The bone marrow is a crucial tissue in the body. Any problem with it shows very drastically on the entire body.
What is a Bone Marrow Transplant?
The bone marrow is a store for all types of hematopoietic stem cells. Any damage to this tissue is a direct hindrance to the blood cells. The blood cells perform various important functions in the body such as transport of oxygen and nutrients, fighting infections, maintaining the body temperature etc. the blood consists of various cells such as red blood cells, the white blood cells (plasma cells, lymphocytes, natural killer cells, leukocytes etc.), and the platelets.
When the bone marrow fails to produce the desired number of blood cells due to any reason, a doctor prescribes a bone marrow transplant. It works on the basic principle that replacing the diseased marrow with a healthy one obtained from a healthy compatible donor.
The diseases which debilitate bone marrow are aplastic anaemia, sickle cell anaemia, thalassemia, cancers such as leukaemia, lymphoma, multiple myeloma or certain myelodysplastic syndromes.
What is required for a Bone Marrow Transplant procedure?
Any medical procedure which involves the exchange of an organ or a tissue or a substance for that matter requires a strict protocol. The success and the failure of the bone marrow transplant procedure depend on this.
Firstly, the donor. The patient whose bone marrow is not working properly is advised by the doctor to get a bone marrow transplant. Usually, all the blood relatives of the patient are examined to see if they are a match.
Matching is a very important step as it can really make or break a transplant. the most important component is the “HLA matching”. Human Leukocyte Antigen or HLA is a protein present on the cell surface. This protein or marker is used by the immune system to differentiate any cell from being foreign. If the HLA matching is not done correctly, the body rejects the tissue and results in a series of complications. The immune system mounts a full-blown attack on the foreign tissue.
How is the patient prepared for a Bone Marrow Transplant procedure?
Bone marrow transplant procedure takes a minimum of a week in the hospital. The patient and the donor’s family are asked to make suitable arrangements for their stay, leaves from the jobs, and other family members.
Doctors also run a full-blood and medical work-up to eliminate all kinds of debilitating illnesses. The patient is required to complete his/her Chemotherapy before receiving the new stem cells so as to gain a better effect.
The recipient is generally immunocompromised till the new cells become active. In order to protect the patient from any kind of infection, he/she is kept in a place which is reserved for people receiving bone marrow transplants. This is done to reduce the chances of exposure to infectious agents.
What is the procedure for a Bone Marrow Transplant?
When all the tests are done, and all the formalities are completed, the doctor gives a red flag for the transplantation. A bone marrow transplant procedure is very much comparable to a blood transfusion.
In case of an autologous transplant, the cells are collected before commencing the cancer treatment. In some cases, patient is transfused with stem cells both before and after the procedure to achieve better results.
If the patient is receiving an allogenic transplant, the cells are retrieved from the donor 1-2 days prior to the transplant.
The cells are taken with the help a needle which is inserted in the hip bone. The patient is usually given local anaesthesia.
What is Leukapheresis?
It is a procedure in which the donor is given a certain drug which facilitates the movement of the stem cells from the bone marrow to the peripheral blood. This makes the harvesting of the tissue during the bone marrow transplant procedure easier. The blood from the donor is then obtained through an intravenous (IV) line. It is connected to a machine which separates the stem cells from other components of the blood and returns the rest of it to the donor.
The next step in the bone marrow transplant procedure is the transfer of the stem cells in the recipient. The stem cells are directly made to flow into the heart using a central venous port which is installed in the upper right portion of the patient’s chest. The heart pumps the cells directly into the bloodstream from where it reaches the bone marrow. The most important part of the bone marrow transplant procedure is the establishment of stem cells in the bone marrow of the recipient.
The patient undergoes multiple sessions to help stem cells to properly integrate themselves to the body. this process is known as “Engraftment”.
Patient is closely monitored by doctors to look for any signs of rejection or other complications.
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