related donor.
But in case of unavailability, doctors consider even the unrelated donor. However, there is no compromise regarding the match exaction of stem cells. Once, the surgeon finds the matching donor; he makes use of the donor’s stem cells for transplantation.
When it is about Allogeneic Bone-Marrow Transplant, higher the degree of match, higher are the chances of success..
Umbilical Cord Blood Transplant:
It is a subtype of Allogeneic Bone-Marrow Transplant wherein the surgeon uses frozen-stem cells to complete the surgery. He receives the cells from the umbilical cord of a new-born baby.
One can use Umbilical Cord Bone-Marrow Transplant without considering a perfect match. It is because the stem cells of a new-born baby are immature. But, the count of stem cells is very less in this case, so the blood count takes a lot of time to recover.
The Procedure of Bone-Marrow Transplantation:
The procedure is not same for all but varies depending upon the type of transplant, disease for which the bone-marrow transplantation is to be carried out, health conditions of the patient, tolerance capacity of the patient etc. You can understand the process of Bone-marrow transplant easily in following steps
Step 1: Ablative or Myeloablative Therapy:
The therapy involves removal of the damaged cells using the chemotherapy or high-intensity radiation. It makes a space in the bone-marrow and creates the space for new stem cells to grow. This method is sufficient to treat the malignancy.
By using ablative therapy, it is possible to stop the production of stem cells in the bone marrow. As a result, the bone-marrow becomes vacant. It is a vital requirement for bone-marrow transplantation. Now, the doctor transmits the new cells to the empty bone-marrow where the cells get the space to grow and also generate new blood cells.
Step 2: Administration of Ablative Therapy:
Once the ablative therapy is complete, then it gets essential to administer the multiplication of stem cells. The doctor carries an analysis if the stem cells multiply at the expected rate. If the multiplication rate is high, then the transplantation process moves to the next step else, the surgeon repeats ablative therapy.
Step 3: Bone-Marrow Transplant:
One requires the central venous catheter for bone-marrow transplantation. The bone-marrow transplantation into the bloodstream does not require surgery and is similar to that of receiving a blood transfusion. The stem cells in blood move freely and find their way to bone-marrow themselves. Once they reach the bone-marrow, they begin to grow, reproduce and generate new cells to convert the damaged bone-marrow into the healthy bone marrow.
Step 4: Post-Surgical Care:
After the completion of Bone-Marrow Transplant, the doctor shifts the patient to the supportive care unit. It is essential to keep the patient away from infections. Continuous blood tests are carried out on the patient to check the threats for side-effects.
The surgeon monitors the diet of the patient. He also keeps an eye on the outcome of any intake. It is vital to carry out minute observation for easy and fast recovery. The entire environment around the patient is kept clean and peaceful.
Risks Involved after Bone-Marrow Transplant:
For BMT, the surgical procedure is carried out on the patient as well as the donor. Both might be under the impression that they have to bear the consequences. So, to clear the doubts of the donor as well as receiver let us check are there any risks involved? If yes, then what?
One of the most complicated situations faced with BMT is the detection of GVHD that is Graft Versus Host disease in the patient. In this condition, the receiver body does not accept the stem cells from the donor’s body.
These stem cells are considered foreign and counter-attacked. Apart from that, some other risks can be cancer, infertility, infections, cataract, stem cell failure, organ damage, and in the rarest of cases, it proves to be fatal. The chances of risks are higher in case of Analogical BMT, as there are higher risks of mismatch.
As far as the donor is concerned, there is no risk in donating the stem cells. A donor has to bear the pain of being under the effect of anaesthesia given during the healing process. Apart from that, the donor is safe in all the ways.
The write-up covers every minute detail about the bone-marrow transplant, which may be highly helpful for patients to decide on their plans to undertake the treatment for themselves or their family members. Bone-Marrow Transplant is a time-consuming process, but a successful surgery results in the rebirth of a patient.