Bone Marrow Transplant in India requires highly-trained medical professionals to replace damaged or unhealthy marrow with a healthy one. This transplant procedure is also called a bone marrow transplantation procedure. A bone marrow transplant is also called a stem cell transplant.
Bone marrow is soft and fatty tissue inside bones. Bone marrow makes blood cells. These cells are:
● Red blood cells carry oxygen and nutrients to the body.
● White blood cells fight infection.
● Platelets control bleeding.
Doctors may recommend bone marrow transplant for many chronic infections, diseases and for cancers as well. The recommendation of bone marrow transplant treatment depends on the health conditions of the patient. Also, bone marrow transplant success rate in India varies from patient to patient.
Bone marrow transplant majorly is of two types.
● Bone marrow harvest – Which is a mini surgical procedure, one under general anesthesia, in which the donor will be asleep and bone marrow removed from the back of hip bones. The amount of bone marrow removed depends on the weight and on the receiving patient.
● Leukapheresis – Firstly, some shots are given to the donor to help stem cells move to the bloodstream. Using a separation machine part of white blood cells that contains stem cells are separated and removed to be later given to the recipient. The red blood cells are returned to the donor.
2. Stem cell infusion
3. Neutropenic phase
4. Engraftment phase
5. Post- engraftment phase
The conditioning period last for 7-10 days
The purpose is (by delivery of chemo and / or radiation therapy).
● To eliminate Malignancy
● To provide immune suppression to prevent rejection of new stem cell
● Create space for new cells
● Infusion – 20 minutes to an hour, varies depending on the volume infused
● The stem cell may be processed before infusion if indicated
● Depletion of T-cells can be performed to decrease GVHD
● Infused through a CVL, much like a blood transfusion
Anaphylaxis, volume overload, and a (rare) transient GVHD are the major potential complications involved.
Stem cell products that have been cryopreserved contain dimethyl sulfoxide as a preservative and potentially can cause renal failure, in addition to the unpleasant smell and taste.
During the period(2-4 weeks) , the patient essentially has no effective immune system Healing is poor and the patient is very susceptible to infection Supportive care and empiric antibiotic therapy are the mainstays of successful passage through this phase.
During this period (several weeks), the healing process begins with resolution of mucosities and lesions required in addition fever begin to subside and infection often begin to clear. The greatest challenges at this time are management of GVHD and prevention of viral infections(Especially CMV)
This period last for months to year hallmark of this phase includes the gradual development of tolerance weaning off of immunosuppression management of chronic GVHD and documentation of immune reconstition.
Before treatment begins, the patient will need to undergo some clinical and physical investigation to proceed with further treatment plans. Central venous catheters tubes (1 or 2) inserted into the bloodstream in the neck region or arm. These tubes provide treatment, fluids, and nutrients if needed. It is also used to pull out blood. The patient can talk to a doctor or a provider for counseling if needed, which will help to prepare for the treatment of bone marrow transplants.
The patient will need to plan out for the procedure and need to handle tasks that are required after transplant:
● Arrange medical leave from office work
● Complete an advance care directive
● Take care of some of the financial statements
● Arrange care of yourself.
● Arrange someone for helping with household chores
● Confirming the health insurance coverage
● Bill payments
● Arrange someone for the care of your children.
● Find a house or home nearby the hospital, if needed.
Bone marrow transplant procedure is done in patients or in hospitals or medical centres which are specialized in BMT. To avoid any kind of infection, patient will be in the hospital for the treatment. Stay in hospital will depends on if the patient suddenly faces any health complications related to bone marrow transplant, transplant type.
● The doctor’s team will regularly monitor patient’s blood count and vital signs.
● You will take precautionary medications to prevent GVHD, to treat or prevent infections; which includes antibiotics, antifungals, and antiviral medicines.
● Blood transfusion will be needed depending upon the severity of the disease.
● All food nutrition’s will be fed through IV.
● Before discharge make sure of all instructions and care which should get follow after discharge.
If you receive a transplant that uses stem cells from a donor (allogeneic transplant), you may be at risk of developing graft-versus-host disease (GVHD). This condition occurs when the donor stem cells that make up your new immune system see your body’s tissues and organs as something foreign and attack them.
