Bone marrow transplant
Definition
A bone marrow transplant is a procedure that transplant healthy bone marrow into a patient whose bone marrow is not working properly. A bone marrow transplant may be done for several conditions including hereditary blood diseases, hereditary metabolic diseases, hereditary immune deficiencies, and various forms of cancer.
The healthy bone marrow may be taken from the patient prior to chemotherapy or radiation treatment (autograft), or it may be taken from a donor (allograft).
Alternative Names
Transplant - bone marrow
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 (immunodeficiencies) such as:
- Congenital neutropenia
- Severe combined immunodeficiency syndrome
- Specific forms of cancer:
- Leukemias
- Lymphomas
- Myeloma
Bone marrow transplant is not recommended for:
- Patients with heart, kidney, lungs, or liver disorders
- Patients with other diseases that may limit survival
Convalescence
The hospitalization period is from 4 - 6 weeks, during which time the patient is isolated and under strict monitoring because of the increased risk of infection. The patient will require attentive follow-up care for 2 - 3 months after discharge from the hospital. It may take 6 months to a year for the immune system to fully recover from this procedure.
Expectations after surgery
Ideally, bone marrow transplant lengthens the life of a patient who would otherwise die. Relatively normal activities can be resumed as soon as the patient feels well enough, and after consulting with the doctor.
Other significant problems with a bone marrow transplant are those of all major organ transplants -- the finding of a donor, and the cost. The donor is frequently a sibling with matching tissue. The more siblings the patient has, the more chances there are of finding a matching donor.
Risks
The risks for any anesthesia are:
- Reactions to medications
- Problems breathing
Chemotherapy given prior to bone marrow transplant (conditioning) may cause significant toxicity, such as mouth sores, diarrhea, liver damage, or lung damage. While waiting for bone marrow to grow, the patient is at high risk for infection.
The major problem with bone marrow transplants -- when the marrow comes from a donor, not the patient -- is graft-versus-host disease. The transplanted healthy bone marrow cells may attack the patient's cells as though they were foreign organisms. In this case, drugs to suppress the immune system must be taken, but this also decreases the body's ability to fight infections.
Bone-marrow transplant - series
Review Date: 10/30/2006
Reviewed By: William Matsui, MD, Assistant Professor of Oncology, Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD. Review provided by VeriMed Healthcare Network.
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