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Bone marrow is the spongy and soft tissue inside bones that produces blood cells. Blood-forming cells are found in the umbilical cord blood and blood stream. These cells turn into blood cells including:
A bone marrow transplant is a procedure to replace destroyed or damaged bone marrow with healthy one. This blood stem cells travel to bone marrow and produce new blood cells. There are three types of Bone Marrow Transplants:
In Autologous Transplant, patient’s own blood-forming cells are collected, stored and frozen. They are then transferred to patient after chemotherapy or radiation. Doctor will decide when to collect the cells from patient, which are then frozen at bone marrow transplant hospitals in India until patient needs transplant.
In allogeneic transplant, marrow is taken from unrelated donor. The donor can be family member or someone else. Patient get donated blood-forming cells from umbilical cord blood. This is the blood collected from placenta and umbilical cord after a baby is born.
Haploidentical transplant is type of allogeneic transplant in which cells are collected from half-matched donor. The donor is a family member.
For autologous transplant, there two options to collect cells:
The cells collected from patients blood stream, this process is known as apheresis. Before apheresis, patient gets shots for few days to increase number of cells in blood stream. During apheresis, blood is removed from vein through an intravenous (IV) line, passed through vein and transferred back to vein. The machine collects the cells that will be used for transplant.
In this procedure, cells are collected from hip bone before surgery. Patient get anesthesia and doctor uses a special needle to take out blood-forming cells from bone marrow.
The doctor tests blood to find patient’s Human Leukocyte Antigen (HLA) type. HLA is a protein found in cells of body. The best outcomes happen when patient’s HLA is closely matches the donor’s HLA. Matching HLA markers is complex and once matched it helps to lower the risks after transplant. Doctor will look for matching donor in family usually sister or brother, because we inherit HLA markers from parents. Each sibling has 25% chances of completely matching patient.
About 70% of patients who need transplant don’t have match in their family. So, doctor will help you to search donor as soon as possible.
Haploidentical, or half-matched, donor is patient’s mother, father or child. Siblings have 50% chance of being half-match for each other and parents are half-match for children. This is a newer type of transplant, this means not all transplant centers perform this type of transplant
Transplant process includes various phases – stem cell collection from donor, conditioning with chemotherapy or radiotherapy, stem cell infusion, pre-engraftment bone marrow suppression and post-engraftment follow up.
Before transplant, patient gets chemotherapy, radiation therapy or both to destroy the diseased blood-forming cells and marrow. Then, damaged cells are replaced with healthy cells. These new cells go into bloodstream through intravenous (IV) line. The cells travel to marrow where they grow and start making healthy white blood cells, red blood cells and platelets.
Average time taken for engraftment is 3-4 weeks. After that patient is discharged and kept on oral medications to prevent infections and diseases. After the bone marrow transplant in India, the patient is monitored for first 3-6 months of transplant. The patient recovers completely in 3-12 months.
Bone marrow or cord blood transplant is the best treatment option for a cure for patients with lymphoma, leukemia, sickle cell anemia and many other diseases. Bone marrow transplant can treat: