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A Guide To Bone Marrow Transplantation

If you have been diagnosed with multiple myeloma or a related plasma cell disorder and are considering a bone marrow transplant at Winship's Bone Marrow and Stem Cell Transplant Center, call us at (404) 778-0519 to request an appointment.

A Guide to Bone Marrow Transplantation

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This program provides corporations access to the most current and comprehensive data on blood and bone marrow transplantation and an opportunity to participate in CIBMTR annual meetings. The annual memberships provide support for CIBMTR research, which has helped to make tremendous advances in the outcomes of transplantation.

Our Bone Marrow Transplant Program has revolutionized the care of patients requiring blood or marrow transplants through many novel advancements including mismatched transplants and outpatient care of bone marrow transplantation.

Our center is a National Cancer Institute-designated Comprehensive Cancer Center that is fully accredited by the National Marrow Donor Program. Learn what makes our program a national referral center for bone marrow transplantation:

Researchers continue to make advancements in bone marrow transplantation through the use of bench to bedside human clinical trials such those that developed half-matched or haploidentical transplantation.

Our clinic provides telemedicine services for patients undergoing bone marrow transplantation and transplant recipients. Virtual visits can help you manage your condition with more ease and flexibility without having to leave your home when appropriate.

A bone marrow transplant 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. A bone marrow transplant is also called a stem cell transplant.

Bone marrow is the spongy tissue inside some bones. Its job is to produce blood cells. If your bone marrow isn't functioning properly because of cancer or another disease, you may receive a stem cell transplant.

A bone marrow transplant can pose numerous risks. Some people experience minimal problems with a bone marrow transplant, while others can have serious complications that require treatment or hospitalization. Sometimes complications are life-threatening.

Your health care provider can explain your risk of complications from a bone marrow transplant. Together you can weigh the risks and benefits to decide whether a bone marrow transplant is right for you.

GVHD may happen at any time after your transplant. Many people who have an allogeneic transplant get GVHD at some point. The risk of GVHD is greater if the stem cells come from an unrelated donor. But GVHD can happen to anyone who gets a bone marrow transplant from a donor.

Another type of allogeneic transplant uses stem cells from the blood of umbilical cords (cord blood transplant). Mothers can choose to donate umbilical cords after their babies' births. The blood from these cords is frozen and stored in a cord blood bank until needed for a bone marrow transplant.

Reduced-intensity conditioning kills some cancer cells and suppresses your immune system. Then, the donor's cells are infused into your body. Donor cells replace cells in your bone marrow over time. Immune factors in the donor cells may then fight your cancer cells.

When the new stem cells enter your body, they travel through your blood to your bone marrow. In time, they multiply and begin to make new, healthy blood cells. This is called engraftment. It usually takes several weeks before the number of blood cells in your body starts to return to the standard range. In some people, it may take longer.

After your bone marrow transplant, you'll remain under close medical care. If you're experiencing infections or other complications, you may need to stay in the hospital for several days or longer. Depending on the type of transplant and the risk of complications, you'll need to remain near the hospital for several weeks to months to allow close monitoring.

If your bone marrow transplant is using stem cells from a donor (allogeneic transplant), you may take medications to help prevent graft-versus-host disease (GVHD) and reduce your immune system's reaction. These drugs are called immunosuppressive medications.

After your bone marrow transplant, you may need to adjust your diet to stay healthy and to prevent excessive weight gain. Your nutrition specialist (dietitian) and other members of your transplant team will work with you to create a healthy-eating plan that meets your needs and complements your lifestyle. Your dietitian can also give you food suggestions to control side effects of chemotherapy and radiation, such as nausea.

After your bone marrow transplant, regular physical activity helps you control your weight, strengthen your bones, increase your endurance, strengthen your muscles and keep your heart healthy. As you recover, you can slowly increase your physical activity.

A bone marrow transplant can cure some diseases and put others into remission. Goals of a bone marrow transplant depend on your condition but usually include controlling or curing your disease, extending your life, and improving your quality of life.

Some people have few side effects and complications from a bone marrow transplant. Others may experience short- and long-term side effects and complications. It can be difficult to predict the severity of side effects and the success of the transplant.

