Bone Marrow Transplant (BMT)

Bone Marrow Transplant (BMT)

Bone marrow transplant (BMT) is the procedure that is used to replace the unhealthy bone marrow with new healthy bone marrow. Bone marrow is the soft fatty tissue inside the bones that is responsible for the production of blood cells. There are several medical conditions to which the bone marrow become dysfunctional and therefore needs to be replaced. Further there are multiple types of Bone marrow transplants based on the donor of the bone marrow or stem cells.

Haploidentical (Half-Matched) Transplant

. T-Cell Depletion is mandating in haploidentical transplant.

. T-Cell Depletion can be done in two ways. INVIVO (T cell depleted by using high dose of chemotherapy inside the body) or INVITRO T cell depletion (T cell depletion by using a machine outside the body). Both these modalities have their advantages and disadvantages. Choice depends on a number of patient and donor related factors.

Allogenic bone marrow transplant (BMT) is typically recommended to treat certain medical conditions where the bone marrow is dysfunctional.

. Cancers like leukaemia, Myelo-dysplasia etc.

. Disease that affect the production of bone marrow cells like

. Aplastic anaemia (acquired or inherited)

. Other marrow failure states (ex. Congenital neutropenia, amega karyocytic thrombocyto-penia etc)

. Severe immunodeficiency syndrome's

. Sickle cell anaemia

. Thalassemia major

To look for options for allogenic bone marrow transplant HLA typing of patient and sibling should be performed.

If there is any sibling they should be tested for HLA typing. HLA typing of parents can be done as some time we are getting full match with parents. In case of non-availability of familial donor unrelated matched donor may be considered.

Most Important Pre-requisite: Stem cell donor (It could be HLA matched sibling/ Parents: HLA typing of patient and sibling/ Parents is needed to identify suitable donor).

Autologous Bone Marrow Transplant ( High dose chemotherapy + autologous stem cell rescue) is recommended to treat where we need to give high dose of chemotherapy to treat underlying disease following which autologous harvested bone marrow is given as rescue. The Indication includes:

.Cancers Like :

. Neuroblastoma

. Medulloblastoma

. Wilm's Tumor

. Lymphoma's

. Multiple Myeloma etc.

. It can also be used to treat various autoimmune diseases the commonest indication being multiple sclerosis.

An autologous bone marrow transplant uses healthy blood stem cells from your own body to replace your diseased or damaged bone marrow.

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