About Bone Marrow Transplant
A bone marrow transplant (BMT) is a special procedure performed to replace either the destroyed or damaged bone marrow with a healthy bone marrow. Bone marrow is soft and fatty tissue present inside the bone, which produces the blood cells.
BMT involves taking the cells usually found in the bone marrow and then giving them back to the patient or another person. BMT aims to transfuse the healthy bone marrow cells into a person after his own unhealthy bone marrow has been treated for killing the abnormal cells.
Need for Bone Marrow Transplant
Various acute and chronic ailments may affect the functioning of the bone marrow and may require bone marrow transplants. Some of the similar conditions are listed below:
Multiple Myeloma This is a cancer which develops in a type of white blood cells.
Amyloidosis This is a rare disease which occurs when amyloid (an abnormal protein, usually produced in the bone marrow) is deposited in any tissue or organ and interferes with its normal functions. Depending upon the type of amyloidosis, a bone marrow transplant may be recommended.
Acute or chronic Leukemia It is a cancer of blood or bone marrow that may eventually need a bone marrow transplant in certain high risk subtypes.
Hodgkin’s or Non-Hodgkin’s Lymphoma These are the cancer of lymphocytes (type of white blood cell). These lymphocytes play a vital role in the immune system.
Myelofibrosis This is a rare type of blood cancer where bone marrow is replaced by fibrous scar tissue. Bone marrow transplant is a treatment which might be considered for patients suffering from this medical condition.
Germ cell tumors These are kinds of tumors where there is growth of cell form from reproductive cells. They are both cancerous or non-cancerous and mainly occur in the ovaries or the testicles.
Immune disorders These disorders lead to abnormally low activity or overactivity of the immune system. An overactivity of the immune system lead the body to attack and damage its own tissues (autoimmune diseases). Low activity of the immune system reduces the body's ability to fight invaders, making it more vulnerable to infections.
Bone marrow failure Aplastic Anemia or Myelodysplastic syndrome in which the bone marrow is unable to form blood cells.
After cancer treatments like chemotherapy or radiation
Some patients after receiving chemotherapy and radiation therapy for cancer, may need a bone marrow transplant.
Type of Bone Marrow Transplant
There are 3 different types of bone marrow transplant:
Autologous bone marrow transplant This is a type of bone marrow transplant where your own cells are utilized. Before receiving a high dose of radiation or chemotherapy, your cells are removed and stored in the freezer. After receiving radiation or chemotherapy treatments, these cells are put back in your body to help in making normal blood cells. This is also called a rescue transplant.
Allogeneic bone marrow transplant This is a type of bone marrow transplant where cells are removed from another person (donor). Most times, the genes of the donor must at least partly match your genes. Before initiating the process, some special tests are done to see if a donor is a good match for you. A sibling is most likely to be a good match. However, sometimes children, parents, and other relatives are also suitable matches. In some cases, donors who are not related to you but matches you, are considered.
Umbilical cord blood transplant This transplant is a type of allogeneic transplant. In this process, cells are removed from a new born baby's umbilical cord right after birth. These cells are frozen and stored until they are needed for a transplant in the future. Umbilical cord blood cells are quite immature, so there is less of a need for perfect matching. Due to the lesser number of cells, blood counts may take much longer to recover.
Pre-Bone Marrow Transplant Evaluation
Before undergoing this procedure, you may need to undergo rigorous evaluation, which includes:
- General health exam: This consists of a physical examination and a cancer screening tests to evaluate your overall health.
- Biopsy: A bone marrow biopsy is done for evaluating its function and to assess for disease involvement.
- Blood tests: There are different blood tests that you may need to undergo to know about gene compatibility.
- Tissue typing: This is required for allogeneic patients only. It includes series of blood tests to evaluate the compatibility or closeness of tissue between the organ donor and recipient.
- Other blood tests: There are series of tests that will be done to detect certain substances in your blood and to evaluate your overall health. These might be done to screen you for any infectious diseases like HIV, to check your organ function, etc.
- Imaging tests: Various tests like CT scan, MRI or PET scan may be recommended to look for any abnormality in the organs.
- Social and psychological evaluation: These evaluations include various measures to assess your stress, financial issues, and support by friends and family.
- Skeletal survey: These are a series of x-rays done for long bones and skulls to assess the disease involvement in patients with multiple myeloma.
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