Layman’s Guide to Bone Marrow Transplant

Bone marrow or simply marrow is soft and spongy tissues that found inside the bones. It contains blood-forming cells called blood stem cells that create different blood cells including:

• White Blood Cell or the WBC which forms the body’s defense system to fight against the infections.
• Red Blood Cell or RBC which carries oxygen throughout the body like a supply chain system.
• Platelet that controls the bleeding.

A bone marrow transplant is a branch of medical treatment that replaces the unhealthy marrow with that of the healthy marrow which is in short called BMT. You will be happy to know that the best BMT doctors in India have developed high quality and affordable treatment of bone marrow transplant among the Asian countries and now India has become the destination of the bone marrow transplant to them.

What is bone marrow transplant?

The BMT is a medical procedure that involves the replacement of damaged or destroyed marrow with healthy bone marrow stem cells. The transplant procedure necessitates extraction of healthy bone marrow stem cells and filters them to infuse back to the donor himself or to the recipient. Before transplanting the healthy bone marrow, chemotherapy or radiation or the both may be applied to ensure that the damaged marrows are killed. This is done in the following ways:

• Ablative treatment — In this method, a high-dose of chemotherapy, radiation or both are applied to kill the cancer cells. In this process, the healthy bone marrows are also deliberately killed so that new stem cells can grow in the bone marrow.
• Reduced intensity treatment — It is also called a mini-transplant where a low radiation and chemotherapy are applied before the transplant. This is generally done in the case of older people who have other health problems.

What are the types of bone marrow transplant?

Bone marrow transplants are of the following three types:

• Autologous bone marrow transplant — When healthy stem cells are removed from a patient’s bone marrow before application of chemotherapy and radiation, the stem cells are stored in a freezer. The healthy stem cells are put back to the patient’s body after radiation or chemotherapy treatment to grow normal and healthy blood cells. As this process is done within the same patient, it is called autologous transplant.
• Allogeneic bone marrow transplant — Within the word allogeneic the term ‘allo’ means other or different, so it’s self-explanatory. The stem cells are taken out from a different person, who is called a donor. A special test is undergone to observe a donor is a good match for a patient, at least the genes of donor match partly with the patient under the treatment. Mostly, a brother or sister may be a good match as a donor for the patient. Sometimes, parents, children, and other relatives are also may be a good match for the patient. Other than relatives of the patient, a donor may be searched from the national bone marrow registries to find out the best possible match.
• Umbilical cord blood transplant — This is another type of allogeneic transplant. Stem cells, in this case, are taken out from the newborn baby’s umbilical cord just immediately after the birth. The stem cells are stored under frozen condition until they are required for a transplant. Since the stem cells present in the umbilical cord are immature, they need a less match and as the numbers of stem cells are much less, blood count needs much longer to recover.

The bone marrow transplant is usually made after chemotherapy and radiation. The best hospital for bone marrow transplant in India has the entire infrastructure for such treatment that acclaimed art of world-class procedure. They deliver the stem cells into the patient’s bloodstream through a central venous catheter. The mechanism is very much similar to that of a blood transfusion. The stem cells are transported through blood and finally reach the bone marrow and it does not require any surgery.

How the stem cells are collected?

The donor’s stem cells are collected in the following two ways:

• Bone marrow harvest — It is a minimally invasive procedure performed under general anesthesia. The bone marrow is taken out from the back of both the hip bones. The amount of bone removed from the donor depends on the body weight of the recipient to whom the marrow will be donated. During the entire process, the donor will be asleep due to anesthesia.
• Leukapheresis — A donor is given shots for several days so that the stem cells can move from bone marrow into blood. The blood is removed through an IV line from the donor under the leukapheresis procedure. The White blood cells that possess the stem cells are separated through a machine and removed and stored under frozen condition. Later the stem cells are given to the recipient.

Which diseases are treated under bone marrow transplantation?

A bone marrow transplant is made to treat the accompanying illness of:

• Aplastic Anemia
• Leukemia
• Thalassemia
• Lymphoma
• Multiple Myeloma
• Neuroblastoma

How does a patient prepare before transplantation?

Before performing the transplantation procedure different tests will be undergone according to the patient’s health condition and medical history. Before transplant one or two tube (s) called catheter will be inserted into the blood vessel of neck and arm to give fluid, nutrition, or to draw blood.

How does a patient prepare after transplantation?

Depending on the treatment either autologous or allogeneic transplant, the procedure is performed in a hospital as an outpatient and does not need to stay overnight in the hospital. But the duration of stay depends on:

• How much amount of chemotherapy or radiation was given to the patient?
• The type of transplant is performed.
• The hospital’s treatment protocol.
• Close monitoring of the patient’s blood count and vital signs.
• Completion of anti-infection treatment including antibiotics, antifungals, and antiviral medicines.
• Until a patient can eat food through the mouth without any side effect.

What is the cost of bone marrow transplant treatment in India?

The bone marrow transplant cost in India varies from 15 lakh to 30 lakh depending on the type of transplant, the age of a patient, general health of the patient.

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