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Bone Marrow Transplant Frequently Asked Questions - BMT FAQs

Bone Marrow Transplant Frequently Asked Questions - BMT FAQs

What is a bone marrow transplant?

 A Bone Marrow Transplant refers to a medical procedure. It involves the infusion of healthy blood-forming cells into your body.

Bone marrows are soft tissues inside our bodies. These produce stem cells and grow those into White Blood Cells, Platelets, and Red Blood Cells.

The procedure replaces damaged and diseased bone marrow.

Doctors use the life-saving method when the bone marrow stops working due to illness or damage. It hinders your body from receiving enough healthy blood cells.

The procedure involves infusion, not surgery,

Where do blood-forming cells used in a transplant exist?

The blood-forming cells used by doctors during a Bone Marrow Transplant come from three sources. These are:

  • Bone Marrow. These are spongy tissues inside bones.
  • Peripheral blood stem cells transplant. The healthcare team gathers blood-forming cells from the circulating bloodstream.
  • While conducting a cord transplant, surgeons use the umbilical cord and placenta from the mother after baby birth.

What is an umbilical cord blood unit? How is it used in transplantation?

Cord Blood is a dependable source to treat Blood Cancer. Doctors use a newfound umbilical cord and placenta in the process.

Mothers are encouraged to donate the umbilical cord after the baby descends. The expert team members collect this after the baby is born.

They store the same as a cord blood unit at public cord blood banks. 

Use of cord blood unit carries the following benefits:

  • Matching is not required. Thus, the doctors can apply to patients with uncommon tissue types.
  • The medical team stores it previously. Therefore, the patient need not wait.
  • Umbilical cords leave less potential for GVHD.

Babies usually get their requirements from a single cord blood unit. It is not viable for adults. Therefore, children have a preference for umbilical cord blood unit uses.

When is a cord blood transplant a treatment option?

Doctors consider the cord blood transplant an ideal option for Leukemia treatment where chemotherapy alone cannot cure.

Acute blood cancer patients cannot wait for the donors to arrive and offer their cells to replace. Thus, doctors use the readily available umbilical cord blood for treatment.

Cord Blood is a treatment option also for the following patients:

  • Condition, where the patient cannot make healthy blood cells. It may be aplastic anemia or various genetic conditions affecting blood, bone marrow, or the immune system.
  • Stem cells transplant patients who are not getting a suitable stem cell donor.

What are the expected outcomes if I have a bone marrow or umbilical cord blood transplant?

Bone Marrow Transplant

The process helps both the patients and doctors allow safe treatment. It also involves the use of high-dose chemotherapy and Radiation Therapy. At the final stage, transference removes and replaces the damaged cell. Patients thus move towards a cure.

New stem cell replaces both the diseased and damaged cells. These also help kill the malignant cells.

Patients recover from the following conditions through Bone Marrow Transplant:

  • Aplastic anemia
  • Acute and chronic Blood Cancer.
  • Bone marrow failure syndromes.
  • Both Hodgkin’s and Non-Hodgkin’s Leukemia.
  • Immune deficiencies.
  • Hemoglobinopathies.
  • Multiple Myeloma.
  • Plasma cell disorders.
  • Neuroblastoma, etc.

Umbilical Cord Blood Transplant

Besides the pediatric patients, the procedure is also applicable for those suffering from donor scarcity. It results in long-term, disease-free survival.

It also reduces the GVHD potential.

How can you compare the survival of patients receiving a transplant from an unrelated donor to those from a related donor?

The common concept stands at a point that stems from a sibling are more effective in creating a disease-free environment. 

However, the situation shows continuous improvement. Currently, the transplant centers assume more care when selecting unrelated HLA for the suffering.

Current researches opine the centers should rely on haploidentical donors. It is so when a sibling or matched unrelated donors are not available.

Doctors apply to treat certain diseases. 

Transplantation is an urgent need there. Umbilical cord blood transplants are also not working.

The application of the theory has helped save thousands of critical ailing lives.

How is a bone marrow donor or umbilical cord blood unit found?

In countries like the USA, people requiring BMT often do not get sibling matches.

The hospitals categorize them as belonging to some race or ethnic varieties. Finding a suitable match from unrelated donors is also hard for these people.

Then the organization searches donors from their origin. They circulate international advertisements. In most cases, the patient party needs to invest a hefty amount for arranging an international donor.

