Bone marrow transplantation (BMT) or hematopoietic stem cell transplantation (HSCT) is a medical procedure in the field of hematology and oncology that involves transplantation of hematopoietic stem cells (HSC). It is most often performed for people with diseases of the blood or bone marrow, or certain types of cancer. Bone marrow transplantation was pioneered in the 1970's by E. Donnall Thomas whose work was later recognized with a Nobel Prize in Physiology and Medicine. Dr. Thomas' work showed that bone marrow cells infused intravenously could repopulate the bone marrow and produce new blood cells. His work also reduced the likelihood of developing a life-threatening complication called Graft-versus-host disease (GVHD). However it remains a risky procedure and it is reserved for patients with life threatening diseases.

Principles

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Most recipients of HSCTs are leukemia patients or others who would benefit from treatment with high doses of chemotherapy or Total body irradiation (TBI). Other patients who receive bone marrow transplants include pediatric cases where the patient has an inborn defect such as severe combined immunodeficiency or congenital neutropenia and was born with defective stem cells. Children or adults with aplastic anemia have lost their stem cells after birth and may not require such high doses of chemotherapy and irradiation prior to a transplant. In this case there is a greater need for immunosuppressive agents. Other conditions that bone marrow transplants are considered for include thalassemia major, sickle-cell disease, myelodysplastic syndrome, lymphoma, and multiple myeloma. More recently non-myeloablative, or so-called "mini transplant" procedures have been developed which do not require such large doses of chemotherapy and radiation. This has allowed HSCT to be conducted in older patients and without the need for hospitalization.

Stem cell collection

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Types of donors

There are two major types of bone marrow transplantation. Autologous bone marrow transplantation involves isolation of HSC from a patient, storage of the stem cells in a freezer, medical treatment of the patient that destroys stem cells remaining in the body, and return of the patient's own stored stem cells to their body. Autologous transplants have the advantage of a lower risk of graft rejection, infection and GVHD. Allogeneic bone marrow transplantation involves two people, one is the (normal) donor and one is the (patient) recipient. Allogeneic HSC donors must have a tissue (HLA) type that matches the recipient and, in addition, the recipient requires immunosuppressive medications. Allogeneic transplant donors may be related (usually a sibling) or unrelated volunteers.

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I still have at least one more chemo if not four, plus a bone marrow transplant despite the remission.
derylykt (Brett Fauver) Wed, 04 Nov 2009 16:34:09 -0000
I still have at least one more chemo if not four, plus a bone marrow transplant despite the remission.
Wellington toddler with Leukemia dies after contracting H1N1 in hospital. Doctors had finally found a bone marrow transplant match for her.
Fox29WFLX (Fox29WFLX) Wed, 04 Nov 2009 16:31:09 -0000
Wellington toddler with Leukemia dies after contracting H1N1 in hospital. Doctors had finally found a bone marrow transplant match for her.
Friend is raising money for bone marrow transplant. visit http://tiny.cc/eljDR to help. Please RT (Thanks @AliyahJennings & @AN for the RT)
TJC_Buell (T.J. Claridge) Wed, 04 Nov 2009 15:42:59 -0000
Friend is raising money for bone marrow transplant. visit http://tiny.cc/eljDR to help. Please RT (Thanks @AliyahJennings & @AN for the RT)
With names like ambulatory infusion room and bone marrow transplant unit, why would anyone like hospitals? Ouchie.
coffeeatyosi (lily agito) Wed, 04 Nov 2009 15:24:17 -0000
With names like ambulatory infusion room and bone marrow transplant unit, why would anyone like hospitals? Ouchie.
Still waiting to hear from the Bone Marrow Transplant Team. If I don't hear anything by noon, I'll try calling them.
kfs21 (Katie Flower-Smith) Wed, 04 Nov 2009 15:19:57 -0000
Still waiting to hear from the Bone Marrow Transplant Team. If I don't hear anything by noon, I'll try calling them.
Eight (8) sleeps until my wife goes into hospital for her bone marrow transplant. Our 3yo can't see his mom for weeks http://bit.ly/1sI2N9
jeffsmyth (Jeff Smyth) Wed, 04 Nov 2009 12:28:41 -0000
Eight (8) sleeps until my wife goes into hospital for her bone marrow transplant. Our 3yo can't see his mom for weeks http://bit.ly/1sI2N9

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