BONE MARROW/

STEM CELL

TRANSPLANT

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Bone marrow is a spongy material that is found inside the bones (particularly the pelvic

bones). Stem cells are blood cells formed at the earliest stage of development in the bone

marrow. When the cells are fully mature they are released into the bloodstream. Bone

marrow produces the cells which develop into the three different types of blood cells: Red

blood cells, white blood cells and the platelets. Normally, most of the stem cells in the body

are in the bone marrow and there are only very small numbers of these cells found in the

bloodstream.

The bones of the hip, chest (sternum/breastbone) and pelvis contain the largest amount of

marrow and stem cells in an adult. Bone Marrow was earlier used as a source of stem cells,

when it was demonstrated that few stem cells also circulate in the bloodstream. These are

called Peripheral Blood Stem Cells (PBSCs).

1 WHAT IS BONE MARROW?

When the stem cells are collected

from the bone marrow the

transplant that follows is called

Bone Marrow Transplant (BMT) and

when peripheral blood is used as

the source of stem cells, the

transplant that follows is called

Per ipheral B lood Stem Cel l

T r a n s p l a n t ( P B S C T ) . T h i s

revolutionary technique changed

the scenario of transplant as it

meant the avoidance of OT,

Anesthesia and the discomfort

associated with Bone Marrow

harvest to the donor. PBSCT is the

preferred mode of transplant.

BMT is done sparingly when SCT is

not possible.

2WHAT IS BONE MARROW/STEM CELL TRANSPLANT?

3 WHO NEEDS BONE MARROW/STEM CELL TRANSPLANT?

Hematopoietic stem cell (HSCT)/Bone marrow transplantation (BMT) is a life saving

treatment for variety of diseases including blood cancers like leukemia, lymphoma,

Myeloma etc as well as benign disorders like aplastic anemia and thalassaemia.

The goal of cancer treatment such as radiation is to destroy cancer cells. Unfortunately,

bone marrow and healthy cells are also destroyed in the process. Also, the cure rate of

Hematological malignancies with chemotherapy is not 100 percent.

The Bone Marrow Transplantation (BMT) and Peripheral Blood Stem Cell Transplantation

(PBSCT) are procedures that restore stem cells that have been destroyed by high doses of

chemotherapy and/or radiation therapy.

4WHAT IS THE LENGTH OF STAY?

In Autologous Transplant,

patient has to stay in the

hospital for 3 to 4 weeks. The

Allogeneic Transplant requires 4

to 6 weeks of stay in the hospital.

The doctor will require seeing

you on regular and periodic

basis as an outpatient following

discharge for the next few

months. Hence international

patients require staying in India

for 4 months including the

hospital stay.

The Follow Up Care

The treating doctor provides

instructions for the follow-up

c a r e , m e d i c a t i o n s a n d

information on preventing

infections. After transplant, the reintegration into life outside the hospital is a big step. It will

take time, as well as patience and understanding with yourself and others, to successfully

negotiate this last part of treatment.

5 WHAT IS ROLE OF BMT IN LEUKEMIA?

Treatment of acute leukemia is very challenging. It requires availability of sophisticated

diagnostic laboratory for accurate diagnosis of disease. Treatment of leukemia requires

prolonged hospitalization, use of chemotherapy, extensive transfusion support and carries

significant risk of infections. Treatment of leukemia is best done at transplant centers to

support patients in the event of failure of chemotherapy. Allogeneic transplant is the only

option for such patients.

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