by Kimberly Allen R.N.
Bone marrow transplants are complicated proceedures that carry significant risks of complications. Bone marrow transplants are used to replace bone marrow that has been damaged or destroyed. Specifically it replaces the “stem cells” in the marrow. Stem cell are the cells that produces all the other blood cells.
There are 3 types of bone marrow transplants currently available:
1. Autologous bone marrow transplants are when stem sells are removed from your blood before you receive high doses of chemotherapy and stored in a freezer. Then after you have completed the treatments with high dose chemotherapy and/or radiation they are put back into your body.
2. Allogeneic bone marrow transplants involve the removal of stem cells from another person to be given to you. In this type of transplant the donor must at least partially match your blood genetically. The person to be the donor will need to have blood tests to determine if their blood is a close enough match. finding donors is sometimes difficult as family members are not always a close enough match and you may need to look to the donor registry for a potential donor.
3. Umbilical cord transplants involve removing the stem cells from the baby’s umbilical cord immediately after birth and stored for future use.
Bone marrow transplants are a complicated and time consuming process that is done in five stages.
1. Physical examination. You will have to have a complete and thorough physical including blood tests and scans to determine how healthy certain organs like your heart and liver are. It is also important to determine if you have any infections and if your organs are strong enough to fight any potential infections post transplant.
2. Obtaining the stem cells. If you are donating your own stem cells for re-transplantation the next step is removing the stem cells. This is done by removing your blood through an IV and putting it through a filter to separate the stem cells from the rest of the cells. The stem cells are then stored until needed and the remaining blood is returned to your body. If a donor is providing the stem cells the same procedure is used.
3. Conditioning. This is preparing your body for the transplant. It involves receiving high doses of chemotherapy to destroy your remaining bone marrow to make room for the transplant marrow. A type of IV known as a central line will be inserted into a large vein in your chest to facilitate administration of the many medications required to prepare your body. these medications are given to also destroy any cancer cells that may be present and to stop your immune system from functioning to decrease the chance of rejection of the transplanted marrow.This process usually takes from 4-7bdays and you will need to remain in the hospital during this time.
4. The transplant, usually takes place 1 to 2 days after the conditioning process is complete. The stem cells that had been retrieved earlier will be administered through your central line.
5. The recovery, is the longest and most dangerous part of the procedure. Not only is there a risk for rejection but your immune system is not functioning so you will need to remain hospitalized and on whats called reverse isolation precautions. These precautions are to prevent you from developing an infection. Everyone that enters your room will have to first wash their hands, then cover their clothes with a long sleeved gown, mask to cover their nose and mouth and gloves. You will have to stay in the hospital until your white blood cell count reaches a number satisfactory to your Dr. After leaving the hospital you will continue to have a high risk for infection for 1-2 years while your immune system returns to pretransplant function.
It’s important to understand the process before you make the decision to have a bone marrow transplant so that you can prepare for life after the transplant.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.