A bone marrow transplant is a procedure used to swap out the patient's diseased bone marrow for good bone marrow cells. The first step in bone marrow transplant procedures and stem cell therapies used to treat patients with various blood-related disorders such as leukaemia, lymphoma, and particular autoimmune disorders is the collecting of peripheral blood or bone marrow stem cells.

Bone marrow is a soft, spongy substance found between the inner chambers of bones, where blood is created. The bone marrow has multiple microscopic compartments that house primitive cells capable of developing into several types of blood cells. These cells are known as stem cells, and they are capable of creating several types of blood cells, such as red blood cells, white blood cells, and platelets.

There are two forms of bone marrow: red and yellow. The majority of bone marrow in children is red marrow, which is high in stem cells. However, because to fat cell invasion, a large portion of the bone marrow in adolescents gets changed into yellow marrow. Red marrow is mainly restricted to a few bones in teenagers, such as the hip bones, breast bone, ribs, shoulder blades, cranium, backbone, arm, and thigh endings.

Malignant
Case-specific detection and treatment of blood malignancies with chemotherapy and other methods are required.

• Acute leukemia – Myeloid & Lymphoid Leukemia
• Chronic Leukemia – Myeloid & Lymphoid Leukemia
• Multiple Myeloma
• Myelodysplastic Syndromes
• Hodgkin’s and Non Hodgkin’s Lymphoma
• Myeloproliferative Disorders
• Neuroblastoma/Ewing’s Sarcoma, Medulloblastoma

Benign Haematology- Benign Disorders Of Blood

• Thalassemia Major & Sickle Cell Disease
• Aplastic Anaemia
• Benign WBC Disorders - LAD/Congenital Neutropenia
• Immunodeficiency Disorders
• Severe Combined Immunodeficiency Disease
• Congenital and Paediatric Syndromes
• Other states of bone marrow failure – PRCA, PNH, Fanconi's Anemia
• Adrenoleukodystrophy
• HLH - Both primary and secondary
• Hurler Syndrome
• Multiple Sclerosis/ Scleroderma

The process of bone marrow transplantation may differ depending on the type of donor and transplant procedure used. In general, there are two kinds of transplant procedures:

• Autologous Bone Marrow Transplant:The bone marrow or stem cells are extracted from the patient's own body and frozen (cryopreserved) for future use in this procedure.
• Allogeneic Bone Marrow Transplant: This procedure involves harvesting bone marrow or stem cells from a donor's body. A donor might be a family member, usually a brother or sister, or an unrelated donor whose bone marrow matches that of the patient and must be an HLA (Histocompatible Leukocyte antigen) match. The bone marrow is delivered to the patient on the same day in this sort of transplant.

Types Of Allogeneic Bone Marrow Transplant:

• HLA (Immune)-Match Related Donor (Siblings) Transplant:The donor of bone marrow or stem cells is typically a sibling (brother or sister) whose HLA (Histocompatible Leukocyte antigen) fully matches that of the patient.
• HLA (Immune)-Matched Unrelated Donor Transplant:The bone marrow or stem cells are donated by a patient's family, usually a sibling (brother or sister) whose HLA (Histocompatible Leukocyte antigen) matches perfectly.
• Haplo Identical Donor Transplant:The patient's biological parents or half-matched siblings are the sources of the bone marrow or stem cells, which are HLA (Histocompatible Leukocyte Antigen) half-matched (haplotype) donors. A perfect match for the patient.
• Umbilical Cord Blood Transplant:Right after birth, umbilical cord blood cells are extracted from a newborn baby's umbilical chord. Because these stem cells are so young, exact matching is unnecessary. The stem cells extracted from the cord are frozen and preserved until they are needed in a transplant.

Following harvest, the bone marrow or stem cells are filtered to remove fat or other particles before being transported to the laboratory for processing, where they are numbered, screened, and ready for infusion.
The type of transplant required depends on the patient's specific medical needs. A doctor will assess the patient's medical condition and make recommendations for treatment. The purpose of a bone marrow transplant is to treat a range of blood diseases and cancers.

BMT Process Consists Of Three Main Phases Which Include:

• Phase 1:The Pre-BMT
• Phase 2:Stem cell transfusion- Day
• Phase 3:TThe Post-BMT

Here is everything you need to know about the transplant process. Beginning with how to prepare for the journey and including what to anticipate along the way, the guide is divided into six stages.

STEP 1: Preparation When the patient arrives at the BMT Centre, the preparation phase begins with medical assessment, guidance, informed consent, and other preliminary activities.

• Beginning of medical Evaluation
• Multidisciplinary treatment Modality
• Insertion of a Central Venous Catheter

STEP 2: Harvesting Bone Marrow/Stem Cells:Apheresis is used to collect stem cells from the bone marrow or peripheral blood. In an allogeneic transplant, stem cells are collected from the donor, whereas in an autologous transplant, stem cells are collected from the patient.

STEP 3: Conditioning:The conditioning stage is the first step towards transplanting. The patient is administered either chemotherapy or radiation therapy, or a combination of the two, during this process. Chemotherapy and radiation therapy are administered in levels that decrease bone marrow function and have the greatest chance of curing the disease. Depending on the chemotherapeutic agents and radiation therapy delivery schedule, some conditioning treatment may be provided in the outpatient setting, potentially shortening the hospital stay. The pre-BMT phase consists of preparation, stem cell harvest, and conditioning.

STEP 4: Transplant:In this stage, the infusion of donor bone marrow or stem cells takes place right after the conditioning regimen has been finished. This is similar to a blood transfusion. The duration beyond the transplant day is considered as the post BMT phase.

STEP 5: Wait for engraftment (new cell growth):As grafting indications are being watched for, this stage include close monitoring, supportive therapy, and the management of problems.

• Close monitoring, assistance, and protection
• Complication management, particularly infection management

STEP 6: Early Recovery And Engraftment:In around 2 to 3 weeks after the transplant, signs that fresh bone marrow or stem cells are grafting (growing and developing) can be expected. Close monitoring and supportive care will continue, and preparations for the patient's return home will begin.

STEP 7: Long-Term Recovery:At this point, the patient is discharged from the centre, any ongoing clinical concerns are discussed, and life patterns are restored. Patients are encouraged to have regular check-ups to avoid long-term consequences.