Bone marrow transplant is also called haematopoietic stem cell transplant (HSCT) as the peripheral blood and umbilical cord blood can be used as stem cell sources. Bone marrow transplant is important in treatment of many diseases in childhood including hematologic malignity, immune deficiency, haemoglobinopathy, bone marrow deficiencies and inborn errors of metabolism. Traditionally used stem cell source for hematopoietic stem cell transplant is the bone marrow. Bone marrow is harvested from the back iliac crest. The number of nuclear cells is decisive in sufficiency of the collected bone marrow.
Many centers prefer peripheral stem cells as the stem cell source in autologous transplant. The patient is administered conditioning regimen before bone marrow transplant. The patient is applied suitable chemotherapy protocols. The purpose of the conditioning regimen in hematopoietic stem cell transplant is to prepare the patient for transplant and has three separate components: "Making room in the bone marrow”, “Immunosuppression” and “Elimination of disease”. It is followed by engraftment. Unless otherwise required, patients are hospitalized for 25-30 days after bone marrow transplant. In this period, red blood and platelet transfusion is rendered. When the bone marrow is engrafted, the patient is discharged for outpatient treatment.
What are types of bone marrow transplant?
• Autologous transplant: Transplanting own stem cells to the recipient.
• Allogeneic transplant: Transplanting full match stem cells from a person, whether a relative or not, to the recipient.
• Haploidentical transplant: Transplanting among half match tissues from the first degree relatives of the recipient.
For which diseases is bone marrow transplant preferred?
• Acute myeloid leukemia
• Acute lymphocytic leukemia
• Myelodysplastic syndrome
• Sickle cell anemia
• Chronic myelocytic leukemia
• Primary immune deficiencies
• Hodgkin’s Lymphoma
• Non-Hodgkin’s Lymphoma