Bone marrow is a soft sponge-like matter containing hematopoietic cells that produce certain sub-particles such as red blood cells, white blood cells, and platelets. These sub-particles should interact regularly in healthy human beings. A bone marrow transplant is performed as an effective treatment method for some diseases leading to pathologies in the blood such as leukemia, lymphoma, and MDS. The procedure though commonly referred to as bone marrow transplant is actually transplantation of the stem cells collected from the circulating blood and bone marrow.
In bone, there is squishy stuff it is red bone marrow. Red bone marrow is that who makes you all blood cells. Every single day bone marrow is making 500 billion blood cells. When you are young inside of your bone there is squishy stuff, it’s pink with a lot of red marrow but as you get older your marrow starts to turn yellow. Yellow bone marrow has a very light color and it’s very soft because it’s mostly fat cell.
When you are a young color of your bone marrow is red that’s because your body needs more blood and it is growing a lot but as you get older and you don’t have a so much growing to do some of the red marrow which makes blood turn to yellow marrow which is basically a fat. Blood vessels that coming right inside your bones to pick up all that new blood being made by the marrow every single day.
Every year more than the 10000 people in the United States are diagnosed with life-threatening diseases such as leukemia or lymphoma, for which a bone marrow transplant is the best or only treatment. A bone marrow transplant is also known as a stem cell transplant. It’s a procedure that infuses healthy blood stem cells in your body to replace your damaged or diseased bone marrow and these cells can come from your own body or they can even come from the donor.
Today bone marrow transplant is an effective therapeutic method for hematological diseases which were once considered untreatable. This method applying by transplanting healthy bone marrow and is now regarded as one of the most promising advanced in medicines due to its high achievement. Bone marrow transplant kind of encompasses a number of different procedures so there is both autologous and allergenic bone marrow transplant and they are quite different.
Autologous transplant is where we take your own cells and then use high dose chemotherapy to kill leukemia or lymphoma or multiple myeloma and then infuse your own cells back in once again. So it really relies on high dose chemotherapy to try and kill leukemia, the myeloma cells, and not so much on the donor cells.
When you are using your own cells the process is: Peripheral blood is just our regular bloodstream and stem cells are the cells that basically form of all the other blood cells and they normally reside in bone marrow. So as a part of this process give a medication to try and release the stem cells from the bone marrow into the blood and then collect them through a catheter that goes into the arm and sometimes into the chest kind of like dialysis. So the blood is processed through the machine and then skims off the stem cells and then returns the majority of the blood back to the patient.
Those cells are taken and stored frozen and then give the patient treatment that kills leukemia or the lymphoma. The reason why cells take out in advance because to protect them from chemotherapy and not injured them when the chemotherapy has done. When chemotherapy did its job of kills cancer cells then infuse those cells back in again so they are not exposed to chemotherapy so they are in a position to try and replicate and reconstitute the bone marrow very quickly. If without taking out these cells they would not be able to recover as well or it would take a very long time to do that and that would complicate the things.
Allogeneic transplant is a little bit different that involves getting a donor. It’s more like a solid organ transplant where you might think of somebody getting a kidney transplant where there is donor involved. In this transplant chemotherapy alone is not sufficient to eradicate the disease and use the immune system of the donor to help out there and try and eradicate the residual of leukemia and lymphoma cells.
Across the world is about the 20 million people who have signed up to be considered as volunteers for a person that needs a bone marrow transplant. The most important stage of the process is finding an eligible donor for the transplantation candidate. The treatment starts with the test for tissue matches in a laboratory. A tissue match between patients and his/her siblings is more likely to occur than with other relatives. However, lack of compatible tissues within the family in this case bone marrow bank can help.
Stem cell collection from the donor is carried out by two individual methods.
- Stem cells are collected by intravenous access on the arm.
- The other method is the removal of marrow through a needle inserted into the pelvis. Anesthesia is applied to a donor and there is no risk except for that possibly involving the anesthesia itself.
- The marrow is delivered to the laboratory immediately after collection. Stem cells are separated from the marrow and placed in a suitable container. Stem cells are then frozen and stored at minus 192 degree Celsius under sterile condition until the time of transplantation.
- Chemotherapy is applied according to the type of disease type before transplantation, because some disease may require chemotherapy as well as radiotherapy. Such a process lasts about two to eight days following the preparation regime marrow transplantation is performed.
- The patient should stay in the specially filtered room with the HEPA filter. The patient and his companion should not go outside the service area during this process, visitors are not allowed.
The initial induction phase where a disease is brought into control, the patient is evaluated to make sure that he/she can undergo stem cell transplantation safely and this process takes few days were to make sure that the heart, lung, kidneys, and liver are functioning at a satisfactory level before proceeding with safe transplantation.
Somebody with acute leukemia often times we see two main problems; one is where the bone marrow, bone marrow is the factory of the blood cells where that fails and when you have failure of the factory of the bone marrow producing cells you can get a low hemoglobin which is the oxygen-carrying red cells so that can lead to shortness of breath or fatigue or tiredness or general exhaustion.
If you have a failure of the white cells production, the white cells are very important to in trying to prevent or treat infections and so then people can sometimes get bloodstream infections or other types of infections such as Skin infection, lung infection kind of things.
Platelets are very instrumental in preventing bleeding, so sometimes bleeding and bruising can be presenting sign there as well.
Multiple myelomas is a very strong bone specific component to it so sometimes bone fracture or bone disease osteoporosis may be a component of that.
The motivation of the psychological status of patients during the treatment process is a vital factor contributing to the successful outcome of the treatment. So informing the patient about the process is imperative.