Bone Marrow Transplantation (BMT) is a medical procedure done to replace damaged bone marrow with healthy bone marrow cells. In this, the stem cells from the bone marrow, which are responsible for producing various blood cells like red blood cells, white blood cells and platelets, are injected in a recipient after a short course of chemotherapy called “Conditioning“.
When is BMT required?
You may experience following symptoms:
- Skin lesions- Plasma cells may form purple lumps
- Painless Swollen lymph nodes in neck, armpits or groin
- Abdominal pain or swelling
- Increased sensitivity in lymph nodes
- Extreme palpitations
- Easy bruising and bleeding
- Enlarged Spleen and liver
- Congenital conditions like short stature, abnormalities of skin, head, ears and development disabilities.
Types of Transplants
This procedure is found to be extremely effective in various Haematological (related to blood) and Oncological (related to cancer) conditions such as leukaemia, lymphoma, and multiple myeloma. Different types of hematopoietic stem cell transplant are as follows:
Autologous Hematopoietic Stem Cell Transplantation
This transplantation procedure involves using a patient’s own stem cells. These stem cells are generally collected from vein of body using a cell separator machine after giving the patient growth factor injections for 4-5 days. After collecting adequate stem cells, patient is given high doses of chemotherapy which kills the disease.
Indications: Multiple myeloma, Lymphoma, Acute Myeloid Leukemia, Neuroblastoma, Certain Brain Tumors
Allogeneic Hematopoietic Stem cell Transplantation
Stem cells are taken from another person, called a donor. The donor must partly match the patient genetically and special blood tests are done to check if the donor is a good match. A brother or sister and sometimes other family members are most likely to be a good match.
Indications:
- Thalassemia
- Sickle cell anaemia
- Aplastic anaemia
- Fanconi anaemia
- Pure red cell aplasia
- Metabolic disorders like Gaucher’s disease
- Krabbe’s disease
- Immunodeficiency states-SCID
- leukocyte adhesion deficiency
- Hemophagocytic lymphohistiocytosis
- Acute lymphoblastic leukaemia (ALL)
- Acute myeloid leukaemia (AML)
- Chronic myeloid leukaemia (CML).
Is Surgery required?
It is “rarely” required. Only when donor is very small then the stem cells are collected by bone marrow aspirations. Mostly, stem cells are collected via peripheral vein and the whole procedure is like donating blood or platelets.
Is there any Risk to Donor?
It is an extremely safe procedure for the donor and the patient can return to normalcy within 6 months- 1year post successful transplant. The modern day advancements are such that the risk to donor is nearly negligible. However, they may get fever and or body pain for 1 day or so whichever is manageable. The donor need not be admitted and does not require anesthesia.
What happens if there is no donor available?
These days we can do unrelated donor search from international bone marrow donor registries. There are already several patients who have been benefitted from transplants with bone marrow or stem cells being donated at international centers and brought to India.
