Bone marrow transplantation is a procedure where the stem cells taken from the matched donors is given to the suitable patients with various blood conditions. During the process stem cells are taken out of the donor’s body and given to the recipient. Stem cells are a special type of cells which have great potential of multiplication and can mature into any other forms of cells. These cells can be present in various parts of the body. Usually cells of this type can develop into any type of blood cells. Most of stem cells of the blood are found in bone marrow (that is present inside the flat bones of our body), peripheral blood (blood in our vessels), and cord blood (blood in the umbilical cord).
Various medical conditions require the stem cell bone marrow transplantation.It may be required when the production of all the cell line in bone marrow is impaired as in aplastic anemia or the cancerous condition in the blood as Lymphoma, Leukemia or the metabolic disorders etc. Bone marrow transfusion can provide cure in various conditions such as aplastic anemia if the transfusion occurs successfully.
Basic steps of Bone Marrow Stem Cell Transplantation can be enumerated below:
1. First the HLA matched donor is found. The chances of siblings being HLA match
donor is high . Sometimes non siblings can also be HLA matched donor. National Marrow Donor Program manages the registry of the people
2. Stem cells are taken from a healthy donor
3. Bag of stem cells which looks similar to blood bag is transfused through the central vein in the chest.
4. If the cells find the way to the bone marrow, it starts producing the cells, which will replete the initial deficiency in the patient. It will take several weeks to produce cells properly.
5. Before the stem cell transplant, the recipient receives chemotherapy or the radiotherapy in order to kill the remaining stem cells in the recipient body before getting the new one.
National Marrow Donor Program is one such institute which facilitates the process of stem cell transplantation. It maintains the registry of people who are willing to donate bone marrow. It matches patient with donors, facilitates health education, and conducts various research. "Be the Match" is the world’s largest adult bone marrow registry. It has listed more than 9 million people. It lists the people who are potential bone marrow donors and also the people who have donated cord blood units.
Like many of the medical procedures, the process of Stem Cell transplantation is not exempt from the possible risk and the benefits. The candidates suitable for transplant are judged on the basis of possible risk and benefit they can possibly have.
The possible risks can be:
1. Before bone marrow transplantation, the patient is given a chemotherapy or radiation to decrease the patient’s stem cells. This decrease the WBC which fights of infection. It leads to increased chances of infection.
2. Sometimes a condition called graft versus host disease (GVHD) can occur. In this condition, the cells from the donor start destroying the body cells of the recipient patients. It may manifests as diarrhea, liver problems etc.
The Benefits are:
1. It can offer cure in patients such as aplastic anemia.
2. The repletion of cells after successful transplantation can help in alleviating the symptoms such as shortness of breath or bleeding problems in the patient.
Why should we register for the bone marrow registry? The question may linger everyone’s mind those who come across it. This is usually because the odds for the person who needs bone marrow transplant within his/her family is 30%. The remaining 70% has to look for the registry for the possible match as the odds of other person being the possible match is one in 20,000. The NMDP maintains the list of the possible donors. The physician who is seeing the patient sends the information to NMDP on his behalf. The request is then processed to find for the possible donor in the computer database. As the possible donor is found, he/she is contacted by NMDP. If he wishes to donate, then the sample can be collected, which can later transferred to the patient via courier.
For More information, please look into the following references:
1. http://en.wikipedia.org/wiki/National_Marrow_Donor_Program
2. http://marrow.org/Home.aspx
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