GVHD may happen at any time after your transplant. Many people who have an allogeneic transplant get GVHD at some point. The risk of GVHD is a bit greater if the stem cells come from an unrelated donor, but it can happen to anyone who gets a bone marrow transplant from a donor.
There are two kinds of GVHD: acute and chronic. Acute GVHD usually happens earlier, during the first months after your transplant. It typically affects your skin, digestive tract or liver. Chronic GVHD typically develops later and can affect many organs.
● Shortness of breath
● Joint or muscle pain
● Vision changes, such as dry eyes
● Persistent cough
● Dry mouth
● Skin changes, including scarring under the skin or skin stiffness
● Mouth sores
● Yellow tint to your skin or the whites of your eyes (jaundice)
On the day of your transplant, stem cells are infused into the body through your central line. The infusion is painless. You’ll be awake during the procedure. After the transplant new stem cells enter the body, they travel through the blood to your bone marrow. Cells multiply and begin to make new and healthy blood cells. This process is called engraftment. It takes some weeks before the number of blood cells in your body starts to return to normal. It will be longer periods for some patients.
some tests are done to monitor the condition. Doctors may recommend some medications to manage complications, such as nausea and diarrhea.
After a bone marrow transplant, you will need to remain under close medical care. Any infections or complications, you may need to stay in the hospital for several days. Depending upon the type of transplant and the risk of complications, you’ll need to remain near the hospital for several weeks to months to allow close monitoring.
You may also need periodic transfusions of red blood cells and platelets until your bone marrow begins producing enough of those cells on its own.
If your bone marrow transplant is using stem cells from a donor (allogeneic transplant), your doctors may prescribe medications to help prevent graft-versus-host disease and reduce your immune system’s reaction (immunosuppressive medications).
After your transplant, it takes time for your immune system to recover. During this time, you may be given medications to prevent infections.
After bone marrow transplant treatment or BMT, some diet factors need to change. You will need to add a healthy diet and nutrition’s to meet needs. Dietician can also give you food suggestions to control side effects of chemotherapy and radiation, such as nausea.
Some of recommendations of food may include:
● Avoid or restrict alcohol intake
● Limits your salt intake.
● Eat a variety of protein rich food including vegetables, fruits, meats, fish, healthy fast, olive oil.
● Avoid grapefruit due to their effect on a group of immunosuppressive medications
● Avoid smoking
Bone marrow transplant treatment or BMT cures some diseases and puts others into remission.
Goals of bone marrow transplant treatment depends on individual situations. It improves quality of life.
Some people complete bone marrow transplantation some people complete bone marrow transplantation with few side effects and complications. Others experience numerous challenging problems, both short and long term. The severity of side effects and the success of the transplant vary from person to person and sometimes can be difficult to predict before the transplant
It can be discouraging if significant challenges arise during the transplant process. However, it is sometimes helpful to remember that there are many survivors who also experienced some very difficult days during the transplant process but ultimately had successful transplants and have returned to normal activities with a good quality of life.
Find out the best hospitals for bone marrow transplant
Find out the best doctors for bone marrow transplant
Overall, the estimated survival of the bone marrow transplant is eighty percent; this means that the patient can have a healthy life for up to 20 years. It’s expected that twenty-five to forty percent of patients, over the age of 60, are expected to survive for three years or more.
If the stem cell transplant is done during the first remission, then the disease-free survival rate can range from thirty to fifty percent. The life expectancy and results of the transplant can vary from person to person. However, a successful transplant will allow the patient to return to their normal routine and live a healthy life.
Bone marrow donation is done under general or regional anaesthesia so the donor experiences no pain during the donation procedure. Discomfort and side effects after the donation vary from person to person. Most marrow donors experience some side effects.
Common side effects of marrow donation include:
● Back or hip pain
● Muscle pain
● Bruising at the collection site
Yes. Bone marrow transplant is the same procedure for children & adults.
Every person’s situation is unique, but most people can expect to spend at least 30 days in the hospital while your body rebuilds your immune system. When your doctors determine your immune system is strong enough, you will be released from the hospital to continue recovery at home. It can take several more months (or even years) after BMT for your immune function to fully recover.