Bone Marrow Transplant: A Possible Cure for Sickle Cell Disease

The soft, spongy tissue in the centre of most bones is called bone marrow. There are two types of bone marrow: Red and Yellow. Red bone marrow contains blood stem cells that can become red blood cells, white blood cells, or platelets. In Adults, bone marrow is primarily located in the ribs, vertebrae, sternum, and bones of the pelvis.

What Are the Functions of the Marrow Inside the Bone?

Bone marrow makes the components of your blood that you need to survive. Bone marrow produces red blood cells that carry oxygen, white blood cells that prevent infection and platelets that control bleeding. The absence of bone marrow can be fatal since it's an essential part of your body.

What Is the Most Common Site of Bone Marrow Test?

The bone marrow fluid (aspirate) and tissue sample (biopsy) are usually collected from the top ridge of the back of a hip bone (posterior iliac crest). Sometimes, the front of the hip may be used. Rarely sternum is used as the site of testing.

Who Needs a Bone Marrow Testing?

Your doctor may order a bone marrow test, if your CBC report shows your levels of platelets, or white or red blood cells are too high or too low that is unexplained. A bone marrow test will help determine the cause of these abnormalities, which can include:

1. Anaemia, or a low red blood cell count.
2. Bone marrow diseases, such as myelofibrosis or myelodysplastic syndrome.
3. Blood cell conditions, such as leukopenia, thrombocytopenia, or polycythaemia.
4. Cancers of the bone marrow or blood, such as myeloma, leukaemia or lymphomas.
5. Infection or fever of unknown origin.

What Does Bone Marrow Transplant (BMT)/ /Stem Cell Transplant (SCT) Do?

A bone marrow transplant takes a donor's healthy blood-forming cells and puts them into the patient's bloodstream, where they begin to grow and make healthy red blood cells, white blood cells and platelets. Patients receive high doses of chemotherapy to prepare their body for the transplant.

Who Needs a BMT?

A bone marrow may be the best treatment option or the only potential for a cure for patients with Sickle cell anaemia, Thalassemia major, Aplastic anemia, inherited immune deficiency disorders, inherited metabolic disorders, Leukaemia (AML, ALL), Myeloma, Relapsed lymphoma, Myelodysplastic syndromes.

Is BMT a Surgery?

A BMT is a procedure that infuses healthy blood-forming stem cells into your body to replace bone marrow that's not producing enough healthy blood cells.

What Are the Different Types of BMT?

Different types of bone marrow transplants depending on who the donor is.

• Autologous BMT: The donor is the patient himself or herself. Stem cells are taken from the patient either by bone marrow harvest or apheresis (a process of collecting peripheral blood stem cells), frozen, and then given back to the patient after intensive treatment.
• Allogeneic BMT: The donor shares the same genetic type as the patient. Donor is usually a brother or sister. Other donors for allogeneic BMT may include the following:
• A Parent: A haploid-identical match is when the donor is a parent and the genetic match is at least half identical to the recipient. These BMT are rare and difficult.
• Unrelated BMT (UBMT or MUD for Matched Unrelated Donor): The genetically matched marrow or stem cells are from an unrelated donor. Unrelated donors are found through national bone marrow registries.

How Long Do You Stay in the Hospital after BMT?

Every patient's situation is unique, but you can expect to spend 30 to 45 days in the hospital or at the outpatient clinic for your transplant.

What Happens after BMT?

Once the transplant is finished, you'll need to stay in hospital for a few weeks while you wait for the stem cells to settle in your bone marrow and start producing new blood cells. During this period you may: feel weak, and you may experience diarrhoea and vomiting, and/or a loss of appetite. You would require regularly visiting your doctor to see if the bone marrow is functioning properly.