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Mary Kugler, MSN, RN,BC
Guide to Rare/Orphan Diseases
What is a bone marrow transplant?
A bone marrow transplant is when special cells (called stem cells) that are normally found in the bone marrow are taken out, filtered, and given back either to the same person or to another person.
Why is it done?
Bone marrow produces stem cells. These stem cells develop into the body's blood cells. Bone marrow is a critical part of the body because it is the body's main blood cell "factory." If something is wrong with the marrow a person can become very ill, even die.
In diseases such as leukemia and aplastic anemia, the bone marrow is unhealthy. The purpose of a bone marrow transplant is to put healthy marrow cells in place of the unhealthy ones. This can treat or even cure the disease.
Whom do the stem cells come from?
- Autologous bone marrow transplant - The donor is the person him/herself.
- Allogeneic bone marrow transplant - The donor is another person whose tissue has the same genetic type as the person needing the transplant (recipient). If no one in the recipient's family has the same tissue type, then the national bone marrow registries' databases are checked for a tissue type match. The chances of a minority person in the United States finding a registry match is lower than that of a white person (see article, Minority Marrow Matches Fewer).
Sources of bone marrow stem cells
- Bone marrow harvest: Collecting stem cells by taking them directly out of the bone.
- Apheresis: Collecting stem cells by filtering the blood.
- Umbilical cord blood: Stem cells are filtered from blood in the umbilical cord after a baby is born.
What the donor experiences
If stem cells are collected by bone marrow harvest, the donor will go to the operating room and while asleep under anesthesia, a needle will be inserted into either the hip or the breastbone to take out some bone marrow. After awakening, he/she may feel some pain where the needle was inserted.
If stem cells are collected by apheresis, the donor is connected to a machine by a needle inserted in the vein (like for blood donation). Blood is taken from the vein, filtered by the machine to collect stem cells, then returned back to the donor through a needle in the other arm.
What the recipient experiences
Bone marrow transplant is a difficult procedure to go through. Usually the person receives high doses of chemotherapy and/or radiation to eliminate whatever bone marrow he/she has left and make room for the new marrow transplant. Once this is done, the new stem cells are put into the person intravenously, like a blood transfusion. The stem cells will then find their way to the bone and start to grow and produce more cells (called engraftment).
Serious problems can occur during the time that the bone marrow is gone or very low. Infections are common, as is anemia, and low platelets in the blood can cause dangerous bleeding internally. Recipients often receive blood transfusions to treat these problems while they are waiting for the new stem cells to start growing.
Are you willing?
If you'd like to become a volunteer donor, the process is straightforward and simple. Anyone between the ages of 18 and 60 and in good health can become a donor. There is a form to fill out and a blood sample to give; you can find all the information you need at the NMDP Web site. You can join a donor drive in your area or go to a local Donor Center to have the blood test done.