Bone Marrow Or Blood Stem Cell Transplant

GENERAL INFORMATION:

What is it?

• Bone marrow or blood stem cell transplant is a procedure to treat diseases such as cancer. Or, other diseases like aplastic (a-plah-stik) anemia (un-nee-mee-uh), and immune (im-yoon) deficiency disorders. Bone marrow transplant is also called "BMT." Blood stem cell transplant is sometimes called "SCT."
  
  
• All blood cells come from one original cell called a stem cell. Stem cells live in the bone marrow which is the spongy tissue inside bones. Stem cells make all the different types of blood cells. Stem cells make red and white blood cells, and platelets.

How does the transplant work? Both BMT and SCT have the following three steps.

• Harvesting: Bone marrow and stem cells can be harvested (taken out) from you or from a donor. It can be harvested from another family member or from a complete stranger. It is called an autologous (aw-tall-uh-gus) harvest if your own bone marrow or stem cells are harvested. Syngeneic (sin-juh-ney-ik) harvest is when the donor is an identical twin brother or sister. Allogeneic (ah-lo-juh-ney-ik) harvest is when the person donating is another family member or a stranger.
  
  
  • To harvest bone marrow, surgery is needed. A needle is put into several places in the hipbones to take out bone marrow. The bone marrow is then purged (cleaned) to remove bits of fat and bone. The bone marrow may also be treated to kill any cancer cells. It is either frozen to use later or taken directly to the person who will get it.
    
    
  • To harvest stem cells, the person donating the stem cells is connected to a special machine. It is called an apheresis (a-fer-e-sis) machine. An IV is put into a vein in the donor's arm or neck. Their blood goes through the IV into the apheresis machine. The machine spins the blood to pull the stem cells out and puts them into a separate bag. The rest of the donor's blood is then put into the IV and given back to them. The donor is connected to the machine 3 to 4 hours a day for 1 to 7 days. The stem cells may then need to be purged to remove any damaged or destroyed stem cells.
    
    
  • Stem cells can also be harvested from umbilical cord blood. This is blood that was donated from the placenta of a baby after the baby was born. The baby who has donated the cord blood does not need it after birth. These cells are cleaned and frozen to be transplanted later.
  
  
• Conditioning: The 2nd step of BMT and SCT is a conditioning program. You will receive radiation or a combination of radiation and chemotherapy. This conditioning program kills as many cancer cells in your body as possible. It also lessens the chance that you will reject the new cells if they come from another person. The conditioning program ALSO kills your remaining bone marrow. This makes room for the transplanted bone marrow or stem cells. This step may not be needed if you are having the transplant for an immune deficiency.
  
  
• Transplanting: This is the 3rd step of BMT and SCT. This is also called the "rescue process." The bone marrow or stem cells are given to you through an IV. The bone marrow or stem cells find their way inside your bones. They take hold inside your bones and start making more blood cells. It may take a few weeks before the stem cells begin to make new blood cells.

Risks:

• There are serious risks with having a BMT or SCT. You may get bad infections while your body works to accept the new bone marrow or stem cells. You may get "graft-versus-host disease" (GVHD) after an allogeneic (family or stranger donor) BMT or SCT. This means that your body is trying to reject the donor cells that were transplanted into your body.
  
  
• There is a chance your body will not accept the bone marrow or stem cells and you may die. Even if you have a transplant and all goes well, your cancer could come back. You could also get a new cancer. You also may die if you refuse to have the transplant after the conditioning program. Call your caregiver if you are worried or have questions about your medicine or care.

Which procedure is best for me? There are advantages and disadvantages to both BMT and SCT. You and your caregiver will work together to decide which type is best for you. The choice depends on many things. Such as, what kind of cancer you have and how healthy you are.

Support:

• Having a bone marrow or stem cell transplant can be very stressful Accepting that you have a life changing illness is hard. You and those close to you may feel scared, angry or sad. These feelings are normal. Talk to your caregivers, family, or friends about your feelings and let them help you. Encourage those close to you to talk to your caregiver about how things are at home. Your caregiver can help your family better understand how to support a person who has had a transplant.
  
  
• You may also want to join a support group. This is a group of people who have also had bone marrow or stem cell transplants. Ask your caregiver for the names and numbers of support groups in your town. Or, you can contact one of the following national organizations for more information.

• National Marrow Donor Program
  3001 Broadway Street NE, Suite 500
  Minneapolis, MN 55413-1753
  Phone: 1-800-627-7692
  Web Address: http://www.marrow.org
  

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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