Stem Cell Transplant from the Bone Marrow and Cord Blood

  • A bone marrow transplant is the replacement of the abnormal/cancerous red bone marrow with a healthy red bone marrow to carry out haematopoiesis.
  • The red bone marrow to be transplanted is usually obtained from the iliac crest of the hip bone under a general anaesthesia with a syringe and is injected into the recipient’s vein-just like it is done in a blood transfusion.
  • The injected bone marrow migrates to the recipient’s bone marrow cavities where the donor’s stem cells divide and multiply, and in case of no rejection, the recipients red bone marrow is entirely replaced by the healthy donor’s red bone marrow that do not produce cancerous/abnormal stem cells.
  • Before a bone marrow transplant in patients with cancer or certain genetic conditions, the defective red bone marrow is destroyed by high doses of chemotherapy and whole-body radiation.

These treatments kill the cancer cells and destroy the patient’s immune cells in order to decrease the chances of transplant rejection. This however is disadvantageous because;

  • The patient’s white blood cells have been completely destroyed by chemotherapy and radiation; thus, the patient is susceptible to infection.
  • The transplanted red bone marrow may produce T-cells that attack the recipient’s tissues, a reaction called graft-versus-host disease.  In addition, the recipient T cells that survived the chemotherapy and radiotherapy can attack the donors transplant cells.
  • The patient must take immunosuppressive drugs for their entire lifetime. These immunosuppressive drugs reduce the immunity; thus, one is prone to infection. In addition, they have several side effects, i.e. fever, muscle aches, headaches, nausea, fatigue, depression, high blood pressure, kidney and liver damage.
  • It takes about 14-21 days for a transplanted bone marrow to produce enough white blood cells to protect against infection.
  • Healthy red bone marrow for transplant may be supplied by a donor or a patient when the underlying disease is inactive.
  • Bone marrow transplants have been used to treat aplastic anaemia, certain types of leukaemia, severe combined immunodeficiency disease [SCID], Hodgkin’s disease, non-Hodgkin’s lymphoma, multiple myeloma, thalassemia, sickle cell disease, breast cancer, testicular cancer and haemolytic anaemia.
  • A modern/recent way/procedure of obtaining stem cells involves a cord-blood transplant.
  • The placenta contains stem cells that may be obtained shortly after birth from the umbilical cord that connects the foetus to the placenta. These stem cells are removed using a syringe and are then frozen and later used for transplant.
  • These stem cells have several merits compared to those from the red bone marrow in that;
  • They are less likely to cause the graft-versus-host disease, thusthematchbetween the donor and the recipient need not to be close for purposes of rejection
  • They are easily stored in blood cord banks.
  • They are less likely to transmit infection.
  • They are numerous compared to stem cells in the red bone marrow.
  • They are easily collected following the permissions of the new born relatives.

Written by Alphonse Oyugi


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