Bone Marrow Transplantation

A bone marrow transplantation is an operation performed to supplant bone marrow that has been harmed or obliterated by illness, contamination, or chemotherapy. This methodology includes relocating the blood stem cells which travel deep down the marrow wherein they produce fresh blood cells and advance the development of new marrow.

Bone marrow is extremely vital for the body as it creates red blood cells, white blood cells, and platelets. A bone marrow transplant replaces damaged stem cells with healthy ones. This aids your body to make sufficient white blood cells and platelets helping you to stay away from diseases, draining issues, or anaemia.

Types of bone marrow transplantation

There are two types of bone marrow transplantation:

• Autologous Transplant: The donor is the patient himself. Stem cells are collected from the patient’s body by the process called bone marrow harvest. Stem cells are then stored away to be frozen. After this, the patient undergoes intensive chemotherapy to treat the disease. This is followed by reinfusion of the stem cells collected from the patient which further helps in restoring blood formation in the body.
• Allogenic Transplant: For this procedure to be successful, the patient needs a genetically matching donor. Both the donor and the patient should have the same gene type. Usually, the donor is a family member. Following the process of bone marrow harvest, stem cells are collected from the donor.

Why is a bone marrow transplant needed

The objective of a bone marrow transplant is to treat numerous kinds of infections and diseases. A bone marrow transplant may be necessary if the expected dosage of chemotherapy or radiation is high.

Bone marrow transplants may also be required if the bone marrow has been obliterated by a sickness. The bone marrow transplant helps in:

• Supplanting infected, non-functioning bone marrow with healthy bone marrow (for conditions like leukaemia, aplastic sickliness, and sickle cell anaemia).
• Rejuvenating the immunity system that will battle existing or leftover leukaemia or other malignant growths not killed by the chemotherapy or radiations utilized in the transfer.
• Supplanting the bone marrow and re-establishing its typical capacity after high dosages of chemotherapy and additionally radiations to treat a malignancy.

Numerous kinds of diseases can also benefit from bone marrow transplantation, including leukaemia, severe aplastic anaemia, lymphoma, multiple myeloma, immune deficiency disorders, some solid tumour cancers, etc.

Treatment

The procedure of bone marrow transplant is as follows:

• The bone marrow transplantation procedure depends on the type of transplant you are undergoing. Medications and the body’s level of tolerance are also examined for the procedure to be conducted.
• Methodologies generally include chemotherapy and additional radiation.

This intense treatment is needed in order to effectively eliminate the danger and make room in the bone marrow for new cells to develop. This treatment is also called ablative, or myeloablative, due to the impact on the bone marrow.

The bone marrow delivers the majority of the blood cells in our body. Ablative treatment delays this cycle of cell creation and the marrow becomes vacant.

An unfilled marrow is expected to account for the new stem cells to develop and build up a robust blood cell creation framework.

• After chemotherapy and radiation are regulated, bone marrow transplantation is given through a focal venous catheter into the circulatory system.

It is nothing but surgery to put the marrow into the bone; however, it is like getting a blood transfusion.

The stem cells find their way into the bone marrow and start replicating and developing new, normal blood cells.

• This is followed by providing supportive care to the patient to forestall any kind of infectious diseases, side effects of treatment, and further complications.

This entails incessant blood tests, closely observing the crucial signs, constant estimation of the fluid input and output, regular weigh-ins, and ensuring a safe and clean environment.

Time taken for the blood creation is called the engraftment period.

Before engraftment, the patient’s blood counts are notably depressed for around 10-20 days; the odds of diseases may be high, so the patients are kept in severe segregation and HEPA-filtered rooms.

During this time, the patient will require close monitoring of blood counts and standard blood/platelet transfusions.

Side effects can involve

Since this is a very intense treatment, the chances of side effects and complications are very likely.

Some are as follows:

• The patient may feel nauseous and may also suffer from a loss of appetite. Most commonly, it lasts for a few days.

The accessibility of modern medications may very well be restricted and controlled to an incredible degree.

• Mouth ulcers are also very likely to occur. These are generally very mild and can be easily treated apart from pain control. If the ulcers are severe, then drinking/swallowing becomes a difficult task. In such situations, patients are given sustenance through veins.
• Patients also tend to suffer from hair loss as a result of intense chemotherapy. This phenomenon is for a very short period and usually lasts till the hair grows back in just a matter of months after the transplant.
• Brief or perpetual sterility may happen in practically all grown-up/adolescent male and female patients after transplant because of side effects of chemotherapy/radiotherapy, although the capacity to engage in sex is not influenced by transplantation.

It is suggested that male patients, who intend to have children, have their sperm stored for future use.

• The liver and heart are vital organs that might be harmed during the transplantation procedure.

Brief or lasting harm to the liver and heart might be brought about by contamination, graft-versus-host disease, high amounts of chemotherapy and radiation, or fluid over-burden.

• Graft Versus Host Disease (GVHD) can be a side effect of allogeneic transplantation.

This condition occurs when the donor’s immune system reacts against the recipient’s tissue. This can be a very severe and fatal condition. GVHD usually affects the liver, skin, GI tract, and lungs of the patient.

In case you have more queries or concerns, visit Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad, or access our website https://www.yashodahealthcare.com/ for more information.