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Bone marrow is the soft, spongy center of your bone where blood
is produced. Marrow is filled with blood-producing cells, called stem cells,
which develop into mature white blood cells, red blood cells or platelets.
White blood cells of various kinds make up part of your immune
system for fighting infections.Red blood cells are responsible for carrying
oxygen throughout your body.Platelets clot your blood to prevent bleeding. Stem
cells are constantly being produced by your bone marrow, and will develop into
the types of cells your body needs.
Most people who need to undergo a bone marrow transplant have cancer, such as leukemia or lymphoma. There
are different types of bone marrow transplants. The type and severity of your
disease determine what type of bone marrow transplant you will need.
Allogeneic Bone Marrow Transplants
An allogeneic bone marrow transplant involves receiving donor bone marrow or peripheral stem cells. This
bone marrow transplant donor is genetically matched and can be related or
unrelated to you. An autologous transplant involves receiving your own bone
marrow or peripheral stem cells. A syngeneic bone marrow transplant
involves receiving your identical twin's bone marrow or peripheral stem cells.
Allogeneic Transplants
An allogeneic bone marrow transplant involves receiving very
high-doses of chemotherapy and/or radiation therapy, followed by the infusion
of your donor's bone marrow or peripheral stem cells. The high-dose cancer
fighting treatments are given to eliminate the cancer in your body. The
infusion of the new marrow or peripheral stem cells during an allogeneic bone
marrow transplant replaces the bone marrow destroyed by the chemotherapy and/or
radiation therapy.
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You may be a potential candidate for an allogeneic bone marrow
transplant if you have leukemia, aplastic anemia, myelodysplasia,
myelofibrosis, high-grade lymphoma or other types of cancers.
A non-myeloablative (“mini”) allogeneic bone marrow transplant
involves receiving low-doses of chemotherapy and radiation therapy followed by
the infusion of your donor's bone marrow or peripheral stem cells. The
objective of the bone marrow transplant is to suppress your own bone marrow by
receiving just enough chemotherapy and radiation therapy to allow your donor
cells to engraft and grow within you. The hope is these donor cells will mount
an immunologic attack against your underlying cancer, generating a response
called the "graft-versus-leukemia" effect or “graftversus- cancer”
effect.
You may be a potential candidate for a mini allogeneic
transplant if you have a slow growing, indolent disorder, such as chronic
leukemia, multiple myeloma, myelodysplasia, low-grade lymphoma, and in some
cases, renal cell carcinoma. The mini allogeneic transplant is not appropriate,
for example, if you have fast-growing acute leukemia.
Autologous Bone Marrow Transplants
An autologous bone marrow transplant involves receiving very
high-dose chemotherapy followed by the infusion of your previously-collected
peripheral stem cells or bone marrow.
The high-dose chemotherapy treatments are given to eliminate the
cancer in your body. The infusion of your new marrow through a bone marrow
transplant or peripheral stem cells replaces the bone marrow destroyed by the
chemotherapy and/or radiation therapy.You may be a potential candidate for an
autologous bone marrow transplant if you have lymphoma, multiple myeloma,
Hodgkin's disease, germ cell cancer, breast cancer or certain types of
leukemia.
Bone marrow transplant procedure in India comprises two major activities: the harvesting of the stem cells and the transplantation of the stem cells.
The procedure for harvesting stem cells is the same for both autologous and allogenic bone marrow transplants in India. Under general anaesthesia, bone marrow is extracted from major bone structure is such as the hip and the spine. There are no surgical incisions, just skin punctures to insert the needles. The harvested stem cells may need to be processed to make them fit for transplantation.
In the second phase, the actual transplantation procedure is performed. All hospitals that perform bone marrow transplant procedure in India have a special and segregated bone marrow transplant unit which is highly sterile. This is because bone marrow transplant patients are susceptible to infections on account of lower levels of immunity.
Prior to the procedure, catheters are inserted to allow administration of drugs, nutrition etc. Patients would receive medications such as antibiotics and antivirus to prevent as well as to treat infections of any kind. Patients scheduled for allogenic transplant will also receive special medications to prevent rejection of the donor cells by the patients immune system.
Healthy stem cells are introduced into the body through the bloodstream, and no surgery is normally necessary. The stem cells upon reaching the bone marrow, engraft there and after a couple of weeks commence production of normal blood cells.
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