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Pre-Bone Marrow Transplant Evaluation

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A bone marrow transplant (BMT) is a special procedure performed to replace either the destroyed or damaged bone marrow with a healthy bone marrow. Bone marrow is soft and fatty tissue present inside the bone, which produces the blood cells.

BMT involves taking the cells usually found in the bone marrow and then giving them back to the patient or another person. BMT aims to transfuse the healthy bone marrow cells into a person after his own unhealthy bone marrow has been treated for killing the abnormal cells.

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Autologous transplant

Collection of cells

Step 1

Collection of cells
This step may take several days. At first, you will get injections of a medication that will increase your cells. Then your doctor and his team will collect the cells through a vein in your arm or chest. These cells will then be stored until needed.

Pre-transplant treatment

Step 2

Pre-transplant treatment
This step usually takes 5-10 days. You will get a higher dose of chemotherapy. Sometimes, patients also receive radiation therapy.

Getting the cells back

Step 3

Getting the cells back
This step is the transplant day. The process takes about 30 minutes for each dose of cells. This is known as an infusion. Your doctor team puts the cells back into your bloodstream via a catheter. You may have more than one infusion.

Recovery

Step 5

Recovery
Your doctor will closely monitor the recovery and growth of your cells and may prescribe you antibiotics to reduce infection. They will also take care of any side effects.

Allogeneic transplant

Identification of donor

Step 1

Identification of donor
This step may take several days. At first, you will get injections of a medication that will increase your cells. Then your doctor and his team will collect the cells through a vein in your arm or chest. These cells will then be stored until needed.

Collection of cells

Step 2

Collection of cells from the donor
The team of doctors will collect cells either from donor’s bone marrow or blood. When the cells are coming from bone marrow, your donor has a procedure known as bone marrow harvest in a hospital's operating room. When the cells are coming from the bloodstream, the donor will get daily injections (shots) of medication for increasing the white cells in the blood for a few days, before the collection process. After this is done, the cells are collected.

Pre-transplant treatment

Step 3

Pre-transplant treatment
This step usually takes 5-7 days. You may receive chemotherapy, with or without radiation therapy for preparing your body to receive the cells from the donor.

Getting the cells back

Step 4

Receiving the donor cells
This step is your transplant day, and your doctor and his team put or infuses the donor’s cells into your bloodstream through the catheter. Generally, this procedure takes less than an hour.

Recovery

Step 5

Recovering
During your initial recovery phase, you will get antibiotics to reduce the risk of infection and other drugs, including medicines to prevent and/or manage graft versus host disease (GVHD). Your doctor’s team will also treat any side effects.

Complications of a bone marrow transplant

As with every surgery, the risk of complications is there and bone marrow transplant is no exception. However, it is not always necessary that a patient develops these complications, but it is good to be aware of it. Below are some of the common complications linked with bone marrow transplant:

Graft versus host disease

If you have undergone an allogeneic transplant, then you are at higher risk of developing GVHD, which is more likely to occur if the cells have been taken from an unrelated donor. However, it may occur otherwise as well. The symptoms of GVHD may occur within the initial month or even after a longer duration of time. These may include:

  • Dry eyes
  • Skin rashes
  • Breathlessness and cough
  • Nausea and vomiting
  • Change in appetite
  • Bloating or diarrhea
  • Jaundice
  • Joint pains

The other complications may include:

  • Damage to organ
  • Infection
  • Cancer
  • Bleeding
  • Problem in eyes such as cataract
  • Problems in liver or kidney
  • Infertility
  • Cramps or numbness in arms or legs
  • Breathing problems
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