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Bone Marrow Transplant
Spine Care
04 January, 2023
A bone marrow transplant (BMT) is a treatment to replace unhealthy bone marrow with healthy bone marrow, which is found inside the bones where the body manufactures and stores blood cells.
Manipal Hospital, India offers the most cutting-edge cancer care and treatment options, including the most difficult bone marrow transplants. Our transplant surgeons are the best in diagnosing and staging the ideal bone marrow therapy for both benign and malignant malignancies. Over 8 lakh successful bone marrow transplants have taken place at our center of excellence for cancer care. Bone marrow transplantation, once regarded as a challenging and uncommon procedure, is now regarded as one of the best cancer therapy success stories. In some cases of blood cancer, it has increased survival rates from almost nil to over 85%. Patients who have received a bone marrow transplant need the best care and comfort possible after the procedure. Under the compassionate supervision of our skilled team of nurses, the patient can recover in the cleanest, most pleasant environment possible thanks to our infection control program.
Jimon Ayinla Fatai from Lagos, Nigeria, who had BMT at Manipal Hospitals in Delhi, shared his journey and experience with his treatment of bone marrow transplantation. He was diagnosed with numerous health difficulties after experiencing a successful spine surgery, which was assessed by the biopsy report. The physicians proposed a bone marrow transplant. He expresses gratitude to the Manipal Hospital administration for his successful bone marrow transplant. He is thankful to the medical professionals and the entire BMT department staff for rendering his effective services.
In a rare instance of bone marrow transplantation, a 3-year-old sister served as a donor for her brother, who had severe sickle cell disease. Dr. C Shivaram, Consultant - Transfusion Medicine, and Dr. Mallikarjun Kalashetty, Consultant - of Haematol Oncology and Bone Marrow Transplantation have shared their experience of performing bone marrow transplantation at Manipal Hospitals, Old Airport Road. Watch the video to know in detail:
The soft, spongy substance known as bone marrow is found in the medullary cavities (centers) of several big bones. Because it contains stem cells that produce blood cells and immune system cells, healthy bone marrow is a crucial component of the body. Each type of cell that can be developed from bone marrow stem cells has a specific role to play in the body. Bone marrow produces many cell types, which are essential for maintaining life. Human bone marrow is of two different types, include:
Red blood cells carry oxygen and nutrients throughout the body.
The white blood cells fight the infection.
Platelets, which are responsible for clot formation.
A bone marrow transplant (BMT) is a treatment used in medicine to restore bone marrow that has been harmed or destroyed by illness, infection, or chemotherapy. During this procedure of bone marrow transplant in India, blood stem cells are transplanted into the bone marrow where they make new blood cells and encourage the development of new bone marrow. The damaged stem cells are replaced with healthy cells through a bone marrow transplant. This aids in the production of adequate red blood cells, platelets, or white blood cells by the body to prevent anemia, bleeding disorders, or infections.
Healthy stem cells can be obtained from a donor or a person's own body. In these circumstances, stem cells can be extracted or cultivated before beginning chemotherapy or radiation therapy. Following storage, these healthy cells are transplanted.
When a person's marrow isn't healthy enough to function correctly, bone marrow transplants are carried out. This could be brought on by ongoing illnesses, diseases, or cancer therapies. Some of the major reasons for undergoing a bone marrow transplant are:
Aplastic anemia is a condition where the bone marrow ceases producing new blood cells.
Marrow-specific malignancies like leukemia, lymphoma, and multiple myeloma.
Chemotherapy-induced damage to the bone marrow.
A genetic condition called congenital neutropenia leads to recurrent infections.
Misshapen red blood cells are a symptom of the genetic blood condition sickle cell anemia.
The genetic blood disorder thalassemia causes the body to produce an abnormal form of hemoglobin, which is a necessary component of red blood cells.
Depending on the donor, there are various forms of bone marrow transplants. The following are some examples of the many BMTs:
The patient is both the donor and recipient. After undergoing intense therapy, the patient's frozen stem cells are returned to them after being removed from the patient via bone marrow harvest or apheresis (a technique for collecting peripheral blood stem cells). Instead of transplant, the word "rescue" is frequently employed.
The patient and the donor have the same genetic makeup. A genetically compatible donor, typically a brother or sister, provides stem cells through bone marrow collection or apheresis.
The umbilical cord is harvested for its stem cells as soon as a baby is born. Compared to stem cells extracted from the bone marrow of another child or adult, these stem cells multiply into mature, functional blood cells more quickly and efficiently. The stem cells are examined, classified, numbered, and frozen until a transplant requires them.
The success of a bone marrow transplant for the patient will be decided by their doctor. The patient will receive a physical examination as well as tests to determine their blood type and the efficiency of their heart, lungs, liver, and other organs.
The patient needs to visit the hospital a few days before their transplant to have a tube called a central venous catheter inserted into a vein in their chest. It will be used by their medical staff to draw blood and administer medication. It will remain there up to the end of their treatment.
