Medical Health Encyclopedia

Bone marrow transplant

Bone marrow is taken from the donor in the operating room while the patient is unconscious and pain-free (under general anesthesia). Some of the donor's bone marrow is removed from the top of the hip bone. The bone marrow is filtered, treated, and transplanted immediately or frozen and stored for later use. Then, transplant material is transfused into the patient through a vein (IV line) and is naturally transported back into the bone cavities where it grows to replace the old bone marrow.

Alternatively, blood cell precursors, called stem cells, can be induced to move from the bone marrow to the blood stream using special medications. These stem cells can then be taken from the bloodstream through a procedure called leukapheresis.

The patient is prepared for transplantation by administering high doses of chemotherapy or radiation (conditioning). This serves 2 purposes. First, it destroys the patient's abnormal blood cells or cancer. Second, it inhibits the patient's immune response against the donor bone marrow (graft rejection).

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Following conditioning, the patient is ready for bone marrow infusion. After infusion, it takes 10 - 20 days for the bone marrow to establish itself. During this time, the patient requires support with blood cell transfusions.

Indications:

Bone marrow transplant may be recommended for:

• Bone marrow deficiency disease caused by:
  • Abnormal red blood cell production, such as thalassemia or sickle cell disease
  • Aggressive cancer treatments (chemotherapy, radiation therapy), especially for leukemia or lymphoma
  • Lack of normal blood cell production (aplastic anemia)
• Immune system disorders (immunodeficiency) such as:
  • Congenital neutropenia
  • Severe combined immunodeficiency syndrome

• Patients with heart, kidney, lungs, or liver disorders
• Patients with other diseases that may limit survival

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