The process involves the extraction of a specific measure of bone marrow from a donor using a needle. Subsequently, this marrow is transferred to a patient with the purpose of replacing their diseased or lacking bone marrow.
The method of utilizing healthy red bone marrow to replace cancerous, defective, or diseased bone marrow in a patient is known as bone marrow transplantation (BMT). In allogeneic BMT, the procedure involves obtaining healthy marrow from a donor who possesses a highly similar tissue type to that of the recipient, often a sibling. On the other hand, autologous BMT entails harvesting the patient’s own healthy bone marrow during a period of remission and subsequently reintroducing it at a later stage. Generally, BMT is reserved for the treatment of severe and potentially life-threatening conditions affecting the blood and immune system, including aplastic anemia, sickle cell anemia, and leukemia.
Another treatment option is stem-cell transplantation, where instead of bone marrow, cells derived from the umbilical cord of a newborn baby or the bloodstream of an adult are transplanted. This alternative approach offers a viable option for replacing damaged or diseased bone marrow.
Prior to transplantation, the recipient undergoes a process wherein all of their existing bone marrow is eradicated using cytotoxic drugs or radiation. This step is crucial to prevent rejection of the donated cells and to eliminate any cancer cells that may be present. The donated bone marrow is then infused into the bloodstream, allowing the cells to navigate their way to the bone marrow cavities, where they begin to proliferate and grow.
During autologous BMT, the patient’s own bone marrow is preserved through cryopreservation, which involves freezing the marrow. Prior to freezing, the marrow is typically treated to ensure the elimination of any undetected cancerous cells. This stored bone marrow can be reinfused into the patient if the disease reoccurs, providing a potential treatment option.
The primary risks associated with BMT include infections that may arise during the recovery period and the possibility of rejection, known as graft-versus-host disease (GVHD). To prevent and manage rejection, immunosuppressant drugs are employed. One approach to reducing the risk of GVHD involves utilizing monoclonal antibodies to eliminate T-cells from the marrow before reinfusion. It is important to note that GVHD does not occur in autologous BMT or stem-cell transplantation.