Once found, the person needs to go through the following processes

  • Registering the unrelated donor.
  • Collect blood samples.
  • Admit in the hospital or clinic once the organization lab doctor confirms the HLA match.

What is my commitment if I join the registry?

On joining the registry, the foremost thing you should do is stay committed. Changing the mind is natural, and the law does not prohibit it.

Yet, consider the patient who stands match to your blood proteins. Your mental change can be life-threatening for the patient.

Think a thousand times before signing the registration form. Vow for the following:

  • I will respond at the earliest hour. Find a patient matching my HLA and inform.
  • I will strive to keep the contact information updated.
  • I will give the blood sample when they ask me.
  • I am ready to receive the injection to increase the number of blood-forming cells in my bloodstream,
  • I will accept the anesthetic surgery while donating my bone marrow.
  • I duly informed my family about the decision. They are ready to support me.

Where is bone marrow or umbilical cord blood transplants performed?

Bone Marrow Transplant can be of two types:

  • The first one is the Bone Marrow harvest. 

It involves a minor surgery held in a hospital outdoor. The donor remains asleep under general anesthesia impact. 

The treatment team takes tissues from the back or both of the hip bones.

The patient gets the infusion almost instantaneously.

  • In the Leukapheresis process, the donor receives medicated injections to help move stem cells from the bone marrow into the blood. They held the process in a clinic with laboratory facilities. 

The lab technician separates WBC from the stem cells. They infuse these into the patient after a waiting period. 

Cord Blood Transplantation

Doctors collect cord blood for resettlement from an umbilical cord and placenta. They gather those just after the birth.

The UCBT is a non-invasive process held in a clinic.

What is peripheral blood stem cell (PBSC) donation?

Peripheral Stem Cell Donation helps the cancerous or blood disease patients receive healthy blood-forming cells.

These cells replace their destroyed cells from the disease impact. 

Often the doctors use chemotherapy or radiation therapy to destroy malignant cells. Often these destruct healthy cells as part of the procedure.

The healthy stem cells may be from the patient or come from a donor.

PSBC is of three types:

  • The Autologous Transplant. Doctors use the stem cells out of the unaffected area. 

The healthcare team gets those previously and saves them in frozen condition before treatment.

  • The Allogenic Transplant. In these cases, the treatment team uses donor cells. The donor must be a person whose blood proteins match the recipient.
  • The Syngeneic procedure. It also is a donor-based process. An identical twin provides for the required stem cells.

Can patients meet or communicate with their marrow donors?

Yes, both the registry organization and the doctors agree that the donor must know the person using his blood stem.

Their contact, however, stays anonymous during the first year after transplant. Send letters, cards, and gifts mutually are general. They cannot meet till the patient recovers from the surgery.

The organization sees that both agree to have the contact information.

Doctors stress over the first year waiting before they can see each other.

The same is not applicable for cord blood donors and recipients.

Explanation

  • Both the donor and the patient are unable to communicate. Thus, there are legal consent and confidentiality restrictions on them.
  • Public cord banks keep the donor name confidential. They need to do this under the privacy protection clause under USA legislation. Banks only disclose the registered number. 

Who can donate umbilical cord blood?

  • Mothers above the age of 18 can donate their cord blood. However, some USA states collect cord blood from younger women too. With the rising of pregnancy age, these cases are becoming obsolete.
  • You cannot donate cord blood if you have generated a twin. The Double-child cord has different tissue types. There is a possibility that the collected blood produces a heterogeneous character.
  • Please do not apply if you have suffered from any cancerous disease ever in your life.
  • Public banks usually do not accept cord from diabetic mothers. However, USA legislation does not bar this.
  • People having Heart, Tissue, or other organ transplants within the last twelve months cannot apply for umbilical cord blood donation.
  • Surrogate mothers can also donate their cord blood. However, the bank will check if they have taken the sperm from an American Association of Tissue Banks facility.

What should I bring to the hospital for my stem cell transplant?

For an average Bone Marrow Transplant surgery, a minimum of two weeks hospital stays is mandatory. Thus, you need to prepare to stay that long.

Besides clothing, you need to bring dry snack foods.

You will be in a hospital gown for the entire period. The authority will also provide you with pajamas, robes, and slipper socks.

Bring the following things for your personal needs:

  • Sweatpants and Sweatshirts.
  • Walking Shoes.
  • Slippers.
  • Shorts.
  • Pajamas or gowns.
  • Scarves.
  • Clothes you are comfortable putting on.

