BMT, A Comprehensive Guide

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BMT is a disease that affects the marrow may induce anemia, weaken the immune system, and cause bleeding disorders. A bone marrow transplant replaces abnormal or diseased marrow with healthy marrow from a donor.

What is BMT?

bmt

Before going to BMT, first of all, we should be aware of, what is marrow?

Marrow, the spongy, gelatinous material inside the bones, serves as the body’s blood factory. It produces Red blood cells, which carry oxygen.

White blood cells, which fight disease.

Platelets, which are instrumental in clotting and wound healing.

BMT cures several types of blood cancer

A BMT may be carried out for several kinds of blood cancer, most commonly myeloid leukemia. This procedure may also be used to treat immune system or blood disorders, including aplastic anemia, severe combined immunodeficiency disease, and thalassemia, a hereditary blood disease.

The major problem in BMT is finding a donor who is compatible with the recipient. To be successful, both donor and recipient should have a similar tissue-type. The recipient’s immune system is then less likely to recognize the new marrow as foreign and reject it. Tissue matching is based on a group of proteins called human leukocyte antigens (HLAs), which are present in the cells and involved in the body’s immune system.

bone marrow transplant procedure donor

BMT recipients have to be kept in sterile conditions because the special drugs they are taking make them vulnerable to infection.

These are inherited from the parents and there is a 25% chance that a sibling will have HLAs that match close enough for a successful transplant. Therefore, the more siblings a patient has, the better chance there is of finding a match.

Age is also an important factor in the success of a marrow transplant. About 75% of patients un-der the age of 20 achieves long-term survival after the transplant, while long-term survival for patients aged 30 — 50 drops to 50 — 60%. The lower success rate is attributed to the increased incidence of complications, such as the sometimes fatal graft-versus-host disease (GVHD).

What happens during BMT?

Bone Marrow

After a suitable donor has been found, the next step is to prepare the recipient for the new bone marrow. First, the disease must be eradicated as much as possible. In the case of leukemia, this entails administering high doses of chemotherapy, followed by radiation to destroy the patient’s bone marrow, the source of cancer. This would usually be fatal, but the aim is to get rid of disease-producing marrow and replace it with healthy donor marrow. In addition, immunosuppressant drugs (which suppress the immune system), such as cyclosporine and a corticosteroid, are given before and after the transplant.

bone marrow transplant process

The surgical procedure begins with the aspiration of the marrow from the donor. Here a hollow needle and syringe are used to remove healthy marrow from the pelvic bone (the ideal site) or the narrow cavity of the breast bone. This is done in an operating theater after administration of general or spinal anesthesia.

Only a relatively small amount of marrow is needed. To avoid anemia, the donor has a unit of blood withdrawn a. the week before, which is then returned to them. The aspirated marrow is passed through a stainless steel screen to break it up into small particles. It is then injected into one of the recipient’s veins. The marrow cells enter the blood system and migrate through the blood to the marrow cavities in the bones. The new cells begin to grow in the marrow and, eventually, they assume the function of the patient’s original marrow in producing new blood cells that are disease-free.

Is BMT painful?

Donors usually find that the procedure is relatively simple and painless. There may be minor soreness and stiffness at the aspiration site for a few days, but most say this minor discomfort is offset by the satisfaction of possibly being able to save a life. For the recipient, the preceding preparation is more unpleasant than the actual marrow transplant. High-dose cancer chemotherapy produces adverse effects, such as nausea and baldness. Total body radiation can cause severe nausea and radiation illness, especially if it is administered in a single dose. To minimize this, the radiation is usually given in several small doses.

bone marrow transplant risks

How long does a BMT take?

The transplant procedure itself takes less than an hour, but the recovery period is lengthy. It takes several weeks for the transplanted marrow cells to begin producing new blood cells. Until then, intensive care is needed to prevent infection. Transplant recipients are usually given antibiotics, immunosuppressant drugs, blood transfusions, and intravenous fluids. They will also be isolated in a sterile environment to avoid infection.

Are there any complications?

Infections and rejection are ever-present dangers for bone marrow recipients. Infections often develop during the first few weeks after a transplant because the patient’s white blood cell count is low; the immune system having been suppressed to prevent rejection of the donor marrow. Low platelet levels may result in bleeding.

Autologous BMT

bone marrow transplant surgery

In some cases, bone marrow may be taken from a patient, while the disease is in remission (not active), and kept in frozen storage. It can then be returned to the patient if the disease becomes active again, once all diseased marrow has been destroyed.

How can I become a donor?

Thousands of patients die each year because they cannot find a suitable donor. If you would like to help, please contact the concerned department.