Bone marrow transplant

What is a Bone Marrow Transplant?

Bone marrow transplant (BMT), also called stem cell transplant, is a procedure in which healthy stems cells are received by people with bone marrow or stem cells that are dysfunctional. Bone marrow is a spongy tissue present inside every bone, and the stem cells are a component of the bone marrow, necessary for the production of red blood cells, white blood cells, and platelets.

According to a study conducted in 2014, the cost of a BMT procedure in India is lesser than that in other countries and has similar success rates.

Why is it done?

The symptoms vary from person to person and are dependent on the underlying causes. The common symptoms seen in individuals prior to BMT are:

• Weakness
• Depression
• Pain
• Nausea
• Anxiety
• Reduced sleep
• Reduced hunger
• Breathing difficulty
• Numb feeling in the hands
• Changes in the skin and nails
• Swelling or sores in the mouth
• Easy bruising
• Recurrent infections
• Anaemia

Who needs it?

Individuals with following disease conditions or disorders may need BMT:

• Cancers, such as leukaemia, lymphoma, and myeloma.
• Aplastic anaemia.
• Thalassaemia.
• Sickle cell disease.
• Solid tumours.
• Other disease conditions that can affect your immune system (whose function is the protection of your body).

How is it performed?

Prior to BMT, your doctor will carry out blood tests to determine the level of blood cells. In addition, heart tests, lung tests, and biopsy (where tissue is taken from the bone and observed for abnormality) are done to confirm the need for a BMT.

Under anaesthesia, the spongy tissue from the bone is collected from a suitable donor using a needle. Stem cells collected from the umbilical cord during delivery can also be used for the same child in case of a future transplant. A healthy donor can leave the hospital in a day and resume normal activities within a week.

Before BMT, you will receive treatment with chemotherapeutic drugs and radiation to destroy the existing unhealthy cells in your bone marrow. It also helps prevent rejection of cells from the donor.

BMT is not a surgical procedure and is similar to blood transfusion. The stem cells are transfused into the vein, and the cells travel to the bone through circulation and start producing blood cells. Growth factors that can stimulate the production of blood cells are also injected. Regular monitoring of the blood through tests is necessary to confirm that the BMT was successful.

1. University of Rochester Medical Center. Blood and Marrow Stem Cell Transplantation. Rochester, NY; [Internet]
2. R. E. Hardy. Bone marrow transplantation: a review.. J Natl Med Assoc. 1989 May; 81(5): 518–523. PMID: 2664196
3. Sanjeev Kumar Sharma et al. Cost of Hematopoietic Stem Cell Transplantation in India. Mediterr J Hematol Infect Dis. 2014; 6(1): e2014046. PMID: 25045454
4. Ozlem Ovayolu el al. Symptoms and Quality of Life: Before and after stem cell transplantation in cancer. Pak J Med Sci. 2013 May-Jun; 29(3): 803–808. PMID: 24353632
5. The Johns Hopkins University. Blood and Bone Marrow. Johns Hopkins Health System; [Internet]