Bone marrow is the soft tissue inside bones, which produces the red and white blood cells and platelets, which are vital for the body’s immune functions. When certain diseases of the blood, like leukaemia, occurs, the high dose of chemotherapy used to destroy the cancer cells can also damage the normal blood cells, requiring a BMT.
One way of transplanting bone marrow is to take it from a donor’s hip bone, separate the stem cells and then infuse it into the patient’s veins. This will be naturally carried to the bone cavities, where it will generate fresh marrow. But this is a painful procedure and is done under anesthesia. But now after discovering that a good yield of stem cells can be harvested directly from blood, we use the method called Peripheral Blood Stem Cell Transplant (PBSCT) for drawing stem cells, which are then transplanted on the patient. Stem cells are taken from the peripheral blood using an apheresis machine.
There are 2 types of bone marrow transplant called autologous and allogenic transplants. Autologous transplant involves isolation of healthy marrow or stem cells from the patient’s own blood before he undergoes high-dose chemotherapy. This is cryo preserved and re-infused to the patient’s body after completion of the chemo treatment.
Allogenic transplant involves a donor, usually a sibling, whose tissue exactly matches the patient’s. Stem cells harvested from the donor are then put into the patient’s veins after giving high dose chemotherapy.
Diseases which require autologous transplant are Multiple myeloma, Lymphoma and few cancers in children like neuroblastoma. It is mandatory to have a reasonable disease control before doing a transplant. Diseases which require allogenic transplant are usually high risk blood cancers.
This is a very complicated procedure as despite a perfect tissue match there is always the possibility of graft rejection.
The post-transplant period is highly critical because the patient’s immune system will not be functioning properly and he/she will be at serious risk of developing infections. The recovery period could be anywhere from three to six weeks.
The decision as to which of these procedures can be opted for a patient depends on the type of the disease and how far it has damaged the bone marrow. If the marrow has undergone extensive damage, an autologous transplant may not be possible. In the case of leukaemia, allogenic transplant is required.
A bone marrow transplant is not a procedure for every one and is adopted for those who fail the standard treatment or whose cancer has been coming back.
It requires machinery for stem cells separation and cryo preservation also a specialised unit with highly sterile environment for post transplant recovery.
KIMSHEALTH Cancer centre has acquired a modern bone marrow transplant (BMT) unit, which will help the institute offer both autologous and allogeneic bone marrow transplants to those suffering from myelomas, lymphomas and acute leukemias at very affordable cost.
