Leukemia Treatment Bone Marrow Transplant

A bone marrow transplant is one possible treatment for leukemia. Diseased cells are destroyed and replaced with healthy bone marrow stem cells from the patient or a bone marrow donor.

Bone marrow is the spongy tissue found within the bones, which contains stem cells that develop into different types of blood cells.

Conditions treated with a bone marrow transplant include:

  • Acute lymphocytic leukemia
  • Acute myelogenous leukemia
  • Chronic myelogenous leukemia
  • Hodgkin’s disease
  • Inherited immune system disorders
  • Myelodysplastic syndromes
  • Non-Hodgkin’s lymphoma
  • Severe aplastic anemia.

Finding a Bone Marrow Donor

Two types of bone marrow donation exist:

  • Allogeneic: Marrow is donated by a bone marrow donor, often a sibling, whose marrow matches the patient’s.
  • Autologous: The patient’s own marrow is harvested when the disease is in remission, and frozen for later use.

An unrelated bone marrow donation may also be used, provided the bone marrow donor matches the patient’s human leukocyte antigen (HLA). HLA is a protein found on cells that helps the body recognize foreign bodies. For a bone marrow transplant to be successful, the donor’s HLA must match the recipient’s.

Bone Marrow Treatment for Leukemia

A bone marrow transplant is a surgical procedure, performed under anesthetic. The surgeon harvests bone marrow in much the same way a bone marrow biopsy is performed. A long syringe is inserted into the body (often the pelvis) and used to withdraw bone marrow.

After removal, the bone marrow is filtered to remove bone fragments and other tissue, leaving only the stem cells. While the typical bone marrow transplant is performed within a few hours of bone marrow donation, harvested stem cells may also be frozen for later use.

Bone Marrow Transplant: The Process

Before a bone marrow transplant, all diseased cells must be killed using chemotherapy or radiation. During this process, the patient may be prescribed prophylactic antibiotics. This is because the preparative treatment causes white blood cell counts to fall, impairing the immune system. Platelet transfusions may also be required to prevent bleeding problems.

During the actual bone marrow transplant, harvested stem cells are introduced into the blood cells, similar to a blood transfusion. The stem cells enter the bone marrow, where they begin to produce blood cells within three to four weeks (a process called engraftment). During this time, the patient may remain in the hospital or require regular checkups.

Complications of a Bone Marrow Transplant

A bone marrow transplant is a major undertaking that carries serious risks. Preparatory chemotherapy or radiation treatment for leukemia essentially shuts down the body’s immune system, leaving the patient at risk of life-threatening infections.

Once the bone marrow transplant is complete, the new white blood cells may mistake the patient’s body as a threat, and cause damage to the internal organs. This is referred to as graft-versus-host disease.

In spite of these risks, a bone marrow transplant is an important treatment for leukemia. Patients should discuss the risks and benefits of a bone marrow transplant with their doctors.

Resources

Health Resources and Services Administration. (2009). Understanding bone marrow transplantation as a treatment option. Retrieved March 26, 2010, from http://bloodcell.transplant.hrsa.gov/TRANSPLANT/Understanding_Tx/index.html.

Leukemia and Lymphoma Society. (n.d.). Blood and marrow stem cell transplantation. Retrieved March 26, 2010, from http://www.leukemia-lymphoma.org/attachments/National/br_1203086953.pdf.

National Cancer Institute. (n.d.). Bone marrow transplantation and peripheral blood stem cell transplantation. Retrieved March 26, 2010, from http://www.cancer.gov/cancertopics/factsheet/Therapy/bone-marrow-transplant.

National Heart Lung and Blood Institute. (2009). What is a bone and marrow stem cell transplant? Retrieved March 26, 2010, from http://www.nhlbi.nih.gov/health/dci/Diseases/bmsct/bmsct_whatis.html.

National Marrow Donor Program. (n.d.). Patient frequently asked questions. Retrieved March 26, 2010, from http://www.marrow.org/PATIENT/Support_Resources/Patient_Frequently_A/index.html.