BMT – Bone Marrow Transplant
Bone marrow is a spongy tissue found in the center of many bones in the human body. The following bones contain either the red or yellow form of bone marrow:
vertebra of the spine
Blood cells are made in the bone marrow. Immature blood cells in the bone marrow, called stem cells, divide and mature to form various types of mature blood cells. These include:
red blood cells that carry oxygen
white blood cells that fight infection
platelets, which are cells that help blood to clot
Some diseases such as leukemia result in unhealthy bone marrow. When this happens, the person may need to have a bone marrow transplant. During this procedure, a doctor will take healthy stem cells from one person – the donor – and inject them through a needle into the blood of a person who needs the transplant. The stem cells travel through the blood into the person’s bone marrow. Ideally, the stem cells attach and make new blood cells, thus fixing the problem.
Who is a candidate for the procedure?
Conditions that depress the bone marrow and may require a bone marrow transplant include the following:
aplastic anemia, a condition in which damaged or destroyed stem cells in the bone marrow limit production of red blood cells
bone marrow depression, where the bone marrow has been damaged by treatments such as chemotherapy or radiation therapy
cancers, such as the blood cancers called leukemia and lymphoma
inherited blood disorders, such as thalassemia
some immunodeficiency disorders, such as severe combined immunodeficiency syndrome, a rare inherited condition
How is the procedure performed?
Usually, bone marrow comes from a donor. The procedure is much more likely to succeed when the donor’s bone marrow closely matches that of the person it is going to. Close relatives such as a sibling or parent are most likely to have matching bone marrow. In some cases, the person may donate his or her own marrow before treatment with chemotherapy or radiation therapy. Then the doctor transplants the person’s own bone marrow back into him or her when it is needed.
Donating bone marrow is generally a painless procedure. A doctor will take the bone marrow from the hipbone with a special needle. Most donors are able to go home the same or the next day.
Receiving bone marrow can be more uncomfortable. A doctor will inject or transfuse bone marrow into the person through an intravenous tube, called an IV. An IV is a tube inserted through the skin and into a vein, usually in the chest or neck.
Preparation & Expectations
What happens right after the procedure?
Chemotherapy and/or radiation can be valuable treatments for some diseases, such as cancer. But along with the damage they can do to the bone marrow, these treatments can also destroy the immune system cells. And that might cause the body to reject the transplanted bone marrow. It may take 2 to 3 weeks or longer for the immune system and bone marrow to begin working again. During this time, the person is at high risk for infections. Isolation and infection control measures are used to protect the person from infection. The person may be in the hospital for 4 to 6 weeks, or longer.
Home Care and Complications
What happens later at home?
Recovery from a bone marrow transplant depends on many factors. These include the underlying disease and the body’s reaction to the procedure. Healthcare professionals will need to monitor the person closely for a few months after the procedure. The doctor will decide when the person is ready to safely return to regular activities.
What are the potential complications after the procedure?
The bone marrow donor has a very low risk of complications during and after the procedure. But the things that might occur include:
allergic reactions to anesthesia
The person getting the bone marrow transplant faces risks that are more serious:
Side effects such as sterility and kidney or liver damage from the chemotherapy and the medicines used to prevent rejection
Graft versus host disease, also called GVHD. In GVHD, the donated cells attack the recipient’s body. This happens because the donated cells “see” the person’s body as foreign.
Bone marrow rejection
In addition, the underlying disease may return, or long-term malfunction of the immune system may occur.