Also known as a stem cell transplant, a bone marrow transplant can be used in two ways; to treat cancers of the blood such as Leukemia, or to replace blood cells that have been damaged or destroyed during chemotherapy. In both instances the treatment follows the same process.
Bone marrow, found inside bones, contains stem cells. Stem cells are cells waiting to develop into one of three types of blood cell (plasma, white blood cell or a red blood cell). In conditions such as Leukemia, these stem cells do not grow properly and instead turn into unhealthy cells.
During a transplant unhealthy cells, are replaced with healthy cells. This can be achieved in one of two ways:
• Autologous transplant – Where healthy cells are removed from the patient’s body and replaced once any damaged or diseased cells have been removed.
• Allogeneic transplant – Where healthy cells are taken from a donor and given to the patient.
Regardless of the type of transplant the processes follow the same steps:
1. Tests & Examination are undertaken to ensure the patient is healthy enough. This can include blood tests, ECG, Echocardiogram and X-rays.
2. Stems cells are then harvested from the donor or the patient. This can be taken from the blood, bone marrow or from chord blood.
3. Conditioning treatment is then administered to prepare the patient for the transplant. This can include administering chemotherapy or radiotherapy to destroy existing bone marrow or cancer cells and to stop the immune system from working to reduce the risk of the transplant being rejected.
4. Once conditioning is complete, stem cells are then passed slowly into the body through a central line – the transplant takes a couple of hours and is done whilst awake.
5. Once the transplant is complete, recovery commences
Recovery from a stem-cell transplant can be a lengthy process. During this period fluids are administered through a nasogastric tube to prevent malnutrition. Regular blood and platelet transfusions are also needed as levels will be low.
The risk of infection after a stem cell transplant is high due to a reduced number of white blood cells. Whilst these blood cells build in numbers – the patient needs to stay in a sterile environment such as a germ-free room, with minimal visitors.
Typically this process can take up to three months, unless complications arise, after which the patient then needs to remain at home for an extended period of time1
Side effects differ from person to person and are mostly encountered during the recovery phase of the treatment. This can include feeling weak, vomiting, diarrhoea and loss of appetite. (NHS, 2015) Also, people can suffer from the effects of having fewer white blood cells, red blood cells and platelets including Anaemia and increased risk of bleeding.
In some cases cells from a donor can attack the host’s cells – this is known as graft versus host disease. The condition is usually mild, but in some instances, it can be life-threatening. It can cause a rash, diarrhoea and in some instances liver damage3