Snacks and Savories include:

  • Cereals, pretzels, crackers, or chips – packed individually.
  • Individually packaged servings of fruits, jelly, and pudding.
  • Granola bars, hard candy, or gum.

Let your family members ask the dietician in the treatment team about the foods.

Is a bone marrow transplant the same as a stem cell transplant?

Doctors often define Bone Marrow Transplants and Stem Cell Transplants instinctively. These two appear synonymous to the listener.

However, these two resettlement procedures are characteristically different.

  • Stem Cell Transplant procedure uses stalk units from the bloodstream. Medical sciences also call it the peripheral procedure.
  • In Bone Marrow Transplant, the healthcare team uses stem cells from the bone marrow.
  • The former one is easier and thus common.
  • The treatment team collects more cells from the bloodstream.
  • Doctors suggest the healthcare team opt for the latter when collecting seems impossible from the bloodstream.
  • In Stem Cell Transfer, your blood count shows quick replenishment.

Why may someone need a bone marrow transplant?

Doctors recommend a Bone marrow transplant to treat different categories of conditions. These include:

1. Blood cell deficienciesBMT cures Aplastic anemia, Fanconi anemia, and many others.

2. Genetic immune-system disorders: The diseases treated include Congenital Neutropenia, Wiskott-Aldrich syndrome, severe combined immunodeficiency syndrome, and acquired immune deficiency syndrome.

3. Inherited blood disorders: The condition include osteopetrosis, adrenoleukodystrophy, metachromatic leukodystrophy, Hurler syndrome, red cell aplasia, beta-thalassemia, sickle cell anemia, etc.

4. .Amyloidosis.

6. Malignant blood diseases. 

These include Acute myelogenous leukemia, lymphoblastic leukemia, chronic myelogenous leukemia, Hodgkin, and non-Hodgkin lymphoma.

Others include Juvenile myelomonocytic leukemia, Multiple myeloma, myelodysplastic syndromes, and plasma cell disorders.

Doctors have also implemented BMT experimentally to treat various autoimmune diseases. These include multiple sclerosis, rheumatoid arthritis, lupus, systemic sclerosis, Crohn’s disease, and many more. Such experiments have produced excellent results so far.

How does the bone marrow transplant procedure work?

Bone Marrow Transplant is of different types. Each of the patterns has its working principle.

  • In the Autologous process, doctors remove stem cells from the unaffected body parts. Then they store them in a freezer. Patients receive high-dose chemotherapy or a combination of chemotherapy or radiation therapy to destruct malignancy.

The healthcare team restores those cells to the body. These become active to produce effective body units to continue physiological activities.

  • Donor provides the stem cells required for treatment. Doctors prefer relatives or siblings with matched blood proteins with the patient. 

Doctors place the cells after applying therapy if needed.

  • In the umbilical cord process, mothers donate this for general use. 

These cords contain enough cells. The medical care team sterilizes those before application.

These cells are immature, thus are universally effective.

How do I find a bone marrow donor?

Donor finding for Bone Marrow Transplant is an arduous task. However, the patient or his allege does not need to bother about it.

The transplant team works with the probable matches to find the best one for you.

  • They will test your blood to know about the human leukocyte antigen type.
  • Next, the team searches for donors carrying the same or similar HLA pattern.
  • They prefer brothers, sisters, or other siblings as HLA is inherited.
  • They will go out for a wild search if failed to get any resemblance in your siblings’ blood cells.
  • Your chosen donor will also become subject to blood tests and other relevant examinations before the doctor team finally takes it. 

What is the process for bone marrow donation?

A Bone Marrow Transplant donor imbibes the following procedures:

  • Donors need to update the health information.
  • The healthcare team explains the donation methods. It also includes the risks and potential side effects. The team expects Questions.
  • The donor will have to sign a consent form. 
  • The team conducts a comprehensive physical examination of the donor.
  • Then they gather the blood sample for matching confirmation.
  • In the previous five days, you will get an injection. It carries Filgratism drugs. It increases blood stem cells in the body.
  • On the PBSC day, they will collect blood from one arm and pass it through a machine. The device gathers the blood-forming cells only.
  • The donor gets the remaining blood back through a needle in the other arm.
  • The whole procedure takes no more than eight hours.
  • Peripheral Blood Stem Cells donation is a painless procedure. However, consider the experienced surgeons only to conduct the process.

