Bone Marrow Transplant All you need to know about bone marrow transplant
What is Rhinoplasty? A special type of treatment for those patients who are suffering from certain diseases or cancers is known as bone marrow transplant (BMT). Bone marrow transplant, also known as stem cell transplant, includes taking of cells that can be found in the stem cells (bone marrow). The aim of bone marrow transplant (BMT) is to transfer healthy bone marrow cells in a patient when their unhealthy bone marrow has been treated for destroying the abnormal cells. Following are the diseases that can be successfully treated by bone marrow transplant (BMT) that includes – • Some solid tumour cancers • Leukaemia • Multiple myeloma
A bone marrow is the soft, fatty tissue inside the bones that contain stem cells which produce RBCs, WBCs, and platelets. When the stems cells fail to produce healthy blood cells, a bone marrow transplant is recommended to replace a damaged bone marrow with the healthy one. The new stem cells help the marrow make healthy blood cells again.
What are the types of Rhinoplasty? • Autologous Bone Marrow Transplant. • Allogenic bone marrow transplant. Autologous Bone Marrow Transplant : In Autologous bone marrow transplant the healthy bone marrow cells from the patient itself are collected and used for the transplant. The success rate is high in Autologous Bone Marrow Transplant as there is no risk of genetic mismatch in the bone marrow/stem cell. But not always Autologous Bone Marrow Transplant is feasible mainly due to non availability of healthy bone marrow tissues in the patient.
A patient is itself a donor. In this Autologous Bone Marrow Transplant, stem cells are taken from a patient by aphaeresis or bone marrow harvest. These cells are then given back to a patient after they have been frozen. When healthy stem cells are taken from the patient's own body and replaced with diseased blood cells, the procedure is termed as autologous bone marrow transplant. Allogenic bone marrow transplant : The bone marrow from a donor which is a close genetic match is used. Allogenic bone marrow transplant is a more difficult procedure comparatively as there is additional need for identifying a potential donor, testing for the genetic match etc.
Allogenic bone marrow transplant needs a lot of tests to confirm the compatibility of the bone marrow and finding the right donor. Hence the cost is also more for Allogenic bone marrow transplant. When the donor is some other person whose tissue has the same genetic type as the patient, the bone marrow transplant is termed as allogenic bone marrow transplant. The donor is most likely to be a brother or sister of the patient. However, it is only in 35% of the cases that sibling's bone marrow is a perfect match.
Bone Marrow Transplant Treatment Process For Bone Marrow Transplant journey, the transplant process is divided into seven steps that guide a patient. The steps begin with how to prepare for the journey and include what to expect along the way. Preparation The starting phase of bone marrow transplant begins when the patient arrives at the treatment centre and begins the process of medical evaluation, orientation, informed consent, and other preliminary activities. • Beginning Medical Evaluation • Conference for Treatment Plan • Central Venous Catheter Evaluation and Insertion • Bone-Marrow/Stem Cells Harvest
Conditioning The conditioning phase of bone marrow transplant begins the actual transplant process. During this phase of bone marrow transplant, high-dose chemotherapy, radiation therapy, or both are initiated. Chemotherapy and radiation therapy are given in doses that obliterate the marrow function and result in the greatest possibility of destroying the disease. Depending upon the chemotherapy agents and radiation therapy administration schedule, some conditioning therapy can be administered in the outpatient setting, thus potentially shortening the inpatient stay.
Transplant The transplant phase of bone marrow transplant is the infusion of donor bone marrow or stem cells. After the conditioning regimen is completed, the patient receives the infusion of bone marrow or stem cells. Waiting for Engraftment : This phase of bone marrow transplant includes close monitoring, supportive treatment, and management of complications while waiting for signs of engraftment (new cell growth).
Engraftment and Early Recovery Approximately 10 to 28 days after bone marrow transplant, signs that the new bone marrow or stem cells are engrafting (growing and developing) can be expected. Close monitoring will continue along with supportive care. Preparation for the return of the patient to the referring physician or center will begin. Long-Term Recovery The long-term recovery phase of bone marrow transplant involves leaving the treatment centre, dealing with any ongoing clinical issues, and re-establishing life patterns. Patients need to follow up for long term complications of bone marrow transplant (BMT).
