Acute leukemia, a type of cancer that affects bone marrow, causes immature white blood cells called blast cells to proliferate and crowd out other blood cells. An estimated 42,000 new cases of leukemia will be diagnosed in the United States in 2010, the National Cancer Institute states. Acute leukemia differs from chronic leukemia, which grows slowly and generally doesn’t require the same intense treatment as acute leukemia. Bone marrow transplant, one form of treatment, can cure leukemia but also has significant risks.
Purpose
The purpose of bone marrow transplantation in leukemia is to kill the cells that are producing too rapidly and crowding out normal cells and replace them with bone marrow that will produce normal blood cells.
Types
A bone marrow transplant involves taking bone marrow from large bones of a donor, which is known an allogeneic transplant, or from the patient himself, which is called an autologous transplant. In most cases, leukemia patients receive allogeneic bone marrow because the person’s own bone marrow contains cancerous cells and using it might return some abnormal cells that can cause a relapse. Most of the time, allogeneic bone marrow donated by a relative or unrelated donor is used to treat leukemia. If the patient has siblings, there’s a 35 percent chance that they will match closely enough, Columbia Presbyterian Medical Center states.
Autologous transplant can be done if a patient with acute leukemia is in remission, meaning that most of the abnormal cells have been destroyed, according to the National Marrow Donor Program “Be the Match.”
Procedures
Chemotherapy is used first to destroy abnormally-dividing blast cells in people with leukemia. Several days later, bone marrow removed from the hip bone of a healthy donor is infused into the patient’s blood stream. From the bloodstream, the cells migrate to the bone marrow, producing healthy cells after a period of two to four weeks.
Side Effects
During the bone marrow transplant, a person will feel like she has a bad case of the flu, with fever, chills, body aches and chest pain. These symptoms, along with diarrhea and vomiting, can continue for several weeks after the transplant, Columbia Presbyterian Medical Center explains.
Complications
Chemotherapy is used to destroy abnormal blood cells, but it also kills any normal white blood cells still present. This leaves the patient vulnerable to infection, because white blood cells are essential for immune system functioning. Until the new bone marrow begins to function and create new blood cells, the patient is at high risk for infection. Large doses of antibiotics help fight off infections and isolation techniques keep patients from exposure to bacteria and viruses.
Rejection of allogeneic bone marrow can occur after bone marrow transplant, which is a potentially life-threatening complication. Graft versus host disease, or GVHD, can also develop after transplant, with the donated tissue attacking the patient’s organs, the University of Maryland Medical Center reports.
