Bone Marrow Transplant (BMT)

Understanding Bone Marrow Transplant (BMT)

Blood-forming cells (blood stem cells) are immature cells that grow into red blood cells, white blood cells and platelets. They are found inside bones, called bone marrow. When mature, the cells leave the marrow and enter the bloodstream.

When disease affects bone marrow so that it cannot function properly, a marrow or cord blood transplant may be the best treatment option. For some patients, this may offer the only potential cure. A bone marrow transplant (BMT) replaces unhealthy blood-forming cells with healthy ones. A BMT can treat more than 70 diseases including: blood cancers like leukemia or lymphoma, bone marrow diseases like aplastic anemia, and other immune system or genetic diseases like severe combined immunodeficiency (SCID), Wiskott-Aldrich syndrome (WAS), and sickle cell disease. Another name for BMT is hematopoietic cell transplant (HCT) and stem cell transplant (SCT).

BMT is not surgery. Before transplant, chemotherapy and sometimes radiation are used to destroy the diseased cells and marrow. Then, the healthy cells are given. The new cells are administered intravenously into the bloodstream and find their way into the marrow. Recovery from BMT can take months or years.

Types of Bone Marrow Transplant (BMT)

There are 2 main types of transplants, autologous and allogeneic. An autologous transplant uses the patient’s own blood-forming cells. An allogeneic transplant uses blood-forming cells donated by someone else. The cells can come from a family member or an unrelated donor through a BMT registry.

Role of Immune Globulin Therapy

Immune globulins are found naturally in the body and help fight infection. When the marrow is “wiped out” from BMT, the patient’s immune globulins may decrease to a level where the patient develops frequent infections. Some patients may benefit from replacement immune globulins while the body recovers from BMT. Immune globulin is extracted from a large pool of human plasma and contains all the important antibodies present in the normal population. Immune globulin therapy can be administered into the blood stream intravenously (IVIG) or under the skin subcutaneously (SCIG).

References:

• Donate Marrow or Blood Stem Cells | Be The Match
• Antibodies: Definition, Types & Function (clevelandclinic.org)
• Wingard JR. Prevention of infections in hematopoietic cell transplant recipients.
  In UpToDate, Bow E (Ed), UpToDate, Waltham, MA. (Accessed on August 31, 2022)