BMT, a life-saver for blood cancer patients

The success rate varies widely depending on several factors, including the diagnosis, patient’s age, the disease status of the patient, general health of the patient prior to transplant and the type of transplant. Techniques and supportive care have improved in recent times and hence patients are generally living longer, disease-free. Bone marrow is the soft, spongy area in the centre of larger bones of the body. The marrow is defined as the factory which produces different types of cells which make up blood. The different types of cells are: red blood cells, which carry oxygen in blood and gives us energy; white blood cells are the immune system which fights infections and platelets form mechanical plug at sites of bleeding by clumping and stop active blood loss.

“All these cells develop from a single ‘mother’ cell in the bone marrow called “hematopoietic stem cell.” The stem cells divide and multiply and later capable of transforming into different type of blood cells. These stem cells are normally found in the bone marrow, however very small number is found in circulating blood and sometimes various techniques could be employed to increase the number of stem cells in blood prior to collection,” said Dr Ponni Sivaprakasam, Senior consultant Paediatric Haematology, Oncology, BMT, Gleneagles Global Health City.

Defective Bone Marrow: Where bone marrow does not produce effective cells, making blood cells non-functional or insufficient blood or with blood cells with reduced life span causing anaemias such as thalassemia, sickle cells anaemia and Bone Marrow Failure.

Defect in immunity: Certain conditions called immune deficiencies where the white cells produced by the bone marrow have an inherent problem causing low or no immunity and this could be life threatening. Blood Cancers: Certain blood cancers which cannot be cured by chemotherapy alone. “Treatment modalities for cancer would include chemotherapy and radiation that could be toxic to the bone marrow. Normal doses of chemotherapy will affect bone marrow function temporarily, say, for about 1-2 weeks when the blood counts drop. This would then be followed by the recovery period which allows the bone marrow to regenerate and produce blood. Certain types of aggressive or high grade cancers are treated with very high dose of chemotherapy. In this process, the bone marrow doesn’t recover following chemotherapy and hence needs to be replaced by patient’s own stored stem cells (previously removed as back-up and frozen in appropriate conditions),” added Dr Ponni.

Medicos say that the risks of life-threatening infections are high in this population, patients are catered for in isolation by experienced nurses and doctors until blood counts recover. The air circulation in the isolation room is exclusively done for this purpose, where the air is filtered (HEPA-filtered) and air from the cubicle is forced out when the door is opened called positive-pressure room.

“The immune system takes about a year to stabilise, thus there is a high risk of viral infections. The patients need to take all precautions and isolation may be recommended. Even the food consumption has to be very carefully monitored and even dietary changes might need to be made,” said consultant oncologist Dr Anitha Ramesh.