Bone marrow is the soft, fatty center of some bones in the body. It contains stem cells that become various blood and immune cells, including red blood cells, white blood cells, and platelets. Each of these cells have specific functions in your body, such as carrying oxygen and helping fight off infections.
Some health conditions like leukemia affect how the bone marrow makes the cells your body needs. When this happens, a bone marrow transplant may be a helpful treatment option for some people with leukemia.
The bone marrow may stop making healthy blood cells when it’s damaged by some types of leukemia. This can also happen as a side effect of treatments such as high doses of chemotherapy or radiation therapy.
Bone marrow failure occurs when your bone marrow cannot make enough healthy blood cells to meet your body’s needs. Bone marrow failure can lead to:
- life threatening infections
- excess bleeding
- other problems caused by low blood cell counts
If you experience bone marrow failure, your doctor may recommend a bone marrow transplant to treat leukemia.
In a bone marrow transplant, healthy stem cells from bone marrow are infused into your body. A transplant can help replace damaged bone marrow cells and, in turn, make healthy blood cells. In some cases, a bone marrow transplant may even help get rid of harmful leukemia cells.
The goal of a bone marrow transplant in treating leukemia is complete remission. This means there are no clinical signs of this disease after therapy.
There are two main types of bone marrow transplants for leukemia:
- Autologous transplant. This type of transplant uses bone marrow cells from your own body.
- Allogeneic transplant. This procedure uses bone marrow cells from a matched donor.
While a bone marrow transplant does not require surgery, it’s a complicated procedure with multiple parts. If you have a bone marrow transplant to treat leukemia, you may go through the following steps:
- Pretransplant testing. Before a bone marrow transplant, you will need a complete physical exam. Your doctor (usually a hematologist or oncologist) will order tests to check your blood and see how well your heart, lungs, liver, and other organs are functioning.
- Conditioning. To get your body ready for the transplant, you may have high doses of chemotherapy to kill the leukemia cells and the healthy stem cells in your bone marrow. This process is called conditioning. It makes space in your bone marrow for the donor stem cells and also suppresses the immune system, so your body will accept donor bone marrow cells.
- Infusion. Next, you will receive an infusion or injection of healthy stem cells.
- Recovery. It often takes
several months to yearsto recover after a bone marrow transplant for leukemia, according to a review of studies from 2017. You will need plenty of rest at home and possibly physical therapy to get regain your strength.
Bone marrow transplants can be used to treat several kinds of leukemia. These include:
- acute lymphocytic leukemia (ALL)
- acute myeloid leukemia (AML)
- chronic myeloid leukemia (CML)
- myelodysplastic syndromes (MDS), a pre-leukemia condition that can lower certain blood cell counts
A bone marrow transplant is particularly effective in treating AML in people who have not had this kind of leukemia before.
Survival rates are also higher in people with any kind of leukemia who receive related matched bone marrow donors, rather than with unrelated matched donors. A related matched donor is a closely related, biological relative.
Having a bone marrow transplant can be challenging, even though it doesn’t require surgery. You may have a range of emotional symptoms, such as:
Side effects and risks may also include:
- upset stomach (nausea, vomiting, or diarrhea)
- loss of appetite
- hair loss
- breathing problems
- premature menopause
- fertility issues
- general weakness
- unusual bleeding
- transplant failure
People who have a bone marrow transplant also have a
Graft-vs-host disease is a very serious side effect in which transplanted bone marrow cells attack the body’s own healthy cells. Signs and symptoms of this include:
- rashes or blisters
- liver damage, which can appear as:
- blood in the stool
- dark urine
- Sjögren’s disease, which happens in
10 to 40 percentof people
- joint pain
- mouth sores
- sexual problems, such as painful sex
Factors that may affect your chances of experiencing adverse effects after a bone marrow transplant include:
- overall health
- the stage of your leukemia
Palliative care to manage side effects and improve your quality of life is an important part of treatment. Let your doctor know about any symptoms or side effects you experience after a bone marrow transplant.
How well a bone marrow works to treat leukemia depends on a number of factors, such as:
- type of transplant (autologous or allogeneic)
- whether donor cells are from someone related to you like a sibling or someone who is not a relative
- severity and stage of leukemia
- your age and overall health
- how well your body tolerates certain procedures or treatments
- any complications or other health conditions that occur
In general, autologous bone marrow transplants are easier for the body to accept than allogeneic transplants. This significantly lowers the risk of some complications. The drawback of autologous transplants is that despite treating the stem cells in a lab, some leukemia cells may return.
After a bone marrow transplant, you may need a series of blood tests to check your blood cell counts to see if they have returned to a normal range.
Once the leukemia is under control, the bone marrow transplant is considered successful. However, in some cases, leukemia can happen again, even after a bone marrow transplant. This is known as a relapse.
Life expectancy, survival rates, and quality of life after a bone marrow transplant have vastly improved due to:
- improvements in accurate donor matching
- antibiotic treatment to control infections after a transplant
- better posttransplant care
A bone marrow transplant is a specialized procedure in which healthy stem cells are infused into the blood. The healthy stem cells then move into the bone marrow and replace unhealthy stem cells. This type of transplant is typically used to treat blood cancers called leukemia.
A bone marrow transplant can be a difficult experience and lead to a number of side effects that can have both short- and long-term effects. However, it is also a very successful leukemia treatment option for many people.