Bone Marrow Transplant is a curative /medical treatment in which defective bone marrow is replaced by healthy marrow. The marrow is either transplanted from a healthy matched donor or the patient’s own disease-free marrow. Bone marrow transplant is indicated in diseases such as blood cancers. Which does not respond to other medication/treatments like Chemotherapy or Immunotherapy? Moreover, it is also indicated in diseases in which the Bone Marrow of the patient, or some blood components become unable to perform their function. For example some disorders like aplastic anemia, Thalassemia, or some platelet dysfunction diseases like Bernard- Soulier syndrome, and red cell dysfunction like red cell aplasia.
Types of Bone Marrow Transplant
There are three types of Transplant
- Allogenic Bone Marrow Transplant.
- Autologous Transplant
- Haplo Identical Transplant
- Syngenic Transplant.
Allogenic Bone Marrow Transplant:
In this type of transplant, a healthy fully matched donor is selected to take Bone Marrow or stem cells. The fully matched donor is then thoroughly screened for any kind of infectious disease like hepatitis B, hepatitis C syphilis, etc. After declaring physical fitness, if a peripheral stem cell transplant is recommended by the consultant the donor is prepared by injecting an injection called G-CSF (granulocyte stimulating factor) to increase the stem cells in the marrow, the total recommended dose is based on the donor’s weight and the injection is normally administered subcutaneously in the abdomen for good results. Furthermore, growth factors are given for 4 days then the donor is admitted on the day of the transplant.
What types of cancers are treated with Allogenic transplants?
Allogenic transplant is offered in the following diseases.
Leukemia(Acute myeloid leukemia, Acute lymphoblastic leukemia,Chronic lymphocytic leukemia, etc)
Severe Aplastic Anaemia
Thalassemia Major
sickle cell anemia
Red cell aplasia
Bernard soulier syndrome and Glanzman thrombesthenia etc.Moreover,
Allogenic transplant is also offered in some diseases that are relapsed after an autologous transplant
What is the process of stem cell collection?
Stem cells are collected peripherally by inserting a large catheter in the neck called Dialysis Catheter OR if Peripheral veins are patent then a large bore needle is inserted to draw blood containing stem cells. The Apheresis machine is attached to the donor blood is moved through the machine Stem cells are collected in a bag called the stem cells collected bag. The rest of the blood is back to donor circulation through another large bore cannula.
The donor remains stable throughout the procedure some sometimes need calcium supplements for hypocalcemia correction. The total time duration for this procedure is around 3-4 hours. After the cell dose is collected donor is discharged home.
Stem Cell Infusion:
Stem cells are infused into the patient on the same day via a central line.
Bone Marrow Collection in Operation Theater:
When the Bone Marrow is collected in OR the donor is given full Anaesthesia and marrow is collected from the iliac crust or the hip bone by inserting needles to aspirate the marrow. The collected marrow is then infused into the patient through the central line on the same day. The donor is then discharged home on the same day.
Autologous Bone Marrow Transplant:
In this type of transplant patient is his /her donor After the patient is free from disease again he is given a GCSF injection to make healthy marrow. After 4 days of GCSF injection dose as prescribed by the transplant consultant patient is admitted to collect healthy stem cells via dialysis catheter and then the cells are preserved in the blood bank. The patient is been given high-dose chemotherapy. The days of chemotherapy depend upon the type of disease. After the course of chemotherapy, the stem cells are re-infused into the patient.
Haplo-Identical Transplant:
Haplo Transplant is the same as Allogenic Transplant but in this transplant, the donor is half-matched with the patient. The process of transplant e.g. the collection of marrow and infusion is the same as in a fully matched Bone Marrow transplant.
Syngenic Transplant: This type of transplant is the same as an allogenic transplant, However, the only difference is, that the donor is an identical twin of the patient.
Bone Marrow transplant consists of special chemotherapy protocols and has different procedures for stem cell collection and infusion. Your transplant consultant will suggest to you the type of transplant you need. Diseases that need Bone Marrow Transplants are Oncological like Leukemia and Lymphomas (AML, ALL . CML, HODGKINS, NON-HODGKINS), multiple Myeloma, etc. Non-malignant diseases include Thalassemia, major Aplastic Anemia, etc. Care of patients after transplant is very crucial and important for better results.
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