When your doctor thinks youвre ready, youвll have the transplant. The procedure is similar to a blood transfusion. If youвre having an allogeneic transplant, bone marrow cells will be harvested from your donor a day or two before your procedure. If your own cells are being used, theyвll be retrieved from the stem cell bank. Cells are collected in two ways. During a bone marrow harvest, cells are collected from both hipbones through a needle. Youвre under anesthesia for this procedure, meaning youвll be asleep and free of any pain. During leukapheresis, a donor is given five shots to help the stem cells move from the bone marrow and into the bloodstream. Blood is then drawn through an intravenous (IV) line, and a machine separates out the white blood cells that contain stem cells. A needle called a central venous catheter, or a port, will be installed on the upper right portion of your chest. This allows the fluid containing the new stem cells to flow directly into your heart. The stem cells then disperse throughout your body. They flow through your blood and into the bone marrow. Theyвll become established there and begin to grow. The port is left in place because the bone marrow transplant is done over several sessions for a few days.
Multiple sessions give the new stem cells the best chance to integrate themselves into your body. That process is known as engraftment. Through this port, youвll also receive blood transfusions, liquids, and possibly nutrients. You may need medications to fight off infections and help the new marrow grow. This depends on how well you handle the treatments. During this time, youвll be closely monitored for any complications.
Find out what bone marrow is and how bone marrow transplants are used as treatment for some types of cancer. You\’re now more likely to have a stem cell transplant (also called peripheral blood stem cell transplant) than a bone marrow transplant. Your doctor considers many different factors when deciding which type of transplant is right for you. Ask them to talk you through it if you are unsure. Bone marrow transplant is a way of giving very high dose chemotherapy, sometimes with whole body radiotherapy. This treatment aims to try to cure some types of blood cancerPsuch asPleukaemia,PlymphomaPandPmyeloma. Bone marrow is a spongy material that fills the bones. It contains early blood cells, called stem cells. These develop into the 3 different types of blood cell.
You have a bone marrow transplant after very high doses of chemotherapy and sometimes whole body radiotherapy. The chemotherapy and radiotherapy have a good chance of killing the cancer cells, but also kill the stem cells in your bone marrow. Before your chemotherapy, your team collects your bone marrow or a donor\’s bone marrow. After the treatment you have the bone marrow cells into a vein through a drip. The bone marrow cells find their way back to your bone marrow. Then you can make the blood cells you need again. This is called a bone marrow rescue. You might have a bone marrowPtransplant using bone marrow from a donor. This is called an allogeneic transplant. PThePcells need to be as similar as possible to yours. First, laboratory staff check the surface of your blood cells and the donor blood cells for certain proteins. The proteins are called HLA markers or histocompatibility antigens. So the test is called HLA typing or tissue typing. Everyone has their own set of proteins. Staff compare the proteins on the cells in the blood samples to see if the HLA markers are the same or very similar. Usually 10 HLA markers are checked. The results of your blood test and the donor\’s test tell your doctor how good the HLA match is between you.
Members of your close family are most likely to have similar proteins to yours. You can have a transplant without a perfect match. This is called a mismatched transplant. If you have a mismatched transplant, you are more likely to have a reaction afterwards. The reaction is called graft versus host disease (GVHD). This means the immune cells from the donated stem cells attack some of your body cells. GVHD typically causes skin rashes, diarrhoea and liver damage. You will have anti rejection drugs to help stop it developing. GVHD can be severe and even life threatening for some people. But mild GVHD can also be helpful for some people. It is an immune system reaction and can help to kill off any cancer cells left after your treatment. Your doctor may consider a half matched transplant (haplo identical transplant). This means the donor is at least a 50% match with you. This could be one of your parents, a sibling or your child. In the past these transplants have been difficult to do due to the increased risk of severe GVHD and infection. But doctors are finding new ways of improving this type of transplant and reducing the risk of GVHD. You might have your own bone marrow given backPto you after high dose treatment.
This is called an autograft or autologous transplant. You have your bone marrow taken (bone marrow harvest) under a general anaesthetic. This means you are asleep and can\’t feel anything during the procedure. You lie on your side on a couch. Your doctor puts a needle through your skin into the hip bone (pelvis). The doctor gently draws out the bone marrow through the needle into a syringe. To get enough bone marrow the doctor needs to put the needle into several parts of the pelvis. You have about 2 pints (1 litre) of bone marrow taken out and then it\’s frozen until it\’s needed. The procedure takes about an hour. P You have the puncture sites covered with plasters. P You might have to stay in hospital for 1 or 2 nights after a bone marrow harvest. Your nurse will give you painkillers to take home if you feel sore. The Anthony Nolan charity has helpful information. They have a register to match people willing to donate their bone marrow or blood stem cells to people who need transplants. They also provide information, support and an online forum for patients and families going through a transplant.