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Bone Marrow Transplantation

Bone Marrow Transplantation

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Published by: Harish Kumar Kumawat on Nov 27, 2012
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Bone Marrow Transplantation
What is a bone marrow transplantation?
Bone marrow transplantation (BMT) is a special therapy for patients with certain cancers orother diseases. A bone marrow transplant involves taking cells that are normally found in thebone marrow (stem cells), filtering those cells, and giving them back either to the patient theywere taken from or to another person. The goal of BMT is to transfuse healthy bone marrow cellsinto a person after their own unhealthy bone marrow has been eliminated.Anatomy of a bone, showing blood cells
Click Image to Enlarge
 
What is bone marrow?
The bone marrow is a soft, spongy tissue found inside the bones. The bone marrow in the hips,breast bone, spine, ribs, and skull contain cells that produce the body's blood cells. The bonemarrow is responsible for the development and storage of most of the body's blood cells. Thethree main types of blood cells produced in the bone marrow include:
 
red blood cells (erythrocytes)
- carry oxygen to the tissues in the body.
 
white blood cells (leukocytes)
- help fight infections and to aid in the immune system.
 
platelets
- help with blood clotting.Each of these cells carries a life-maintaining function. The bone marrow is a vital part of thehuman body.
What are stem cells?
Every type of blood cell in the bone marrow begins as a stem cell. Stem cells are immature cellsthat are able to produce other blood cells that mature and function as needed.Stem cells are the most important cells needed in a bone marrow transplant. Stem cells, whentransplanted, find their way to the recipient's marrow and begin to differentiate and produce all
 
types of blood cells that are needed by the body.
Why is a bone marrow transplant needed?
The goal of a bone marrow transplant is to cure many diseases and types of cancer. When achild's bone marrow has been damaged or destroyed due to a disease or intense treatments of radiation or chemotherapy for cancer, a bone marrow transplant may be needed.A bone marrow transplant can be used to:
 
replace diseased, non-functioning bone marrow with healthy functioning bone marrow(for conditions such as leukemia, aplastic anemia, and sickle cell anemia).
 
replace the bone marrow and restore its normal function after high doses of chemotherapy or radiation are given to treat a malignancy. This process is often called"rescue" (for diseases such as lymphoma and neuroblastoma).
 
replace bone marrow with genetically healthy functioning bone marrow to prevent furtherdamage from a genetic disease process (such as Hurler's syndrome andadrenoleukodystrophy disorder).Bone marrow transplantation has risks involved, some of which are life threatening. The risksand benefits must be weighed in a thorough discussion with the bone marrow transplant teamprior to the procedure.Each child experiences diseases differently and a bone marrow transplantation may not beappropriate for everyone who suffers from these diseases. Some of the diseases that have beentreated with bone marrow transplant include the following:
 
leukemia
 
lymphomas
 
some solid tumors (i.e., neuroblastoma, rhabdomyosarcoma, brain tumors)
 
aplastic anemia
 
immune deficiencies (severe combined immunodeficiency disorder, Wiskott-Aldrichsyndrome)
 
sickle cell disease
 
thalassemia
 
Blackfan-Diamond anemia
 
 
metabolic/storage diseases (i.e., Hurler's syndrome, adrenoleukodystrophy disorder)
 
cancer of the kidneys
What are the different types of bone marrow transplants?
There are different types of bone marrow transplants depending on who the donor is. Thedifferent types of bone marrow transplant may include the following:
 
autologous bone marrow transplant
 The donor is the child him/herself. Stem cells are taken from the child either by bonemarrow harvest or apheresis (a process of collecting peripheral blood stem cells) and thengiven back to the child after intensive treatment. Often the term "rescue" is used insteadof "transplant."
 
allogeneic bone marrow transplant
 The donor shares the same genetic type as the child. Stem cells are taken either by bonemarrow harvest or apheresis from a genetically-matched donor, usually a brother orsister. Other donors for allogeneic bone marrow transplants include:
o
 
a parent - a haploid-identical match is when the donor is a parent and the geneticmatch is at least half identical to the recipient. Unfortunately, parents may not bea good enough match to be donors in many cases.
o
 
unrelated bone marrow transplants (UBMT or MUD for matched unrelated donor)- the genetically matched marrow or stem cells are from an unrelated donor.Unrelated donors are found through the national bone marrow registries.
 
umbilical cord blood transplant
 Stem cells are taken from an umbilical cord immediately after delivery of an infant.These stem cells reproduce into mature, functioning blood cells quicker and moreeffectively than do stem cells taken from the bone marrow of another child or adult. Thestem cells are tested, typed, counted, and frozen until they are needed for a transplant.Because the stem cells are "new," they are able to produce more blood cells from eachstem cell. Another advantage cord blood has is that the T-lymphocytes (part of theimmune system that causes graft-versus-host disease) are not completely functional thisearly in the stage of life. Recipients of cord blood transplants have a decreased risk forsevere graft-versus-host disease.
The bone marrow transplant team:
The group of specialists involved in the care of children who are undergoing a transplantprocedure is often referred to as the "transplant team." Each individual works together to providethe best chance for a successful transplant. The bone marrow transplant team consists of:

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