All That You Need to Know About Bone Marrow Transplant: Introduction, Types, Indications and Risks

What is a bone marrow?

Bone marrow is a flexible, fatty, soft tissue present in the interior of the bones. The chief function of a bone marrow is to produce different kinds of blood cells.

What is a Bone Marrow Transplant?

Bone marrow transplant is a surgical procedure where a bone marrow that is destroyed or damaged by cancer, chemotherapy, infection or another condition is replaced with healthy bone marrow stem cells.

What are the types of Bone Marrow Transplant?

1. Autologous bone marrow transplant: As the name suggests (auto meaning self), in this type of transplant the person’s own stem cells are used. Stem cells are taken and preserved in the freezer before beginning a process that destroys bone marrow cells like radiation therapy or chemotherapy. Once these treatments are over, self-stem cells are put back in place. Such a transplant is sometimes called as rescue transplant.
2. Allogeneic bone marrow transplant: As the name suggests (allo meaning other), in this type of transplant stem cells from another person (referred to as a donor) are used. It’s necessary that the patient’s and donor’s genes match, for which special tests are performed before the procedure. Usually, siblings can act as good donors, otherwise children, parents or relatives can also fit as donors.
3. Umbilical cord blood transplant: Logically, this is a sub-type of allogeneic transplant. Instead of an adult donor, the stem cells transplanted are taken from a neonate’s umbilical cord at the time of birth. The stem cells are then stored and transplanted when needed. Since umbilical blood cells are quite immature, the requirement of matching is not absolute. However, in such transplants it takes longer to recover the blood counts as the number of stem cells is little.

When is a Bone marrow Transplant needed?

A bone marrow transplant is required when bone marrow is non-functional, dysfunctional or was destroyed due to medical procedures. Donor’s WBCs (white blood cells) may fight any remaining cancerous cells. The process is similar to our natural immune system where WBCs attack any pathogen (bacteria or viruses) in the event of an infection. A senior oncologist at a reputed cancer hospital in Delhi recommends that a bone marrow transplant may be needed in following conditions:

1. In various cancers like lymphoma, leukemia, multiple myeloma or myelodysplasia
2. In various conditions where bone marrow isn’t functioning properly like congenital neutropenia, aplastic anemia, , thalassemia, sickle cell anemia and severe immune system disorders
3. After the destruction of bone marrow due to radiation therapy or chemotherapy.

What are the risks and complications associated with Bone Marrow Transplant?

Risks are:

1. Hypotension
2. Chest Pain
3. Fever with chills
4. Flushing
5. Headache
6. Altered taste
7. Hives
8. Nausea and vomiting
9. Diarrhea
10. Shortness of breath
11. Pain

Possible complications are:

1. Internal bleeding which could involve brain, lungs, intestines or any other area of the body
2. Anemia
3. Cataract
4. Damage to internal organs like liver, kidneys, heart and lungs
5. Clotting in small liver veins
6. Pre-mature menopause
7. Delayed growth in recipient children
8. Graft failure
9. Graft versus host disease (GVHD)
10. Life threatening infections
11. Mucositis: Inflammation and soreness of mucosal lining in parts like throat, mouth, esophagus and stomach.