All You Need to Know about Autologous Bone Marrow Transplant

Battling a disease like cancer can take a big toll on your health. Your doctor may have advised you to go for an “autologous bone marrow transplant”. But, the process may seem complicated,  to say the least. Here, we have simplified the procedure so that you can decide if it is actually the right option for you.

What is an Autologous Bone Marrow Transplant?

An autologous bone marrow transplant involves taking healthy stem cells from your body and transplanting them to replace the damaged or diseased bone marrow.  These stem cells could come from two sources:

• Bone marrow stem cells: In this, a procedure known as bone marrow harvesting is used to collect stem cells from your bone marrow. The procedure is carried out while you are asleep in the operating room (general anesthesia). The different sites from where the bone marrow can be collected include the breastbone and the front and back of your hips. The procedure usually takes about 60 to 90 minutes. This procedure lasts for about 60-90 minutes. Most people are discharged on the same day of the process.
• Peripheral blood stem cells:  These cells are obtained from your bloodstream through a procedure called apheresis. Since the number of stem cells in the blood is low, you will receive injections before the procedure. These shots contain medicine that leads to increased production of stem cells which then travel from the bone marrow to the bloodstream.  These stem cells are then collected for the transplant when you are awake.

Preparing for Your Autologous Bone Marrow Transplant

To be well-prepared for the transplant, you can follow the given steps:

• Learn as much as possible about the transplant by discussing it with your doctor and other members of the transplant team.
• Get your finances in order and contact your insurance company
• Get your pre-transplant tests done. These are a series of medical tests such as blood tests, X-rays, EKGs, CT scans, and many more. The healthcare team uses these test results to decide if you are physically and mentally fit for the transplant.
• Explain the transplant process to your family and friends. Identify a person who can act as your caregiver.
• If fertility is a concern for you, discuss the effect of the treatment on your fertility in detail.

How is an Autologous Bone Marrow Transplant Performed?

A tunneled catheter will be placed into a large vein in the upper chest after you have been admitted to the hospital. This allows the transplant team to draw out blood, provide electrolytes, fluids, and medicines and also infuse stem cells.

Your autologous transplant will be carried out in the following phases:

• In the first phase, you will receive a treatment called conditioning. This involves giving chemotherapy to kill the cancer cells or to suppress your immune system. Since conditioning affects normal cells as well, you can experience symptoms like fatigue, hair loss, nausea, mouth sores, vomiting, low blood cell counts, and even infertility. It also affects immune function. Hence, your doctor may give you prophylactic medications to lower your chance of infections.
• After this, you will receive stem cells via the catheter. These stem cells will travel to the bone marrow where they will make new healthy blood cells. This is known as engraftment.
• Engraftment takes time,  usually up to 10-14 days. Thus, the period between the transplant and engraftment is marked by a significant drop in your blood counts. The immune system is compromised putting you at a very high risk of infections. You will have to be very careful with your diet and hygiene during this phase.

As engraftment begins, there will be an increase in your red blood cells (RBCs), platelets, and white blood cell counts (WBCs). Platelets and RBCs are recovered before the platelets. You may also experience symptoms like rash, fever, and bone pain. However, these can be managed.

Once your transplant team believes your symptoms are under control or completely gone, you will be discharged from the hospital.

After the discharge, the recovery period can last for a year or more. During this phase, it is vital to take medications regularly to avoid infections as the immune system is still returning to normalcy.

Benefits VS Risks

Some of the advantages of going for an autologous transplant are:

• Stem cells are readily available as these can be harvested from your body
• Since there is no need for a donor, the possibility of graft rejection is also eliminated
• You are also not at risk for GVHD(graft versus host disease). Thus, you don’t need to take immunosuppressive drugs.

Though it offers promising benefits, it also has potential risks:

• The stem cells obtained for the transplant may be contaminated with tumor cells. These when put back into the body can lead to increased chances of relapse.
• After an autologous transplant, the immune system remains the same as before. If the immune system could not fight the disease before, likely, it may not be able to do so after the transplant.

Avail Bone Marrow Transplant Across the World

Conclusion

Undergoing an autologous bone marrow transplant is never an easy decision to make. But, by being aware of the process, its benefits, and risks, you can accurately judge if you would like to pursue it as a treatment. You should ask your doctor as many questions as possible to ensure you are comfortable. An informed decision will give you the peaceful mind necessary for a positive outcome.

Reference Links:

• https://www.mayoclinic.org/tests-procedures/autologous-stem-cell-transplant/pyc-20384859
• https://www.cancer.net/navigating-cancer-care/how-cancer-treated/bone-marrowstem-cell-transplantation/what-bone-marrow-transplant-stem-cell-transplant