The marrow in the hip bone may be harvested using a long needle by the doctor. It is performed in an operating room while the patient is under general anesthesia. The process takes one to two hours. They can leave that day or the following morning. For a few days, they might feel tired and sore.
A process known as apheresis is used to harvest cells directly from the patient’s blood. For a few days before the procedure, the patient needs to take a medication called filgrastim, which causes their bone marrow to produce and release a large number of stem cells. The stem cells will then be extracted from their blood by their medical team using a machine that draws blood from a vein in their arm. The remaining cells return to their bloodstream. Since apheresis is an outpatient operation, they won't need to spend the night in the hospital. Normally, it takes two to four hours.
A bone marrow transplant surgeon in India will pair the patient with someone whose white blood cells contain the same human leukocyte antigen protein (HLA). The patient’s family's HLA type is a genetic trait. The procedure to obtain stem cells is the same whether the donor is a relative or a stranger. At birth, once the umbilical cord has been clamped and cut, umbilical cord blood cells will be harvested if parents opt to donate them.
Chemotherapy, radiation, or both may be administered before the transplant. This can be done by two methods involving:
To eradicate any cancer cells, high-dose chemotherapy, radiation, or both are administered. Additionally, this destroys any remaining healthy bone marrow and enables the development of new stem cells in the bone marrow.
Before a transplant, lower dosages of chemotherapy and radiation are administered. This makes it possible for older people and those with other medical issues to have a transplant.
A bone marrow transplant injects healthy blood-forming cells into the patient's bloodstream, where they may start to multiply and generate red blood cells, white blood cells, and platelets. The patient or a donor who has been evaluated and found to be a good match has already provided the healthy cells that will be used in the transplant. The patient receives the given cells using an intravenous (IV) catheter, or tube, at the time of the transplant.
Understandably, a lot of potential patients want to know if a bone marrow transplant hurts. But the majority of the time, a bone marrow transplant is painless. The procedure is not painful, and the patient is awake the entire time. Getting blood or medication through an intravenous (IV) catheter or tube is quite similar to a bone marrow transplant operation. For many patients, receiving therapy is a big step that means a lot. Like a second birthday, some people commemorate and celebrate the day for a very long time.
The degree of genetic similarity between the donor and recipient is the main factor determining whether a bone marrow transplant will be successful. Finding a good match among unrelated donors can occasionally be exceedingly challenging.
The engraftment will be continuously assessed. After the initial transplant, it usually takes between 10 and 28 days to be finished. An increasing white blood cell count is the initial indicator of engraftment. This demonstrates that the transplant is generating fresh blood cells.
An average bone marrow transplant recovery period lasts three months. However, it can take up to a year to fully recover. Recovery is dependent on several things, such as:
The condition is being treated.
Chemotherapy
Radiation
Donor match
Where the transplant is performed.
Some side effects may be encountered by the patient following the transplant that may linger with them for the rest of their life.
The complications may differ depending on the patient’s condition and other related factors. Some of the complications due to BMT include:
Infections are more likely in patients with severe bone marrow suppression. Most infections are caused by bacteria. Infections from fungi and viruses can be fatal. Any infection has the potential to lengthen hospital stays, hinder or delay engraftment, and potentially harm organs permanently. The immunosuppressed patient is frequently given antibiotics, antifungal medications, and antiviral medications to fend off dangerous infections.
Due to malfunctioning bone marrow, thrombocytopenia (low platelets) and anemia (low red blood cells) can be severe and even fatal. Low platelets can result in life-threatening bleeding in the brain, GI tract, and lungs.
It is typical to experience pain from GI irritation and mouth sores. Radiation and chemotherapy treatments at high doses can lead to severe mucositis (inflammation of the mouth and GI tract).
The primary cause of the fluid overload is the kidneys' inability to handle the massive amounts of fluid that are administered via intravenous (IV) medications, nourishment, and blood products. Additionally, illness, infection, chemotherapy, radiation, or antibiotic use might harm the kidneys.
It is an essential function that could be harmed after transplant. The lungs and pulmonary system may experience potentially fatal consequences such as infection, airway inflammation, fluid overload, graft-versus-host disease, and hemorrhage.
The heart and liver are crucial organs that could sustain harm during the transplant procedure. High doses of chemotherapy and radiation, infection, graft-versus-host disease, and fluid overload can all result in temporary or permanent damage to the liver and heart.
A potential problem is the transplant's (graft's) inability to establish itself in the bone marrow. Graft failure can be caused by infection, recurring illness, or inadequate stem cells in the given marrow to promote engraftment.
A bone marrow transplant can result in a significant and potentially fatal complication. It occurs when the immune system of the donor responds to the tissue of the recipient. The new or transplanted immune system might target the entire patient and all of his or her organs, in contrast to an organ transplant, where the patient's immune system will try to reject only the donated organ. The GI tract, liver, skin, and lungs are the most typical locations for GVHD.
Manipal Hospitals Global
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