Before your high dose chemotherapy, your team collects your stem cells or bone marrow. Or they collect a donor's stem cells or bone marrow. After the treatment you have the cells into a vein through a drip. The cells find their way back to your bone marrow. Then you can make the blood cells you need again.

You might have a course of high dose BEAM or LEAM chemotherapy. Then most people with Hodgkin lymphoma have their own stem cells or bone marrow back after the high dose treatment. This is called an autologous transplant.

You lie on your side on a couch. Your doctor puts a needle through your skin into the hip bone (pelvis). The doctor gently draws out the bone marrow through the needle into a syringe. To get enough bone marrow the doctor needs to put the needle into several parts of the pelvis. You have about 2 pints (1 litre) of bone marrow taken out and then it's frozen until it's needed.

A bone marrow transplant is a procedure used to treat certain types of cancer and some other diseases. Before the bone marrow transplant takes place, a person's bone marrow cells are destroyed with radiation or chemotherapy.

The cells that normally live in the bone marrow and that are responsible for making blood cells are then replaced. Bone marrow cells are blood cells that are located in the spongy center of bones. These include:

Cells to replace your original cells can be taken from your blood or bone marrow before the procedure starts. Bone marrow cells also can be taken from a different person (a donor) whose cells are a good match for the person receiving the transplant (the recipient). A good match means certain chemical markers on the cells of both donor and recipient are as close as possible and thus minimizes the possibility that the cells will be rejected by your body.

Bone marrow transplants are used most commonly to treat leukemias, lymphomas, Hodgkin's disease, and multiple myeloma. Bone marrow transplantation is particularly helpful, since these diseases affect the bone marrow directly.

Bone marrow transplants also can be used to treat noncancerous conditions, including aplastic anemia, congenital deficiencies of the immune system and thalassemia major. In these conditions, a new bone marrow and new bone marrow cells are needed because the diseased bone marrow is not able to produce necessary cells that may be helpful in fighting the disease to be treated.

The next step in a bone marrow transplant is to determine where the replacement cells will come from. There are two options. The cells can be taken from the person having the transplant before the main procedures. This is called an autologous transplant. The other option is for the cells to come from a donor. This is called an allogeneic transplant.

If a donor's cells will be used, a donor has to be found whose cells match the patient's cells as closely as possible. It is best if the donor is a close relative because there is a better chance that the cells will match and thus minimize the likelihood of being "rejected." If this is not possible, matching donors sometimes can be found through a bone marrow registry, such as the National Marrow Donor Program in the United States.

A plastic tube called a catheter will be placed into a large vein in your chest with one end sticking through the skin. This will be used to take blood samples and to insert the new cells. Next, you will have the main chemotherapy and radiation as your doctor prescribed. These treatments are designed to treat the underlying condition, but they also cause destruction of the bone marrow cells.

You also may have tests of your bone marrow to see how well the new cells are growing. This test is called a biopsy. A small sample of your bone marrow is removed through a needle and is examined under a microscope. You also will have tests to see whether any cancer remains.

In fact, in some protocols under investigation, donor bone marrow cells are transplanted into recipients who have not had their own bone marrow eliminated. These so-called "mini-transplants" theoretically work well because of the graft-versus-tumor effect. These types of transplants are being investigated mainly for use in situations in which a full transplant may not be possible or where other options are limited.

If you have had a bone marrow transplant, you will be monitored closely for possible complications, and your doctor will tell you what danger signs to watch for. Bone marrow transplant programs are highly specialized and need to be conducted in specially equipped and staffed facilities to minimize the likelihood of complications.

Soon after chemotherapy has begun, the patient will enter an apparent disease-free state termed clinical remission (CR), where the lymph nodes are normal, and no disease can be clinically detected. This is deceptive, since, in nearly all cases, surviving mdr lymphoma cells still exist, hidden in the bone marrow or blood; eventually, these will grow, remission will fail, and the prognosis is nearly uniformly fatal within 1-2 years. A similar progression exists for people, with a slightly longer time-line of 3-5 years. 041b061a72


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