About Bone Marrow Transplants
A bone marrow transplant generally involves the grafting of blood stem cells from a donor and administering them to a recipient with the purpose of generating new cell growth.
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History
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The first (identical twin donor) human bone marrow transplant was performed by Dr. Edward Donnall Thomas, Nobel Prize Laureate of Medicine and Physiology, at the Fred Hutchinson Research Center in 1958. The recipient was a 3-year-old child who had been diagnosed with leukemia, end-stage. Although the procedure did prove to be successful, the child's disease came out of remission within six months.
The first successful bone marrow transplant where the donor was a non-twin sibling, took place in 1968. Then the first bone marrow transplant to occur in which the recipient and donor were completely unrelated was performed in 1973.
Function
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Bone marrow is the spongy tissue found within the inner core of the bones. This tissue contains undifferentiated (immature) stem cells termed as "hematopoietic." These hematopoietic cells develop into red blood cells, white blood cells and platelets.
Found to be most plentiful within the hip bones, bone marrow is typically grafted from the donor and aspirations are taken from the iliac crest area to detect diseases of the blood like anemia, leukemia and myeloma. However, hematopoietic cells can also be found in the blood stream as well as in the umbilical cord. They, too, can be used in bone marrow transplants.
Becoming necessary when a life-threatening illness is present, a bone marrow transplant makes it possible for the body to make blood cells again. The blood cells are necessary to prevent hemorrhage, for the transport of oxygen and immunity. In the instances of cancer, high doses of chemotherapy and radiation treatments completely destroy the bone marrow. Unless the patient receives new bone marrow cells, they will most likely die.
Best performed when the cancer is determined to be in remission, a bone marrow transplant is first done by harvesting marrow from a donor that has been effectively HLA-matched. After processing, the bone marrow can be administered via IV to the recipient. Once in the blood stream, stem cells move inside the bones to generate blood cell reproduction.
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Types
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There are three specific kinds of bone marrow transplants performed:
Autologous Transplantation--the donor is also the recipient. He has previously stored his own bone marrow for later use.
Syngeneic Transplantation--the recipient is an identical twin of the donor.
Allogeneic Transplantation--the bone marrow is donated by someone other than the recipient or his identical twin. Typically, it is a sibling or parent. This would include those who are unrelated.
Considerations
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A complication that can occur as early as a few weeks of transplantation, graft versus host disease(GVHD) develops when the recipient's immunity defenses attack, or reject, new bone marrow cells. Of course, this condition is only possible with allogeneic transplants. To prevent this, the recipient is given immunosuppressant drugs prior to the procedure.
Other possible complications might include: systemic infection, and bleeding.
Time Frame
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It takes about two to four weeks for the transplantation of bone marrow to generate new blood cell growth. Depending upon the type of transplant performed, it can take anywhere from a few months to a couple of years for the recipient to fully recover.
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