Most people envision the transplant as a surgical procedure, but the process really involves infusing the patient with stem cells from a donor or from himself. The infused cells give rise to platelets, red blood cells, white blood cells--all the things needed to have healthy blood. This procedure gave oncologists a whole new tool to treat cancer. While in the past, treatment focused on killing cells, bone marrow transplants focus on growing healthy new ones.
History
Dr. Donnall Thomas of the Fred Hutchinson Cancer Institute of the University of Washington received the 1990 Nobel Prize for developing a treatment of cancer patients using bone marrow transplants. In his 1990 presentation speech, Professor Gösta Gahrton said that 10,000 lives had already been saved using this technique.
Procedure
Bone marrow transplants make the use of very high-dose chemotherapy regimens. Frequently, doctors are not able to give very high doses of chemo drugs because they destroy the cell-generating tissues in bone marrow. These high doses can be used if they immediately are followed by a bone marrow transplant. The bone marrow transplant includes the stem cells that give rise to white blood cells, red blood cells and platelets that were destroyed by the chemo. In this way, the entire blood-producing tissue is replaced.
Applications
According to the National Bone Marrow Donor Program, bone marrow transplants are used to treat various leukemias, non-Hodgkin's lymphomas, aplastic anemia, sickle cell anemia, inherited immune and metabolic disorders. It is also the treatment of last resort for many cancers.
Donations
In many instances, a bone marrow transplant requires a donor. In some instances, the patient can provide her own tissue. If the patient provides her own cells, it is called an autologous donation. Autologous donations require purging the collected sample of all unhealthy cells before reintroducing it into the body of the patient.
Stem Cells
Bone marrow tissue is used because it contains stem cells. Stem cells are pluripotent. This means that they can turn into almost any type of cell. For this reason, bone marrow transplants are also called stem cell transplants. The nomenclature is not always clear, because whereas a bone marrow transplant involves stem cells taken from bone marrow, a stem cell transplant can involve stem cells from many different sources, including umbilical cord blood.
