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Autologous Bone Marrow Transplant and its advancement

Many diseases can be treated successfully through autologous bone marrow transplantation or BMT. Initially used for only the treatment of immunodeficiency where a product or cell series is replaced, autologous bone marrow transplant has become a regular course of treatment for many forms of leukemia. Recently, diseases such as thalassemia and other metabolic diseases have also been treated by bone marrow transplants. Trials are underway for better forms of bone marrow conditioning to avoid leukemia relapse and graft rejection. This article talks about autologous bone marrow transplant, why it is performed, and the conditions it treats. The bone marrow transplant cost in India for autologous transplants is approximately Rs. 8 to 10 lakh.

What is a bone marrow transplant?

A bone marrow transplant is a recognized medical procedure to replace destroyed and damaged bone marrow with healthy bone marrow stem cells. Bone marrow, the soft, fatty tissue within your bones, produces blood cells. Stem cells are the immature cells in the bone marrow that produce various blood cells in your body. Therefore, a bone marrow transplant is also called a stem cell transplant. 

One might need a bone marrow transplant if the bone marrow stops working and does not produce enough healthy blood cells. Bone marrow transplants are done either by using your body cells (autologous transplant) or from a donor (allogeneic transplant). 

Description

Before a bone marrow transplant, chemotherapy, radiation, or both may be given to the patient. It may be done either by:

Ablative Treatment – Radiation or high-dose chemotherapy or both are given to destroy the cancer cells. It may kill the healthy bone marrow and allow new stem cells to grow in the bone marrow. 

Reduced Intensity Treatment – Low doses of radiation and chemotherapy are given before the transplant, allowing senior people and those with other health issues to undergo a transplant.

Types of bone marrow transplant

The three kinds of bone marrow transplantation are:

Autologous bone marrow transplant – Stem cells are removed before administering high-dose chemotherapy or radiation and stored in freezing temperatures. After the treatment, the stem cells are put back in the body to produce normal stem cells. 

Allogenic bone marrow transplant – Stem cells are removed from a donor whose genes at least partially match the patient’s genes. Donors can be siblings, parents, children, and other relatives. 

Umbilical cord blood transplant – In this type of transplant, the stem cells from a newborn’s umbilical cord are removed and preserved until required for a transplant. 

The bone marrow transplant is usually done after the radiation and chemotherapy are completed. The stem cells are transferred to the bloodstream through a central venous catheter. Donor stem cells can be collected either through bone marrow harvest or leukapheresis.  

When is a bone marrow transplant performed?

A bone marrow transplant is done to:

  • Safely treat the condition with high doses of radiation and chemotherapy by replacing or saving the bone marrow.
  • Replace or repair damaged marrow with stem cells.
  • This method provides new stem cells that can help kill cancer cells directly.

Your physician may recommend a bone marrow transplant if you have cancers like leukemia, lymphoma, or multiple myeloma.

A disease that impacts bone marrow cell production can be congenital. Examples are neutropenia, aplastic anemia, thalassemia, or severe immune system illness.

What is Autologous Bone Marrow Transplant?

An individual’s blood-forming stem cells are collected in an autologous bone marrow transplant. The patient is treated with a high dosage of chemotherapy that can kill cancer cells. It can also get rid of the blood-producing cells remaining in the bone marrow. Later, the preserved stem cells are put back in the bloodstream to let the bone marrow produce new blood cells. 

The stem cells in the bloodstream that are collected or harvested in autologous transplantation are called peripheral blood stem cells or PBSCs. In an autologous transplant, you will undergo a procedure known as apheresis to collect blood stem cells. Before this procedure, the patient will receive injections every day for growth to enhance stem cell production and move the stem cells into the bloodstream so that they can be collected.

In the apheresis procedure, blood is drawn from the patient’s vein and circulated via a machine. This machine separates the blood into many parts, including stem cells. These stem cells from this transplant are frozen and collected for future use. The procedure then returns the remaining blood to the body.

Conclusion

When performed by experts, autologous bone marrow transplants can treat most types of cancers. With time, a successful transplant can produce new blood cells and platelets. You can cover the bone marrow transplant cost in India by availing of health insurance from a reputed health insurance company.

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