Normally a small fraction of the cellular components of stem cells float in the blood circulation. This peripheral stem cell pool can be enhanced by a course of daily injections of a growth factor.
Peripheral stem cell harvest is done usually on the 4th / 5th / 6th day. The patient will be made to lie down on a couch and a drip will be put into the vein of each arm and the procedure takes about 3 hours.
Blood will be collected from one arm, via the drip, into a machine called a centrifuge, which spins it to separate out the peripheral stem cells.
These are collected and the remaining blood is returned through the drip in the other arm. The Peripheral stem cells can even be frozen until the patient has had the high-dose treatment.
About a week or two before the bone marrow harvest is done, the patient (or the donor, for an Allogeneic transplantation) may have 1 to 2 units of blood taken. This will be given back during the bone marrow harvest.
The harvest itself is carried out under general anesthesia, so one will feel nothing. It involves the removal of some marrow from inside the bones at the back and front of the pelvis. (The hip bones).
The patient or donor will have to stay in the hospital overnight to recover fully from the general anesthesia. Usually, it feels sore for a few days and mild painkillers may be required. These will be administered by the nurses or doctors before the patient leaves the hospital.
On occasions when the patient does not have a good matched relative / unrelated donor, a partially matched, unrelated cord blood with adequate cell dose would be an option.
This is the blood that is left behind in the placenta and the umbilical cord after the delivery of a baby. Cord blood is rich in peripheral stem cells and can be used instead of bone marrow for transplantation.
A day or more after the intensive chemotherapy is completed; the patient will start to feel slightly better. The patient's own, or the donated bone marrow or peripheral stem cells or cord blood will then be given through the central line into a vein. They will find their way back via the bloodstream to the bones, where they will start to grow and develop into mature blood cells
It will be at least two or three weeks before some of the 'new' blood cells are released into the bloodstream, and it may be up to six weeks before one can leave the hospital.
Bone marrow is the tissue found inside bones where blood cells are developed and stored. The bone marrow cells that make other blood cells are called stem cells which are needed in a bone marrow transplant.
Patients suffering from the following diseases may benefit from BMT
Matching HLA class I & Il is done by blood tests or buccal swab alone. It is not necessary to test the donor's bone marrow at this stage.
It is usual to start by testing the brothers and sisters, as they are likely to provide the best match; parents are not usually good matches, but there is a 7% chance for the parent to match.
The donor should be in good health. He or she will be given a thorough medical checkup to make sure that there will be no risk to his or her own health from the procedure.
Generally, before the stem cell infusion, the treatment lasts 4 to 6 days in total and consists of high doses of chemotherapy & radiotherapy
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