Bone Marrow Transplant

What is a bone marrow transplant?

When the bone marrow is not producing sufficient healthy stem cells, which is where red and white blood cells, and platelets, come from, then a bone marrow transplant may be an option. This is sometimes the case when disease, such as leukemia, multiple myeloma, or sickle cell anemia, is life threatening.

Types of bone marrow transplants

A bone marrow transplant involves preserving stem cells extracted (taken out) from the bone marrow and then introducing or re-introducing those cells to the body. The three types of bone marrow transplant are:

• Autologous – meaning the stem cells are coming from the patient and are being extracted before radiation and chemotherapy treatment. The person's own stem cells are later infused back into the body.
• Allogeneic – meaning the stems cells come from a healthy, "matching" donor, who may or may not be a relative of the person needing transplant, but whose genetic type is a match for that person. The stem cells may also come from a cord blood bank.
• Syngeneic – meaning the stem cells are coming from the patient's identical twin

There are a number of risks and potential complications with this procedure, but it can preserve and prolong life for some people.

What to expect from a bone marrow transplant

With autologous bone marrow transplant, a protein called G-CSF is used to trigger the growth and release of stem cells from the bone marrow. The cells are then filtered from the rest of the blood and harvested (collected) through a needle. The harvested stem cells are then frozen (a process called cryopreservation) until they are ready to be reintroduced to the body.

The goal with autologous transplant is to preserve your own stem cells so your body can undergo the intensity of radiation, which will kill any additional cancer cells in the bone marrow and will also intentionally suppress your body's immune system. This will keep the immune system from attacking the new cells when they get reintroduced.

The stem cells are reintroduced to the body by way of an intravenous line (in your vein). The cells travel through the blood to the bone marrow where they will begin healthy production of new blood cells. This process is called "engraftment."

After transplant, you will be particularly at risk of infection due to your weakened immune system from radiation treatments. Your doctor will monitor you closely, checking your blood counts daily and carefully assessing your condition, especially in the first 100 days. Recovering from bone marrow transplant is a lengthy process (it may take up to a year or more to fully recover) and there is plenty of risk of complication as well as side effects from radiation and chemotherapy. Your age and other factors may also affect how well and how quickly you recover.