Different types of Bone Marrow Transplant

There are three kinds of Bone Marrow Transplants:

1. Autologous bone marrow transplant:

means “self.” Immature marrow cells (stem cells) are removed from the patient himself before he receives high-dose chemotherapy or radiation treatment. After these treatments are done, the stems cells are put back in the body. This is called a “rescue” transplant.

2. Allogeneic bone marrow transplant:

“Allo” means “other.” Immature marrow cells are removed from another person, called a donor. Most times, the donor must have the same genetic makeup as the patient, so that their blood is a “match” to the patient’s. Special blood tests are done to determine if a donor is a good match for the patient. A brother or sister is most likely to be a good match. However, sometimes parents, children, and other relatives may be good matches. If the patient’s identical twin becomes the donor then it is called Syngeneic bone marrow transplant. Donors who are not related to the patient may be found through international bone marrow registries.

3. Umbilical cord blood transplant:

Immature marrow cells (stem cells) are removed from a new born baby’s umbilical cord immediately after being born. The stem cells are stored until they are needed for a transplant. Umbilical cord blood cells are so immature, that the problem of mismatch seldom occurs.

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Treatments of Sickle Cell Disease and Sickle Cell Anemia

Sickle cell anemia is an inherited blood disorder that causes blood cells to become hard, sticky and shaped like a sickle or “C.” As a result, while traveling through the blood vessels, cells may become stuck and block the flow of blood throughout the body. This may cause a variety of symptoms and medical problems, including bacterial infections, pain, tissue damage, stroke and anemia. Blocked blood flow also can cause damage to the spleen, kidneys and liver.

1.Hydroxyurea (Droxia, Hydrea): This prescription drug, originally used to treat cancer, may be helpful for children and adults with sickle cell disease. When taken daily, it reduces the frequency of painful crises and acute chest syndrome and also reduces the need for blood transfusions. It works by causing an increase in fetal hemoglobin (a type of hemoglobin found in newborn babies) that prevents the formation of sickle cells. This is a preventative medicine only. It does not relieve pain once a patient has already developed a pain crisis.

2.Blood Transfusions: Simple blood transfusions can also be given at a regular schedule (every 4-6 weeks) to prevent sickle cell problems. In some instances, patients are placed on a special machine so they can receive exchange transfusions where 6 to 10 units or a total of 1500 cc are replaced with normal blood cells. The most common reason that children receive scheduled transfusions is for the prevention of stroke. Blood transfusions are very effective at preventing stroke as well as preventing pain crises, acute chest syndrome, enlarged spleen (splenic sequestration) and allowing leg ulcers to heal.

3.Bone Marrow Transplant: Because red blood cells are made in the bone marrow, a bone marrow transplant is a potential cure for sickle cell disease. In a bone marrow transplant, a patient is given high dose chemotherapy and usually radiation to the entire body to wipe out the bone marrow. Then, bone marrow from a donor (usually a sibling) is given through an IV to the patient. The donor bone marrow cells repopulate the patient’s bone marrow and start to make red blood cells, which are normal red blood cells that do not sickle.

One problem with transplant is that it is often difficult to find a bone marrow donor who is a match. Also, because of the high dose chemotherapy and radiation, patients can experience many side effects and there is a 5-10% risk of death. Recently, doctors have been performing bone marrow transplants using less intense chemotherapy and radiation to try and reduce the side effects and the risk of death.

How to Get Started ?

The patient should have a related and matching donor. The following tests should be done for both patient and the related donor and also please email the reports to us for opinion by India’s leading specialist doctors.

1. HLA typing
2. Serum Ferritin Report
3. Blood screening Report