Hematology and Blood Disorders

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Perspective - Hematology and Blood Disorders (2023) Volume 6, Issue 4

Bone marrow transplantation: A lifesaving procedure

Avery Gray *

Department of Coagulation Disorders, University of Tokyo, Japan

*Corresponding Author:
Avery Gray
Department of Coagulation Disorders, University of Tokyo, Japan
E-mail: Gray44@u-tokyo.ac.jp

Received: 28-Feb-2024, Manuscript No. AAHBD-24-136394; Editor assigned: 01-Mar-2024, PreQC No AAHBD-24-136394 (PQ) Reviewed:14-Mar-2024, QC No. AAHBD-24-136394Revised:20-Mar-2024, Manuscript No. AAHBD-24-136394 (R); Published:27-Mar-2024, DOI:10.35841/aahbd-6.4.164

Citation: Gray A. Bone marrow transplantation: A lifesaving procedure. Hematol Blood Disord. 2024;6(4):162

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Introduction

Bone marrow transplantation (BMT) is a medical procedure used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. These stem cells can be sourced from the patient (autologous transplant), a donor (allogeneic transplant), or an identical twin (syngeneic transplant). BMT is primarily used to treat hematological malignancies such as leukemia and lymphoma, as well as non-malignant conditions like aplastic anemia and certain genetic disorders. This article explores the types, indications, procedure, and outcomes of bone marrow transplantation [1].

Autologous Transplantation: Involves harvesting the patient’s own stem cells before administering high-dose chemotherapy or radiation therapy. The stem cells are then reinfused to re-establish marrow function. This type is commonly used for multiple myeloma and certain lymphomas [2].

Allogeneic Transplantation: Involves transferring stem cells from a compatible donor, often a sibling or unrelated donor matched through the HLA system. It is used for a wider range of conditions, including acute and chronic leukemias, myelodysplastic syndromes, and severe aplastic anemia [3].

Syngeneic Transplantation: Involves using stem cells from an identical twin, providing a genetically identical source of marrow, thus eliminating the risk of graft-versus-host disease (GVHD). [4].

Hematological Malignancies: BMT is a cornerstone treatment for acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), and lymphomas. Non-Malignant Hematological Disorders: Conditions such as severe aplastic anemia, thalassemia, and sickle cell disease can be treated with BMT to restore normal hematopoiesis [5].

Genetic and Metabolic Disorders: Inherited conditions like severe combined immunodeficiency (SCID), Hurler syndrome, and other lysosomal storage disorders may benefit from BMT. Solid Tumors: In some cases, high-dose chemotherapy followed by autologous BMT is used for germ cell tumors and neuroblastoma [6].

Preparation: Includes pre-transplant evaluations, finding a suitable donor for allogeneic transplants, and conditioning therapy. Conditioning involves high-dose chemotherapy, with or without radiation, to eradicate malignant cells and suppress the immune system to prevent graft rejection [7].

Stem Cell Collection: For autologous transplants, stem cells are harvested from the patient’s blood or bone marrow. For allogeneic transplants, donor stem cells are collected through peripheral blood stem cell collection or bone marrow harvest [8].

Engraftment and Recovery: Engraftment typically occurs within 2-4 weeks, indicated by rising blood counts. The patient is closely monitored for complications, including infections, bleeding, and GVHD in allogeneic transplants [9].

The success of BMT depends on several factors, including the type of transplant, the patient’s underlying condition, and overall health. Complications can include: Graft-versus-Host Disease (GVHD): A significant risk in allogeneic transplants where the donor’s immune cells attack the recipient’s tissues. Acute GVHD affects the skin, liver, and gastrointestinal tract, while chronic GVHD can involve multiple organs [10].

Conclusion

Bone marrow transplantation is a critical therapeutic option for many life-threatening hematologic and genetic disorders. While it offers the potential for cure, it is associated with significant risks and complications. Advances in transplantation techniques, supportive care, and the development of novel therapies continue to improve outcomes and expand the applicability of BMT.

References

  1. Appelbaum FR. Hematopoietic-cell transplantation at 50. New England J Med. 2007;357(15):1472.

    2. Indexed at, Google Scholar, Cross Ref

  2. Copelan EA. Hematopoietic stem-cell transplantation. New England J Med. 2006;354(17):1813-26.

    3. Indexed at, Google Scholar

  3. Gyurkocza B, Sandmaier BM. Conditioning regimens for hematopoietic cell transplantation: one size does not fit all. Blood, J American Soci Hematol. 2014;124(3):344-53.

    4. Indexed at, Google Scholar, Cross Ref

  4. Pasquini MC, Wang Z. Current use and outcome of hematopoietic stem cell transplantation: CIBMTR Summary Slides, 2010.

    5. Indexed at, Google Scholar, Cross Ref

  5. Thomas ED, Storb R, Clift RA, Fefer A, Johnson FL, Neiman PE, Lerner KG, Glucksberg H, Buckner CD. Bone-Marrow Transplantation: (First of Two Parts). New England J 1975;292(16):832-43.

    6. Indexed at, Google Scholar, Cross Ref

  6. Anasetti C, Logan BR,. Peripheral-blood stem cells versus bone marrow from unrelated donors. New England Journal of Medicine. 2012;367(16):1487-96.

    Indexed at, Google Scholar, Cross Ref

  7. Niederwieser D,. Hematopoietic stem cell transplantation activity worldwide in 2012 and a SWOT analysis of the Worldwide Network for Blood and Marrow Transplantation Group including the global survey. Bone marrow transplantation. 2016;51(6):778-85.

    8. Indexed at, Google Scholar, Cross Ref

  8. D’Souza A, Fretham C. Current uses and outcomes of hematopoietic cell transplantation (HCT): CIBMTR summary slides, 2018. Center for International Blood and Marrow Transplant Research (CIBMTR). http://www. cibmtr. org. Accessed. 2019 Aug 25;30:2019.

    9. Indexed at, Google Scholar, Cross Ref

  9. Horowitz MM, Gale RP, Sondel PM,. Graft-versus-leukemia reactions after bone marrow transplantation.

    10. Indexed at, Google Scholar, Cross Ref

  10. Socié G, Ritz J. Current issues in chronic graft-versus-host disease. Blood, The Journal of the American Society of Hematology. 2014;124(3):374-84.

    11. Indexed at, Google Scholar, Cross Ref

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