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Bone marrow transplant is an advanced medical procedure which is used to treat diseases which were once thought to be incurable. It was first successfully used in the year 1986. Now they have been used to treat patients who have been diagnosed with leukemia, aplastic anaemia, lymphomas such as multiple myeloma, Hodgkin’s disease, immune deficiency disorders and tumors such as ovarian and breast cancer.
Sometimes the marrow is diseased in certain cancerous and non cancerous diseases like leukemia, sickle called anaemia, lymphoma, multiple myeloma, aplastic anaemia, congenital neutropenia, thalassemia, etc. Sometimes the bone marrow can be destroyed by heavy doses of chemotherapy for cancers in the body. In such situations, replacement by a healthy bone marrow is needed for the patient to survive.
The replacement of this destroyed or diseased bone marrow by a healthy marrow is called as bone marrow transplant. In these cases there is malfunctioning of the bone marrow and this results in defective blood cell production. In bone marrow transplant, a healthy marrow is infused in the blood stream of the patient. In a successful transplant, the new bone marrow shifts to the cavities of the large bones, and starts producing normal blood cells.
Autologous bone marrow transplant- Auto means self. In this procedure immature marrow cells, that is, the stem cells, are removed from the patient himself, before he takes the radiation or the high dose chemotherapy treatment. After these treatments are done, the stem cells will be put back into the body. This is called as a rescue transplant.
Allogeneic bone marrow transplant- Allo means others. In this procedure, immature marrow cells are removed from another person, who is the donor. The donor needs to have the same genetic makeup as the recipient. The blood too needs to match. There are many tests which are done to check if the donor is a good match for the patient. A brother or sister is a good match mostly. Relatives, parents and children can also be good matches. If the patient has an identical twin who is the donor, then it is called as syngeneic bone marrow transplant.
Umbilical cord blood transplant- In this, immature marrow cells are removed from the umbilical cord of a new born baby immediately after birth. These stem cells are stores till they are needed for a transplant. Umbilical cord blood vessels are very immature, so the problem of mismatch does not occur much.
The first step is extraction the bone marrow cells from the donor by making punctures under general anesthesia. In step 2, pre-engraftment is done in which high dose chemo-radiotherapy is done. Here the blood stem cells are destroyed and the normal blood cells are not produced. The patient has to be kept in a clean room at this time. The third step is post engraftment. Here the donated stem cell will start functioning. The patient can come out of critical isolation at this time.