Bone Marrow Transplant
Contents
About Bone Marrow Transplant
A Bone Marrow Transplant (BMT), also known as a hematopoietic stem cell transplant, is a medical procedure used to replace damaged or destroyed bone marrow with healthy stem cells. These stem cells develop into red blood cells, white blood cells, and platelets, which are essential for carrying oxygen, fighting infection, and preventing bleeding.
BMT is primarily used to treat blood cancers and serious blood or immune system disorders. The healthy stem cells may come from the patient (autologous transplant) or from a donor (allogeneic transplant).
Types of Bone Marrow Transplant
- Autologous Bone Marrow Transplant:
In this type, the patient’s own stem cells are harvested and stored before undergoing high-dose chemotherapy or radiation. The cells are then returned to the body to restore healthy bone marrow. - Allogeneic Bone Marrow Transplant:
Stem cells are received from a genetically matched donor (a sibling, relative, or unrelated donor). This type is used in conditions where the patient’s own marrow is diseased or defective. - Umbilical Cord Blood Transplant:
Stem cells are collected from a newborn’s umbilical cord and placenta. These cells are less mature, reducing the risk of rejection, and are often used in pediatric transplants. - Haploidentical Bone Marrow Transplant:
A type of allogeneic transplant using a donor who is a half match, such as a parent or child. This approach expands donor options, especially for patients with rare matches.
Conditions Treated with Bone Marrow Transplant
BMT is recommended for patients with:
- Blood cancers such as:
- Leukemia (AML, ALL, CML, CLL)
- Lymphoma (Hodgkin’s and Non-Hodgkin’s)
- Multiple Myeloma
- Bone marrow failure syndromes:
- Aplastic Anemia
- Myelodysplastic Syndrome (MDS)
- Inherited metabolic or immune disorders:
- Thalassemia Major
- Sickle Cell Anemia
- SCID (Severe Combined Immunodeficiency)
- Hurler’s Syndrome
Risk Factors
- Graft-Versus-Host Disease (GVHD): A serious complication of allogeneic transplants where the donor’s immune cells attack the recipient’s tissues.
- Infections: High risk of infections due to low white blood cell count post-transplant.
- Bleeding: Caused by low platelet count after transplant.
- Organ Damage: High-dose chemo or radiation can damage liver, lungs, heart, or kidneys.
- Infertility: A potential long-term side effect.
- Cataracts: Can develop over time due to radiation or steroids.
- Relapse of Original Disease: In some cases, the original cancer or disorder can return.
- Graft Failure: The donor stem cells do not grow or function properly in the recipient.
Investigations
Before undergoing BMT, patients undergo a thorough evaluation to ensure fitness for the transplant and to match with a suitable donor:
- Complete Blood Count (CBC) and other blood tests
- Bone Marrow Biopsy to assess the disease
- HLA Typing (Human Leukocyte Antigen Test) to match donor and recipient
- Chest X-ray and CT scans to check organ function
- Heart and Lung Function Tests
- Infectious Disease Screening
- Psychological Assessment to prepare the patient and caregivers
Side Effects
Common side effects after BMT include:
- Fatigue and weakness
- Mouth sores and gastrointestinal issues
- Skin rashes or dryness
- Hair loss (from chemotherapy)
- Nausea or vomiting
- Low immunity for several months
- Emotional changes like anxiety or depression
Most side effects are temporary and manageable with medication, nutrition, and supportive care.
Success Rate
The success rate of bone marrow transplant depends on several factors such as the type of disease, age, donor match, and overall health of the patient:
- Autologous Transplant: 70–90% success in many blood cancers
- Allogeneic Transplant: 60–80% in well-matched donors and early-stage disease
- Children and younger adults often have better outcomes
- Long-term survival and cure are possible, especially if transplant is done early in the disease course
Recovery may take 3 to 12 months, and patients need regular monitoring and follow-up care during this period.