A bone marrow transplant is a medical procedure in which a donor provides a special kind of blood, called hematopoietic stem cells, to a recipient. Bone marrow transplants are usually performed under anesthesia while the blood is taken from a large bone, usually the pelvis, in order to provide a large enough area to remove enough stem cells without compromising the surrounding bone marrow. Bone marrow recipients often require stem cells due to certain medical conditions in which their body is deficient in producing endogenous stem cells. These conditions may include blood-related cancers such as leukemia, lymphoma and multiple myeloma, severe types of anemia, immune system disorders, sickle cell disease and other conditions.
Desired Effects
Patients who receive bone marrow transplants have an increased rate of survival and recovery. The procedure is most often used in patients with blood-related cancers. According to the National Cancer Institute, bone marrow transplants make it possible for patients to receive very high doses of chemotherapy or radiation in order to treat tumors. Radiation and chemotherapy treat tumors by interrupting the growth of rapidly dividing cells. They also affect blood cells which fight infection, carry oxygen and prevent bleeding. A bone marrow transplant from a donor can help recipients to produce more white blood cells, red blood cells and platelets. The National Cancer Institute also states that close relatives, especially brothers and sisters, are the best match for bone marrow transplants because the stem cells are nearly identical and result in far less complications.
Side Effects
Recipients of bone marrow transplants may also experience several side effects. According to Cancer Help UK, the side effects occur at the highest rate just after the transplant and for the few weeks following it. Some of the side effects include an increased risk of infection, anemia, risk of bleeding, feeling sick and diarrhea, sore mouth, difficulty eating and drinking, feeling weak, infertility and graft-versus-host disease. Many of the side effects from a bone marrow transplant will go away once the body starts to produce more blood cells to fight infection and carry oxygen. Some conditions are more serious, such as infertility and graft-versus-host disease, a condition in which the donor's stem cells identify the host as a foreign body and attack the host. Doctors can prescribe immuno-suppressant drugs if this condition persists.
Sleep Disturbances
Patients who receive a bone marrow transplant may be affected negatively immediately before and after the procedure in terms of distress and quality of sleep. In the January 2009 issue of "Bone Marrow Transplantation," Dr. Jutta Rischer and associates found that the emotional preparation for a bone marrow transplant can cause significant sleep disturbances. Hospital settings also contributed to sleep disturbances prior to bone marrow transplants. Thirty-two percent of patients experienced sleep disturbances immediately before hospital admission, 77 percent during their time at the hospital, and 28 percent after being discharged. Family support and psychological pre-treatment may help reduce sleep disturbances associated with bone marrow transplants.
Considerations for the Donor
Most of the focus is aimed at the recipient of the bone marrow due to his fragile state of health, but there are issues that concern the donor as well. The weeks prior to surgery, donors should practice maximum health with proper nutrition and limited use of alcohol, tobacco, opiates or other substances that may potentially affect bone marrow health. The National Institutes of Health states that bone marrow donation rarely poses a health risk to the donor. The donor may feel sore at the site where the marrow was harvested, but recovery time should only last days or weeks.
Post-Transplant Nutrition
Recovery after a bone marrow transplant is a crucial time for the recipient. Proper nutrition can make a big difference during the recovery period. The Cleveland Clinic suggests that patients should take multi-vitamins and take in large amounts of calcium and phosphorous to help bones grow and strengthen. Patients should also take in electrolytes such as potassium and magnesium. These help maintain the fluid balance in patients. Patients should try to avoid alcohol for several weeks after receiving a bone marrow transplant.
References
- National Cancer Institute: Bone Marrow Transplantation and Peripheral Blood Stem Cell Transplantation
- Cancer Help UK: Side Effects of Bone Marrow and Stem Cell Transplants
- "Bone Marrow Transplantation"; Sleep Disturbances and Emotional Distress in the Acute Course of Hematopoietic Stem Cell Transplantation; Dr. Jutta Rischer et al; January 2009
- "Bone Marrow Transplantation"; Health-Related Quality of Life in Survivors of BMT for Paediatric Malignancy: a Systematic Review of the Literature; Dr. Sally Anne Clarke et al.; May 2008
- Cleveland Clinic: Nutrition after Bone Marrow Transplant
