FAQs On Bone Marrow Transplant
by PRIYANSHU SAXENA Medi MarcomQ-What is Blood Marrow Transplantation?
Ans- Blood and Marrow Transplantation
is a form of intensive treatment used to treat certain cancers like leukaemias,
lymphomas and some non-cancerous diseases like thalassemia.
Bone
marrow is found inside our bones, and is the ‘factory’ that makes blood. It is
responsible for producing white blood cells (to protect against infection), red
blood cells (to carry oxygen around the body) and platelets (to prevent bleeding).
Stem cells are blood cells at their earliest stage of development in the bone
marrow, before they have become committed to developing into white cells, red
cells or platelets. It is these stem cells which are the key factors in
transplantation. They replace the diseased marrow as well as provide immunity
against cancers and infections.
Q- What
are the different types of blood and marrow or stem cell transplantation?
Ans- There are
two main types of transplants –
Autologus and Allogenic
Autologus
Transplants : This means that the bone marrow or stem cells
used for the transplant are one’s own. A little bit of the patient’s bone
marrow or peripheral blood stem cells is taken and stored before high dose
treatment.
When the
treatment is over, the bone marrow or stem cells are given back through a vein.
Allogeneic
Transplants: In this
type of transplant, bone marrow donated by someone else is used. It is
essential that the donor's tissue matches. The most suitable donor is usually a
close relative, most commonly a brother or sister.
Rarely,
parents can also be the source for haploidentical transplants.
It is
also possible to get a good match from an unrelated donor from international
registries. Umblical cord blood stem cells from public cord blood banks is also
available in India.
There are
three main steps in the transplantation process-
The
first step - The aim
here is collection of the bone marrow or stem cells (the harvest) from the
donor. We now know that the umbilical cord blood is also rich source of stem
cells.
The
second step - The aim
in this step is to completely destroy the exiting bone marrow and thereby help
the patient receive the new stem cells.
The
third step - The aim
here is to in fuse the bone marrow or stem cells through the intravenous route,
like a blood transfusion. There may be no signs of a new bone marrow growing
for two to three weeks, and occasionally it may be a few months before the new
bone marrow produces all the components of the blood adequately.
Q-How are the peripheral blood stem
cells collected?
Ans- Stem cells
harvesting is done following a course of daily injections of growth factor.
This procedure takes about 3 hours. The patient will be made to lie down on a
couch and a transfusion will be put into the vein of each arm. Blood will be
collected from one arm, into a machine called a centrifuge, which spins it to
separate out the stem cells. These are collected, and the remaining blood is
returned through the vein in the other arm. In some cases it is curative, in
others it is the only way to controls the disease and prolong life.
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