Will I need any additional medical tests before the transplant?

Yes. The transplant center will conduct several tests before declaring you a fit for a transplant donor. The tests take the form as discussed:

  • There will be blood tests to establish the ABO blood type. 

It will help the doctor identify your blood type. Donor blood type must have a match to that of the recipient.

  • Blood tests also accompany the Serology testing. The result will show if the donating person has transmittable diseases. 

These include HIV, hepatitis, and cytomegaloviruses.

  • The second one involves the tissue type examination. The clinic uses Donor Blood samples to test for Human Leukocyte Antigen patterns. Bone Marrow Transplant requires that donor HLA or blood protein types are congruent with the patient. The healthcare team conducts the test with absolute precaution when in unrelated donor cases.

Can I have visitors during the transplant?

  • Family members and friends are always welcome to see the transplant patient. A clinic member previously checks if the patient is ready to meet the visitors.
  • Usually, clinics do not allow over two visitors at a time. 

The rest should wait for their turn to visit the patient.

  • For pediatric patients, the hospital authority will ask for an attendant. He will work for the pediatric patient safeguard. 
  • Overnight visitors must have attained maturity. They also ensure that the child gets adequate rest.

How are stem cells collected?

Stem cells collection from bone marrow is a comparatively safe procedure. Patients are under general anesthesia during the entire period.

The surgeon inserts a sterilized needle into the lower backbone marrow cavity. It sucks the marrows out of the bone.

He repeats the process several times. 

The collection process takes two hours. 

The gathering from the bloodstream is complicated. Yet, surgeons prefer the process as it helps collect enough blood cells.

These are enough to support courses of high-dose chemotherapy. 

Bloodstream stem cells also support treating several blood cancers. It also helps to treat solid tumors.

The patient gets a dose of cytokines through IV injection. It increases stem cells number in the blood.

Doctors collect both mature and immature units and process those in a machine to get the required quality cells in the required volume.

How long am I supposed to stay at the hospital after the transplant procedure?

The hospital stay after a successful BMT differs according to the ailing condition. Thus, the transplant type also impacts the duration.

Usually, the retaining can be anything between 30 and 100 days. The treatment team gives an idea, but it may change.

Your staying will also depend on the following collaterals:

  • How your body reacts to the procedure.
  • If the side effects also bring about a new ailment.

How do I know which type of bone marrow transplant is right for me?

Your Bone Marrow Transplant team comprises specialists from different backgrounds. Jointly, they will conduct an extensive evaluation before deciding the type of resettlement that befits you.

The final opinion depends on various factors.

First, they will appraise the disease under treatment. It is critical to know whether the required cell is present in your body.

Doctors prefer the autologous process to the lead place. It eradicates most of the side effects. These also include the GVHD.

Common factors include:

  • The patient’s age, overall health, and medical history.
  • The nature of the disease and its extent.
  • Whether the person can tolerate anesthetic medicines.
  • Donor availability.
  • Expectations from the disease turnout and the treatment.
  • Your feelings and preferences.

Will my blood type matter during the bone marrow transplant procedure?

Not exactly; the transplant matches the blood proteins type of the patient and the donating person. Through the HLA tests, they look at genetic markers on the WBCs.

Transplantation occurs when the markers in the patient’s body match the donors. Having the same or similar blood type is not necessary.

What are the risks of infection from an unrelated bone marrow transplant?

An allogeneic transplant carries the risks of severe infections. Unless controlled, these may turn fatal.

  • The first one is disease relapse. It occurs when the treatment team fails to control lymphocyte infusions.
  • GVHD is a common occurrence after an unrelated transplant. It has both chronic and acute types. The former one usually comes up after six months or so. But, the latter may come into action within the first month.
  • Severe pneumonia is a fatal infection after an unrelated BMT. It affects the lower respiratory tract. Often it combines with hypoxia.
  • You may get Sepsis as an outcome of positive blood culture. Fever and septic shocks are the general symptoms.
  • The application of high-dose chemotherapy or radiation therapy also accompanies a central nervous system infection.

Can Donor change mind?

Any donor has the right to change their mind about being a donor at any time. 

The Spirit of donation comes from the inner mind. No one can induce you to donate.

If you decide not to donate after completing the registration, the registration organization should receive information in the first place.

The organization thus can continue its search for donors with another prospective candidate. Curing a life-threatening disease is of prime importance.

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