Bone Marrow Transplant: Types, Procedure, Benefits of Recovery

For individuals who have leukemia, lymphoma, and other serious blood diseases, a bone marrow transplant can provide a true opportunity for recovery by replacing their damaged or diseased bone marrow with healthy stem cells.

Our haematology/oncology team has a strong background in transplant medicine and operates state-of-the-art blood banking and post-transplant care units at Mahatma Gandhi Medical College & Hospital (MGMCH). Whether it's the diagnosis, treatment, or recovery, our doctors and patient care teams partner with each family to make a complicated process feel manageable.

What is bone marrow?

Bone marrow is the soft, spongy tissue found inside certain bones. It contains stem cells that produce the body's blood cells, including red blood cells, white blood cells, and platelets. Diseases affecting the bone marrow can interfere with normal blood cell production.

Blood Cancers and Bone Marrow Disorders

Bone marrow cancers such as leukemia and multiple myeloma are characterised by the growth of abnormal cells in the bone marrow, and the healthy blood cells are pushed out of the marrow. Some common signs of bone marrow cancer are

• Persistent fatigue or weakness
• Frequent or recurrent infections
• Easy bruising or unusual bleeding
• Bone or joint pain
• Unexplained weight loss
• Fever or other symptoms depending on the underlying condition

The marrow can become damaged by other bone marrow diseases, including aplastic anemia and the myelodysplastic syndromes, which can also lead to a bone marrow transplant if the condition is severe.

Bone Marrow Biopsy: Diagnosing the Problem

A bone marrow aspiration and biopsy may be performed to examine the bone marrow and help diagnose blood and marrow disorders. During aspiration, a liquid sample of marrow is collected, while a biopsy removes a small core of marrow tissue for examination. MGMCH's Clinical Hematology Department provides both bone marrow aspiration and biopsy as part of its diagnostic services.

The procedure and pain-management approach can vary depending on the patient and clinical circumstances. Your treating team can explain what to expect before the procedure.

What is a bone marrow transplant?

In a bone marrow transplant (BMT), an individual's unhealthy marrow is replaced by healthy stem cells from the person's own body or from another person (donor). These stem cells migrate to the bone marrow and start to make healthy blood cells once again. An important treatment for leukemia, some lymphomas, and other serious blood or immune system diseases.

There are two types of bone marrow transplants:

Autologous Bone Marrow Transplant: Stem cells are collected from the patient's own blood or bone marrow before conditioning treatment and are subsequently returned to the patient. MGMCH lists autologous transplantation for conditions including multiple myeloma and lymphoma.

Allogeneic Bone Marrow Transplant: Stem cells are obtained from another person whose tissue type is sufficiently compatible with the recipient. Donors may include a matched sibling, a matched unrelated donor, or a haploidentical donor, depending on the patient's circumstances. MGMCH lists all three donor categories.

Leukemia and Bone Marrow Transplant

Leukemia is a cancer of blood-forming tissues, including the bone marrow. Depending on the type of leukemia, disease risk, response to initial treatment, and individual clinical factors, a bone marrow transplant may be considered as part of treatment. MGMCH lists bone marrow transplantation among the treatment options for leukemia.

Bone Marrow Transplant Procedure

The typical steps of the bone marrow transplant are as follows:

• Conditioning: This is done by giving high doses of chemotherapy or radiation that eliminate diseased marrow so the body can receive new stem cells.
• Stem Cell Infusion: Healthy stem cells (from the patient or from a donor) are infused into the bloodstream via a central line, which is like a blood transfusion.
• Engraftment: After infusion, the transplanted stem cells begin establishing themselves in the bone marrow and producing new blood cells. The timing varies between patients and transplant types.
• Recovery and Monitoring: The patient continues to be monitored closely as the immune system recovers, and periodic blood tests are taken to monitor progress.

Bone Marrow Transplant Donor and Donor Risks

Identifying an adequate bone marrow donor requires tissue typing between donor and recipient to match certain tissue markers. Siblings have the best chance of a match, but unrelated donor registries are used when a sibling match is not available.

After donating, donors may feel pain, fatigue, or headache but rarely have serious complications. The vast majority of donors recover fully in the few days to weeks following the procedure.

Bone Marrow Transplant Side Effects

As with any treatment, a bone marrow transplant has some side effects:

• Lack of strength and lethargy after illness
• Raised risk for infection from a compromised immune system
• Loss of appetite or nausea
• Graft-versus-host disease (GVHD) (allogeneic transplants) when donor cells attack the patient's body
• Temporary hair loss due to chemotherapy treatments

Most of the side effects are controlled through medicines and careful medical monitoring, and many get considerably better as the new marrow is taking over.

Bone Marrow Transplant Cost in India

The price of a bone marrow transplant in India is dependent on the type of transplant, hospital stay duration, and the complications faced during recovery.

Allogeneic transplants are usually more expensive due to the requirement for donor matching and monitoring after the transplant. A few patients try government schemes or charities that provide free bone marrow transplant in India in such cases, depending on their eligibility. Talking to the hospital's transplant team about a specific cost estimate prior to beginning treatment aids planning.

Completing the recovery process after a bone marrow transplant

It's a slow process, and you have to be patient. During the first few weeks, patients remain in a hospital where they can be closely monitored for infection, while their new marrow starts to make blood cells. Complete immune recovery may be a matter of several months or a year; there is a need for regular check-ups, dietary control, and avoiding infections during this period.

Final Word

Bone marrow transplantation is an established treatment option for selected patients with blood cancers and other serious hematological disorders. MGMCH's Department of Clinical Haematology provides autologous and allogeneic bone marrow transplantation, along with specialised diagnostic and supportive haematology services. Treatment decisions depend on the underlying disease, disease status, donor availability, and the patient's overall clinical condition.