Bone Marrow Transplant
Bone Marrow & Stem Cells
Stem cells are special cells that can make copies of themselves and change into the many different kinds of cells that your body needs. There are several kinds of stem cells and they are found in different parts of the body at different times.
Cancer and cancer treatment can damage your hematopoietic stem cells. Hematopoietic stem cells are stem cells that turn into blood cells.
Bone marrow is soft, spongy tissue in the body that contains hematopoietic stem cells. It is found in the center of most bones. Hematopoietic stem cells are also found in the blood that is moving throughout your body.
When hematopoietic stem cells are damaged, they may not become red blood cells, white blood cells, and platelets. These blood cells are very important and each one has a different job.
Red blood cells carry oxygen throughout your body. They also take carbon dioxide to your lungs so that it can be exhaled.
White blood cells are a part of your immune system. They fight pathogens, which are the viruses and bacteria that can make you sick.
Platelets form clots to stop bleeding.
A Bone Marrow Transplant is a medical treatment that replaces the bone marrow with healthy cells. The replacement cells can either come from the patient’s own body or from a donor. A bone marrow transplant is also called a stem cell transplant or, more specifically, a hematopoietic stem cell transplant. This restores the body’s ability to create red blood cells, white blood cells, and platelets.
Transplantation can be used to treat certain types of cancer, such as leukemia, myeloma, and lymphoma, and other blood and immune system diseases that affect the bone marrow.
Types of Bone Marrow/Stem Cell Transplants
Autologous Transplant: Stem cells for an autologous transplant come from your own body. Sometimes, cancer is treated with a high-dose, intensive chemotherapy or radiation therapy treatment. This type of treatment can damage your stem cells and your immune system. That’s why doctors remove, or rescue, your stem cells from your blood or bone marrow before the cancer treatment begins.
After chemotherapy, the stem cells are returned to your body, restoring your immune system and your body’s ability to produce blood cells and fight infection. This process is also called an AUTO transplant or stem cell rescue.
Allogeneic Transplant: Stem cells for an allogeneic transplant come from another person, called a donor. The donor’s stem cells are given to the patient after the patient has chemotherapy and/or radiation therapy. This is also called an ALLO transplant.
Many people have a “graft-versus-cancer cell effect” during an ALLO transplant. This is when the new stem cells recognize and destroy cancer cells that are still in the body. This is the main way ALLO transplants work to treat cancer.
The Transplant Process
Usually, a small tube called the catheter is inserted into the patient’s chest and it stays through the transplant process. The health care team can give chemotherapy, medications, and blood transfusions through a catheter. A catheter greatly reduces the number of needles used in the skin, since patients require regular blood tests and other treatments during a transplant.
AUTO Transplant
- Collection of stem cells: This may take several days. First, a shot of medication is given to the patient to increase the number of stem cells. Then the stem cells are collected through a vein in the arm or chest. The cells are then stored until required.
- Pre-Transplant treatment: This may take 5-10 days. A high dose of chemotherapy is given. And occasionally even radiation therapy is given.
- Putting back the stem cells: This happens on the day of the transplant. Each dose of stem cells usually takes about 30 minutes. This process is called infusion. Stem cells are put back into the bloodstream using the catheter. There might be more than one infusion required.
- Recovery: The patient’s cell’s recovery and growth is closely monitored and antibiotics are given to reduce infection. Any side effects are accordingly treated.
ALLO Transplan
- Donor Identification: A matched donor is needed for an ALLO transplant. Testing is done on potential donors, and if required, the list of unrelated volunteer donors is searched.
- Collection of stem cells from the donor: Stem cells are collected from the donor’s blood or bone marrow. If the cells are taken from their bloodstream, the donor will get daily injections of a medication to increase white cells in their blood for a few days before the collection. If the cells are collected from bone marrow, the donor has to undergo a procedure called a bone marrow harvest.
- Pre-transplant treatment: This takes 5 to 7 days. The patient is given chemotherapy, with or without radiation therapy, to prepare the body to receive the donor's cells.
- Putting the donor cells: This is done on the day of the transplant. The donor cells are infused into the bloodstream through the catheter.
- Recovery: During recovery, the patient will be given antibiotics to reduce the risk of infection and medications to prevent and manage GVHD (graft-versus-host disease). Any other side effects will also be monitored and treated.
Transplants are complex medical procedures & some steps may occur in a different order, depending on the patient’s specific needs.
Recovery Post a Bone-Marrow Transplant
The recovery takes time. Initially, the patient is monitored closely after the transplant. During this time it is important to look out for signs of infection. The intensive chemotherapy that is given before the transplant also damages the immune system. This is done so that the patient’s body can accept the transplant without attacking the stem cells. Due to this, it takes time for the immune system to work again, thereby increasing the risk of an infection right after the transplant. To reduce the risk of infection, antibiotics and other medications are given. In the case of an ALLO transplant, the medications include drugs to prevent or manage GVHD. Regular blood tests & other tests need to be done to examine how the patient’s body and immune system are responding to the donor cells. The patient may also get blood transfusions through the catheter.
Then a long-term recovery plan will be made by the healthcare team, which will involve regular checkups over the next few months and sometimes over years.
Signs of a successful Transplant
The success of the transplant may mean different things to the patient, their family, and the health care team. However, the following factors indicate that the transplant worked well.
- The blood counts are back to safe levels: The blood count measures the levels of red blood cells, white blood cells, and platelets in the blood. At first, the transplant makes these numbers very low for a couple of weeks. This affects the immune system and puts the patient at risk of infections, bleeding, and tiredness. The health care team can lower these risks by giving blood and platelet transfusions. In addition, antibiotics are given to help prevent infections. When the new stem cells multiply and make more blood cells, the blood counts go back up. This is one way to know if a transplant was successful.
- The cancer is controlled: Curing cancer is often the goal of a bone marrow/stem cell transplant. A cure may be possible for certain cancers, such as some types of leukemia and lymphoma. For other diseases, remission of the cancer is the best possible result. Remission means having no signs or symptoms of cancer.
Treatment cost
| Procedure | Price | Hospital Stay |
|---|---|---|
| Thalassemia Transplant | USD 22,000 | 21 Days |
| Pediatric Bone Marrow | USD 12,000 | 7 Days |
| Autologous for Lymphomas - Bone Marrow | USD 19,000 | 7 Days |
| Multiple Myeloma - Bone Marrow | USD 19,000 | 7 Days |
Doctors & Hospitals
Top Transplant Surgeons
Dr. Rahul Naithani
MBBS, MD in Pediatrics, DM in Clinical Hematology, Fellowship in Pediatric Hematology/Oncology & Bone Marrow Transplantation
Dr. Vikas Dua
MBBS, MD (Paediatrics ) , FNB (Paediatric Haematology Oncology)
Dr. Neha Rastogi
MBBS, Diploma in Child Health, DNB (Paediatrics), Fellowship (Paediatric Haemato Oncology & Bone marrow transplantation)
Recommended Hospitals
Max Healthcare
Delhi
Fortis Healthcare
Gurgaon
Medanta Hospital
Gurugram
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or email care@vrozarthealth.com
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