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Bone Marrow Transplant

Bone Surgery

Bone Marrow Transplant

Description

There are three kinds of bone marrow transplants:

  • Autologous bone marrow transplant: "Auto" means "self." Stem cells are removed from you before you receive high-dose chemotherapy or radiation treatment and stored in a freezer (cryopreservation). After high-dose chemotherapy or radiation treatments are done, your stems cells are put back in your body to add to your normal blood cells. This is called a "rescue" transplant.
  • Allogeneic bone marrow transplant: "Allo" means "other." Stem cells are removed from another person, called a donor. Most times, the donor must at least partly match you genetically. Special blood tests are done to determine if a donor is a good match for you. A brother or sister is most likely to be a good match. However, sometimes parents, children, and other relatives may be good matches. Donors who are not related to you may be found through national bone marrow registries.
  • Umbilical cord blood transplant: Stem cells are removed from a newborn baby's umbilical cord immediately after birth. The stem cells are stored until they are needed for a transplant. Umbilical cord blood cells are so immature, there is less of a need for matching.
    Before the transplant, chemotherapy, radiation, or both may be given. This may be done in two ways:
  • Ablative (myeloablative) treatment: High-dose chemotherapy, radiation, or both are given to kill any cancer cells. This also kills all healthy bone marrow that remains, and allows new stem cells to grow in the bone marrow.
  • Reduced intensity (nonmyeloablative) treatment, also called a mini transplant: Patients receive lower doses of chemotherapy and radiation before a transplant. This has allowed older patients, and patients with other health problems to have a transplant.
    A stem cell transplant is done after chemotherapy and radiation is complete. The stem cells are delivered into your bloodstream through a tube called a central venous catheter. The process is similar to getting a blood transfusion. The stem cells travel through the blood into the bone marrow. Usually, no surgery is needed.
    Donor stem cells can be collected in two ways:
  • Bone marrow harvest. This minor surgery is performed undergeneral anesthesia, meaning the donor will be asleep and pain-free during the procedure. The bone marrow is removed from the back of both hip bones. The amount of marrow removed depends on the weight of the person who is receiving it.
  • Leukapheresis. First, the donor is given 5 days of shots to help stem cells move from the bone marrow into the blood. During leukapheresis, blood is removed from the donor through an IV line in a vein. The part of white blood cells that contains stem cells is then separated in a machine before being returned to the donor.

Risks

A bone marrow transplant may cause the following symptoms:

  • Chest pain
  • Chills
  • Drop in blood pressure
  • Fever
  • Flushing
  • Funny taste in the mouth
  • Headache
  • Hives
  • Nausea
  • Pain
  • Shortness of breath

Possible complications of a bone marrow transplant depend on many things, including:

  • The disease you are being treated for
  • Whether you had chemotherapy or radiation before the bone marrow transplant
  • Your age
  • Your overall health
  • How good of a match your donor was
  • The type of bone marrow transplant you received (autologous, allogeneic, or umbilical cord blood)

Complications can include:

  • Anemia
  • Bleeding in the lungs, intestines, brain, and other areas of the body
  • Cataracts
  • Damage to the kidneys, liver, lungs, and heart
  • Delayed growth in children who receive a bone marrow transplant
  • Early menopause
  • Graft failure, which means that the new cells do not settle into the body and start producing stem cells
  • Graft-versus-host disease, a condition in which the donor cells attack your own body
  • Infections, which can be very serious
  • Inflammation and sorenes in the mouth, throat, esophagus, and stomach, called mucositis
  • Pain
  • Stomach problems, including diarrhea, nausea, and vomiting