Bone marrow transplant
Key points
- A bone marrow transplant is a procedure to transplant healthy bone marrow into a patient whose bone marrow is not functioning properly.
- Bone marrow is found in a soft fatty tissue inside bones.
- Chemotherapy given prior to bone marrow transplant (conditioning) can cause significant toxicity, such as mouth sores, diarrhea, liver damage, or lung damage.
- Bone marrow transplant prolongs the life of a patient who would otherwise die.
Alternative names
Transplant - bone marrow
Definition
A bone marrow transplant is a procedure to transplant healthy bone marrow into a patient whose bone marrow is not functioning properly. Problems in bone marrow are often caused by chemotherapy or radiation treatment for cancer. This procedure can also be done to correct hereditary blood diseases.
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).
Description
Bone marrow is found in a soft fatty tissue inside bones. This is where blood cells (red blood cells, platelets, and white blood cells) are produced and developed. If a patient develops a disease of the blood cells, especially cancers such as leukemia, he or she may require high doses of chemotherapy to destroy the cancer. However, this also destroys normal blood cells.
Alternatively, hereditary or acquired disorders may cause abnormal blood cell production. In these cases, transplantation of healthy bone marrow may save a patient's life. Transplanted bone marrow will restore production of white blood cells, red blood cells, and platelets.
Bone marrow transplant patients are usually treated in specialized centers and the patient stays in a special nursing unit (a bone marrow transplant unit, or BMT) to limit exposure to infections.
Donated bone marrow must match the patient's tissue type. It can be taken from the patient, a living relative (usually a brother or a sister), or from an unrelated donor (found through the national marrow donor program). Donors are matched through special blood tests called HLA tissue typing. (See HLA antigens.)
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 and/or radiation (conditioning). This serves two 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).
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.