What are the Requirement of a Bone Marrow Transplant A bone marrow transplant is required when high doses of radiation therapy or chemotherapy treatment has damaged the bone marrow stem cells. Bone marrow transplant (BMT) may also be required when a disease has destroyed the bone marrow. A Bone marrow transplant (BMT) is used for - • Replacing of a bone marrow with a genetically healthy functioning bone marrow. This is done for preventing more damage from a genetic disease. • Replacing of non - functioning and diseased bone marrow with a healthy functioning bone marrow. This is done in specific conditions like sickle cell anaemia, leukaemiaand aplastic anaemia.
Replacing the bone marrow for restoring its normal functioning after being given high-doses of radiation therapy and chemotherapy for treating a disease. This procedure is known by the name of rescue for conditions like neuroblastoma and lymphoma. • Regenerating a new immune system that will help to fight off other cancers that are not destroyed by the radiation therapy or chemotherapy used in the transplant, or residual or existing leukaemia.
Complete Bone Marrow Transplant Procedure A bone marrow transplant depends on following conditions such as a patient's ability to tolerate certain medications, the type of transplant and the disease that requires a transplant. The bone marrow transplant includes the following – • The preparation of a bone marrow transplant involves high doses of radiation therapy and/or chemotherapy. This is required for treating a specific disease and also to create a sufficient room in the bone marrow for the new cells to develop. Myeloablative or ablative is the name given to this therapy due to its effect on the bone marrow.
The bone marrow transplant is given from the central venous catheter in the bloodstream after administering radiation therapy and/or chemotherapy. Bone Marrow Transplant is not considered as a surgical procedure. The stem cells start to grow into healthy blood cells by making their way into the bone marrow. • A supportive care is offered after the bone marrow transplant for preventing complications, infections and side effects. This care involves providing a clean environment, frequent blood tests, and daily weigh-ins, strict measurement of fluid input and output, and monitoring of vital signs.
Who can be a donor for an Allogenic Bone Marrow transplant? Matching bone marrow is done by blood tests alone. It is not necessary to test the donor's bone marrow at this stage. It is usual to start by testing the brothers and sisters, as they are likely to provide the best match parents are not usually good matches. The donor should be in good health. He or she will be given a thorough medical check up to make sure that there will be no risk to his or her own health from the procedure.
How Doctor’s Collect bone marrow About a week or two before the bone marrow harvest is done, the patient (or the donor, for an Allogenic transplantation) may have 1 to 2 units of blood withdrawn. This will be given back during the bone marrow harvest. The harvest itself is carried out under general anesthesia, so one will feel nothing. It involves the removal of some marrow from inside the bones at the back and front of the pelvis (the hip bones). The patient or donor will have to stay in hospital overnight to recover fully from the general anaesthesia. Usually it feels sore for a few days and mild painkillers may be required. These will be administered by the nurses or doctors.
How are the stem cells collected? Stem cell harvesting is done following a course of daily injections of a growth factor. This procedure takes about 3 hours. The patient will be made to lie down on a couch and a transfusion will be put into the vein of each arm. Blood will be collected from one arm, into a machine called a centrifuge, which spins it to separate out the stem cells. These are collected, and the remaining blood is returned through the IV in the other arm. The stem cells can even be frozen. What is Umbilical Cord Blood Transplantation? Many children and young adults with serious blood diseases such as leukaemianeed a bone marrow transplantation to give them
A chance to live. Unfortunately a marrow donor cannot always be found. Sometimes searching for a donor takes so long that the patient dies before a compatible donor is available. However, now a new source of blood forming stem cells has been found - Umbilical Cord Blood. The stem cell in the cord blood is of high quality and very potent in producing blood cells. Cord blood transplants appear to cause less serious immunological side effects. The 'matching' between donor and recipient appears to be less critical. This means that the chance of finding suitable cord blood for transplantation is much greater than that of bone marrow.
Which are the best hospitals for Bone Marrow Transplant in India? Some of the best hospitals for Bone Marrow Transplant in India are: • Apollo Hospital Delhi • Fortis Memorial Research Institute Gurgaon • Wockhardt Hospitals Delhi • Medanta - The Medicity Gurgaon • Artemis Hospital Gurgaon • BLK Super Specialty Hospital Delhi • Kokilaben Hospital Mumbai • Sri Ramachandra Medical Center, Chennai • American Oncology Institute, Hyderabad
Indraprastha Apollo Hospitals, New Delhi • Dharamshila Hospital, India • Aster Medcity, Kochi • Krishna Institute of Medical Sciences, Secunderabad • Global Hospital, Hyderabad • Aware Global Hospital, Hyderabad • Narayana Institute of Cardiac Sciences, Bangalore • SevenHills Hospital, Mumbai
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