What is Bone marrow and Stem Cell Transplantation?
Bone marrow is the tissue which resides in the spongiform tissues of bones. Stem cells which reside inside the bone marrow form the origin of all cells in human body. Hematopoietic stem cells, which are also found in the bone marrow, mature and differentiate into various blood cells (red blood cells, white blood cells, and platelets). In this context, bone marrow transplantation and stem cell transplantation have identical meaning.
Why Is Bone Marrow Transplant Surgery Done?
Inability of a bone marrow to produce blood cells sufficiently or failure to produce blood cells due to any reason whatsoever will lead to numerous problems, including anemia, being prone to infections and bleeding diathesis. Blood cancers (leukemia, lymphoma), various genetic disorders and the diseases which involve the bone marrow may be the underlying cause of the dysfunction in the bone marrow. In this case, patients should be transferred a healthy bone marrow tissue. The bone marrow can be obtained from the patient or another healthy person.
What Are Types of Bone Marrow Transplantation?
Bone marrow transplantation is classified into two types. First, it is classified according to the donor of the bone marrow or the stem cell. Autologous bone marrow transplantation implies that the bone marrow is obtained from the patient, while the bone marrow of a healthy donor is used in allogeneic bone marrow transplantation. In allogeneic transplantations, the donor can be the sibling (ideal donor), blood relatives or any unrelated person. In syngeneic transplantations, stem cells of the identical twin are used.
The second classification is based on the tissue transplanted. Bone marrow transplantation refers transferring the bone marrow tissue to a patient, while stem cells are used in Peripheral Blood Stem Cell Transplantation. In the cord blood transplantations, stem cells are harvested from the placenta and the umbilical cord.
Drugs that are used in treatment of certain diseases may suppress the bone marrow tissue, leading to permanent damage. In such diseases, healthy bone marrow of the patient is harvested, frozen and stored before the treatment is started. The healthy bone marrow is transferred back to the patient after the disease is treated with high-dose medication(s). The risk of rejection and the possibility of stem cells to attach native body tissues are low, as the patient’s own bone marrow tissue is used. Autologous transplantation is, therefore, safer than the allogeneic transplant.
Use of bone marrow or peripheral blood stem cells obtained from the sibling of the patient, a blood relative or an unrelated person becomes necessary when the bone marrow of the patient loses its functions due to various reasons. Similar to autologous transplantation, high-dose medications are administered for treatment of the diseases before the allogeneic transplantation. The risk of rejection or Graft Versus Host Disease (native cells are attacked by donor cells) is lower in allogeneic transplantations, as other immune cells of the donor are transplanted to the recipient along with stem cells that form blood cells.
How Is Bone Marrow Transplanted?
A series of examination and procedures are required to assess overall health of the patient and to prepare the patient physically for transplant surgery after it is decided that disease of the patient can be treated with bone marrow transplant. These tests, which investigate if the recipient and donor meet certain criteria, may take several days to complete. A catheter is inserted into one of the major veins inside the patient’s body shortly before the transplant stage.
Bone marrow can be suctioned out of the bone with a special needle in autologous transplantation cases. Another method is to administer a medication to the patient which increases the stem cell production in the bone marrow and ensures that the stem cells are released into blood. Next, stem cells inside the patient’s blood circulation are harvested with a procedure, called apheresis. Next, stem cells or bone marrow are frozen and stored to be used after treatment of the main disease.
The first step of allogeneic bone marrow transplant is to find an appropriate donor for the patient. The stem cells obtained from peripheral blood or bone marrow of the donor are frozen and stored until the transplant surgery is performed.
For both transplant groups, the cancer, condition which damages the bone marrow, is treated with high-dose medications before the bone marrow transplantation. Next, immune system of the patient is suppressed and the frozen blood cells are transferred to the patient via catheter.
Stem cells migrate to the bone marrow of the patient following bone marrow transplant and divide there. Next, production of healthy blood cells begins. The immune system is suppressed for a period of time determined by the physician. Moreover, risks of infection, bleeding and anemia caused by low blood values are supervised and treated. The bone marrow starts functioning properly and the blood cell counts are restored to normal ranges within a few weeks under normal circumstances, but it may also take longer in case of any complication. Patients are transfused red blood cells or platelets to manage the conditions caused by low blood counts in this period. Otherwise, infections or other complications may prolong the hospital stay and cause negative effects on the success of the transplant.
The transplant patients are informed in detail regarding precautions they are required to take for their lives after the transplant before they are discharged. Moreover, it is critical for the patients to use medications that are prescribed during discharge strictly as instructed by the physician.
Organ transplantation success rates in global hospital and physician network of Hera Healthcare are comparable to or above the global averages. Transplant patients are closely monitored and have the option to contact us at the minute they have any concern after being discharged.
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