Sahyadri Hospital

Bone Marrow Transplant

By Dr. Shashikant Apte

Bone Marrow Transplant (BMT) is one of the most effective procedures that help in treating various types of blood cancer. Most of these cancers start in your bone marrow where blood is produced. The bone marrow is a soft, spongy liquid tissue in the center of the bones. It has a rich supply of stem cells, and its main job is to make blood cells that circulate in your body. BMT majorly includes a medical process to replace the bone marrow that has been damaged or destroyed due to infections or diseases. BMT helps in production of new blood cells and promotes growth of new marrow. This further helps the body make enough white blood cells, platelets or red blood cells to avoid infection or bleeding disorders.

Types of BMT:

Autologous bone marrow transplant also known as rescue transplant is the technique where stem cells are removed from the body before the patient receives high-dose chemotherapy or radiation treatment. The stem cells extracted from the body are stored in a freezer at adequate temperature and returned into the body after the chemotherapy.

Allogenic bone marrow transplant is when another donor’s stem cell are removed and injected into the patient’s body. Certain tests are performed in order to determine the match of donor’s genes to patients. A family member such as a sister or a brother is most likely to be a good match.

Umbilical cord blood transplant is a kind of allogenic transplant which uses stem cells of newborn’s umbilical cord right after birth. These stem cell collected are then stored and used when needed. Today, bone marrow transplant has become easier due to the advance technology in collecting and storing bone marrow from the donor’s body. Bone Marrow is usually collected from donor body and stored for future use.

Donor’s stem cells can be collected in two ways.

Bone marrow harvest is a common procedure used for collecting donor’s stem cells. A minor surgery is performed on the donor and the marrow is removed from the back of the pelvic bone. The harvested marrow is filtered, stored in a special solution in bags, and then frozen. When the marrow is to be used, it’s thawed and then put into the patient’s blood through a vein, just like a blood transfusion. The stem cells travel to the bone marrow and start to make blood cells.

While in Leukapheresis, the donor’s stem cell from the bone marrow is moved into the blood after which the blood is removed from the body through IV line. The white blood cells & red blood cells are separated, saving the white blood cells for the patient and returning the red blood cell to the donor.

A successful BMT depends on the match between the donor & recipient genes. Sometimes it get difficult to find a good match among unrelated donors. The patient is kept under close monitor after the transplant. It generally takes around 10 to 28 days after the initial transplant to notice the first signs of rising white blood cell count. However, it takes around typically 3 to 12 month to recover completely. Recovery also depends on various factors such as donors match, condition of the patient being treated, chemotherapy, etc. It is also possible that some of the symptoms stay with the patient’s life long. One can also donate their bone marrow by registering on the Marrow Donor Registry website.

A bone marrow transplant is sometimes the only option to treat the life-threatening blood cancers disorders. With increasing technology and new researches on the topic each day, it is only becoming easier to treat blood cancer.

Blog Admin

Dr. Shashikant Apte,
Consultant – Haematology & BMT Unit at Sahyadri Speciality Hospital, Deccan Gymkhana, Pune