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Bone Marrow Transplant(BMT)

bone marrow transplant
Bone marrow and healthy blood cells are among the things that are used to keep people alive and can even save a life by donating it. But what we are going to address today is the introduction of Bone Marrow Transplant (BMT) and the types of this procedure .

Bone marrow definition

Bone marrow is the spongy tissue inside some bones of the body, including the thigh bone, which contains immature cells, called stem cells. Bone marrow is a major center of blood cell production and is therefore a vital part of the human body.
bone marrow transplant

What is a bone marrow transplant?

Bone marrow transplantation is the replacement of a patient's damaged or diseased bone marrow with healthy bone marrow.
Bone marrow transplant is a medical method in which stem cells are extracted from the bone marrow and refined. They are then used for the same individual( AUTO transplant )or another person(ALLO transplant).

What diseases can be treated by BMT?

The first bone marrow transplant was successfully completed in 1986 and since then, bone marrow transplantation has been used to treat diseases such as aplastic anemia (inability to build new tissue), leukemia, bone marrow cancer, immune system disorders, lymphoid tissue tumors ( Lymphoma) Like lymphadenoma (Hodgkin's disease) and some solid tumors such as breast and ovarian cancer.

Why bone marrow transplant?

In the body of people with one of the diseases listed above, either premature and defective blood cells are produced (leukemia patients) or the number of blood cells is severely low (patients with aplastic anemia).Incomplete blood cells accumulate alongside normal blood cells, disrupt their function, or even invade other tissues. Abnormal blood cells can be destroyed using high doses of radiation chemotherapy, but these can also damage normal blood cells in the bone marrow.
In bone marrow transplantation, the doctor uses radiation to kill abnormal cells and damaged bone marrow cells are replaced with bone marrow. It should be noted that ,although bone marrow transplantation does not guarantee that the disease does not return, it does help the patient enjoy a longer life.

Types of bone marrow transplantation

The 3 forms of bone marrow transplant are:

 

 
1- Autologous Transplant
During the AUTO transplant ,healthy blood stem cells from the patient’s own body are used to replace with diseased or damaged bone marrow . In this procedure the patient's bone marrow is removed and exposed to anticancer drugs to kill malignant cells. The resulting product is then frozen and stored to later be injected to the patient.
2- Allogeneic transplantation (donor transplant)
In ALLO transplant the patient receives a stem cell transplant from another person .Usually a sibling or family member , an acquaintance or another donor (volunteer )who has no relationship to the patient. This person must have close tissue type matches to the patient's body. This is the most common transplant done in which stem cells used in transplant are collected from :The donor's blood
The bone marrow within a donor's hipbone
The blood of a donated umbilical cord
bone marrow transplant
bone marrow transplant
3- Syngeneic Transplant (identical twin transplant) In this transplant method , healthy stem cells (bone marrow) are harvested from the identical twin ,who has a very similar tissue ,to be replaced with patient’s stem cells which have been destroyed due to disease or radiation therapy
-There are other methods, such as Umbilical Cord Blood Transplantation, in which the stem cells are taken just after the baby is born. These stem cells’ success rate and efficiency in the bone marrow transplant to another child or other adult is much greater.

How is bone marrow transplant done?


After collecting stem cells bone marrow by one of the 3 methods mentioned above, high doses of chemotherapy with or without radiation therapy is given to the patient to destroy the damaged or diseased bone marrow.Finally, the healthy collected bone marrow is heated and injected with a needle through a vein to replace the damaged bone marrow.After the bone marrow enters the bloodstream, the transplanted cells are directed to the bone marrow site and produce white blood cells, red blood cells, and new platelets.

Bone marrow transplant complications

Short term (early) complications of a bone marrow transplant
These side effects are essentially similar to other types of chemotherapy, although more severe. These include:
  • Low blood cell count (fatigue, increased risk of infection, bleeding)
  • Nausea, vomiting
  • Decreased appetite
  • Mouth ulcers
  • hair loss
  • Graft versus host disease (GvHD):which may occur only in allogeneic transplantation
One of the most common and serious short-term complications is the increased risk of infection. Antibiotics are often given to prevent infection. Other complications, such as red blood cell counts and platelets, may require transfusions of blood products or other therapies.

Long-term (late) complications of a bone marrow transplant
Some complications can persist for long or may not occur for months or years after transplantation. These include:
  • Graft versus host disease (GvHD): seen only in allogeneic transplantation.
  • Damage to the lungs, which leads to shortness of breath.
  • Infertility
  • Thyroid injury that causes problems with metabolism.
  • Cataract (eye lens damage that can lead to visual impairment).
Bone damage called aseptic (non-infectious) necrosis in which the bone dies due to poor blood supply. If the injury is severe, the patient may need to replace part of the bone and joint.
Secondary cancers many years later.
 
bone marrow transplant
 

Graft versus host disease (GvHD)

One of the most serious complications of allogeneic transplant is GvHD. This reaction occurs when the donor has taken over the patient's immune system. When this occurs, the immune system may consider the tissues of the recipient's body external and attack them.
Symptoms can include severe skin lesions, itching, mouth ulcers (which can affect eating), nausea and severe diarrhea. Yellowing of the skin and eyes can be caused due to liver damage. The patient may also become tired and have muscle aches. Sometimes GVHD can be debilitating, and if severe enough, it can be life-threatening.
Medications that affect the immune system may be given to control it.

Cost of BMT In Iran

Iran is the second country after Italy (in terms of the number of transplants) in bone marrow transplant. The complications of bone marrow transplant in Iran are less than in foreign advanced centers while the prices are significantly cheaper so don’t hesitate and click on the Free consultation icon on the upper right corner of this page .


Author: Maryam Shiani

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