Types, Procedures, Risks & Recovery: What Is a Bone Marrow Transplant?

A bone marrow transplant is a procedure that implants healthy blood-making stem cells into the body to replace damaged or diseased bone marrow. A bone marrow transplant is required in cases where the bone marrow is not functioning or cannot produce enough healthy blood cells. There are two main types of bone marrow transplants: autologous and allogeneic. Here is everything you need to know about bone marrow transplants, various bone marrow transplant benefits, major reasons for bone marrow transplant, and the recovery process after the surgery.

What Are the Types of Bone Marrow Transplant?

Autologous Bone Marrow Transplants

Autologous stem cell transplant uses healthy blood stem cells in the body to replace diseased or damaged bone marrow. During a stem cell transplant, using cells from one’s own body has some advantages over using stem cells from someone else. For example, there is no incompatibility problem between the transplanted cells and the body’s own cells in autologous stem cell transplants.An autologous bone marrow transplant may be an option only if the body produces enough healthy bone marrow cells. These cells can be harvested, frozen, and stored for later use. Autologous stem cell transplants are often used in people who need high doses of chemotherapy and radiation in professional bone marrow transplant hospitals. Autologous stem cell transplant helps replace damaged bone marrow. Autologous stem cell transplants are mostly used to treat the following conditions:

• Hodgkin lymphoma
• Myeloma
• Non-Hodgkin lymphoma
• Plasma cell disorders

Allogeneic Bone Marrow Transplants

Allogeneic stem cell transplant uses healthy “blood stem cells” from a donor to replace diseased or damaged bone marrow. Allogeneic stem cell transplant is also called allogeneic bone marrow transplant. The donor could be a family member, an acquaintance, or a stranger. Cells used in allogeneic stem cell transplantation can be collected from different sites such as:

• From the donor’s blood
• From the bone marrow in the donor’s hip bone
• From donated umbilical cord blood

There are certain bone marrow transplant requirements before an allogeneic stem cell transplant is performed, such as taking high doses of chemotherapy or radiation to destroy the diseased cells and prepare the body for donor cells. An allogeneic stem cell transplant may be an option for people with a variety of diseases, including:

• Acute leukemia
• Adrenoleukodystrophy
• Extreme anemia
• Bone marrow failure syndromes
• Chronic leukemia
• Hemoglobinopathies
• Hodgkin lymphoma
• Immune deficiencies
• Inborn errors of metabolism
• Multiple myeloma
• Myelodysplastic syndromes
• Neuroblastoma
• Non-Hodgkin lymphoma
• Plasma cell disorders
• POEMS syndrome
• Primary amyloidosis

How Is the Bone Marrow Transplant Procedure Done?

Before undergoing a bone marrow transplant, a series of tests and procedures are performed to assess the patient’s general health and to ensure that he is physically ready for the transplant. An evaluation may take several days or longer.If an autologous transplant is planned, a procedure called apheresis is used to collect blood stem cells. Before apheresis, daily injections of growth factors are administered to increase stem cell production and transport stem cells into the circulating blood to be harvested. During apheresis, blood is taken from a vein and circulated in a special machine. The machine separates the blood into different parts, including stem cells. Stem cells are collected and frozen for use during transplantation. Then, the remaining blood is returned to the body.In a transplant using stem cells from a donor (allogeneic transplant), a suitable donor is searched, and, when found, procedures for stem cell harvesting are performed. Stem cells can come from the donor’s blood or bone marrow. The transplant team decides which is better according to the patient’s condition. Another type of allogeneic transplant uses stem cells from umbilical cords (cord blood transplant). Mothers can choose to donate their umbilical cord after the birth of their baby. The blood from these cords is frozen and stored in a cord blood bank until a bone marrow transplant is needed.

Recovery: What Happens After the Bone Marrow Transplant?

When new stem cells enter the body, they travel from the blood to the bone marrow. Over time, they multiply and begin to make new, healthy blood cells. While it usually takes a few weeks for the number of blood cells in the body to return to normal, it may take longer for some people. Therefore, it is important to closely monitor the patient’s condition in the days and weeks after a bone marrow transplant. For this, a number of blood tests and similar analyses can be applied to the patient. Complications such as nausea and diarrhea may be observed, and medication may be required to cure them.After a bone marrow transplant, immediate and close medical care is required. If infection or other complications occur, a hospital stay for several days, or sometimes longer, may be required. Within 60 days after bone marrow transplant, the patient may need periodic transfusions of red blood cells and platelets until the bone marrow begins to produce enough of the healthy cells on its own.Even months or years after transplant, patients may be at higher risk for infection or other complications. Bone marrow transplant statistics show that periodic lifelong follow-up appointments should be made to monitor for late complications.

Things to Consider After a Bone Marrow Transplant

If the bone marrow transplant uses stem cells from a donor (allogeneic transplant), doctors may prescribe drugs that reduce the immune system’s reaction (immunosuppressive drugs) to prevent Graft-versus-Host Disease (GVHD). It takes time for the immune system to recover after a transplant. During this time, medications may also be given to prevent infections.After a bone marrow transplant, dietary adjustments may be necessary to stay healthy and prevent excessive weight gain. The nutritionist (dietician) and other members of the transplant teamwork with the patient to create a healthy eating plan that meets their needs and complements their lifestyle. It is even more important to take steps to prevent cancer after a transplant. It is necessary not to smoke, use sunscreen when outside, and have cancer screenings recommended by the doctor.

Frequently Asked Questions About Bone Marrow Transplants

What happens during a bone marrow transplant? How is it done?

On the day of transplantation, stem cells are given to the body through the catheter. The transplant is painless, and the patient is not put to sleep during the procedure.

Is bone marrow transplant painful for the recipient?

While the recipient goes through the procedure relatively painless since the stem cells are injected through a vein, the donor may experience some pain after the anesthesia wears off.

Who can donate for a bone marrow transplant?

While 60 is the upper limit for bone marrow transplant donors, the most important factor in choosing a donor for a bone marrow transplant is the analysis of HLA, the proteins on the blood’s surface, and tissue cells. This HLA count must be as closely matched as possible to the recipient.

Does blood type matter for bone marrow transplant?

Patients and donors need to have a matching HLA type, not their blood type.

Can I undergo a bone marrow transplant abroad?

There are numerous international clinics and hospitals that accept international patients looking for a bone marrow transplant. For more information and costs, such as bone marrow transplant cost in India, click here.