Choose the content to read

• What is a stem cell?
• What diseases can be treated by a bone marrow transplant?
• What is the bone marrow transplant procedure?
• What are the advantages of bone marrow transplant?
• Bone Marrow Transplant at MedPark Hospital
• Bone Marrow Transplant Program

Bone Marrow Transplant (Stem Cell Transplant)

Bone marrow transplant, or stem cell transplant, is a medical procedure involving transfusing healthy blood-forming stem cells into the body to replace unhealthy bone marrow cells incapable of producing healthy or sufficient blood cells. Bone marrow transplant or stem cell transplant treats hematologic diseases, rare diseases, or certain cancers, including leukemia, lymphoma, multiple myeloma, amyloidosis, aplastic anemia, or inherited blood disorders in the blood system, including thalassemia or autoimmune diseases, enabling patients to live a healthier life and a chance of living a long life.

What is bone marrow?

Bone marrow is a porous, sponge-like tissue found in the central cavity of the bones (particularly the hip bone, thigh bone, sternum, or spine). Bone marrow contains blood cells forming stem cells, which develop into progenitor cells for various lineages of blood cells, including red blood cells, white blood cells, and platelets. Stem cells can also be found in the circulating peripheral blood and the umbilical cord blood, which are important sources of bone marrow transplantation. Doctors prefer using stem cells to replace damaged bone marrow cells due to fatal diseases, enabling the reconstituted bone marrow to perform its physiologic functions and create healthy new blood cells.

What is a stem cell?

Stem cells are unique cells produced by the body during the early stages of fetal development. They are precursor cells or pluripotent cells without specific functions, capable of self-renewal and differentiation into various matured cell types, such as skin cells, brain cells, muscle cells, heart muscle cells, and blood cells, including red blood cells, white blood cells, and platelets. Stem cells have unique properties; they can countably divide themselves more times than normal cells to replace deteriorating cells while retaining the same genetic features (undifferentiated states). With these special properties, doctors leverage stem cells to treat difficult, complex, or rare diseases, including hematological cancer, genetic blood disorders, or immunodeficiency diseases, giving the patient a chance to cure the disease and allowing the blood and immune systems to function normally.

How many types of bone marrow transplants?

Bone marrow transplant, or stem cell transplant, is classified into 2 types based on the source of stem cells used for transplantation, including:

1. Autologous stem cell transplantation is a bone marrow transplant with the patient’s stem cells collected from peripheral blood (apheresis) or bone marrow as a source of stem cells before transfusing them back into the patient to treat various malignant diseases, such as leukemia, lymphoma, or multiple myeloma. The doctor will collect stem cells from the patient after the disease is in remission for a while. The doctor will then administer a high dose of chemotherapy and radiation to kill the cancer cells before transplanting stem cells enriched with good-quality blood cells back into the body to produce healthy blood cells and platelets, reduce complications, and reduce infection after administering high-dose chemotherapy.
2. Allogeneic stem cell transplantation is a bone marrow transplant using the donor's collected blood or bone marrow as a source of stem cells. The donors may be from the same family member who is related by blood or from other donors who are not related by blood, including:
   • Sibling donors from the same family who are related by blood (match-related donors) with human leukocyte antigen (HLA) are 100% compatible with the recipient.
   • Non-sibling donors are matched unrelated donors with a full match of the major human leukocyte antigen (HLA)
   • Haploidentical donors, or donors with human leukocyte antigen (HLA) that are half-compatible with the recipient, such as a blood-related sibling or parent.

What diseases can be treated by a bone marrow transplant?

Blood cancers

• Leukemia
• Lymphoma
• Multiple myeloma
• Hodgkin lymphoma (HL)
• Non-Hodgkin lymphoma (NHL)
• Acute myeloid leukemia (AML)
• Acute lymphoblastic leukemia (ALL)
• Myelodysplastic syndrome (MDS)
• Chronic myeloid leukemia (CML)
• Chronic lymphocytic leukemia
• Juvenile myelomonocytic leukemia (JMML)
• Neuroblastoma
• Myelofibrosis

Blood disorders

• Thalassemia
• Aplastic anemia
• Amyloidosis
• POEMS syndrome
• Severe combined immunodeficiency syndrome (SCID)
• Paroxysmal nocturnal hemoglobinuria (PNH)
• Wiskott-Aldrich syndrome (WAS)
• Inherited metabolic disorder
• Autoimmune diseases
• Multiple sclerosis
• Systemic sclerosis

What is the bone marrow transplant procedure?

Preoperative bone marrow transplant

• The doctor will conduct a thorough physical examination of the bone marrow transplant recipient, including complete blood count, CT scans to check the condition of blood cells as well as liver and kidney, and an echocardiogram to assess the body's readiness for bone marrow transplantation.
• The doctor will administer drugs to stimulate the production of stem cells before collecting them from the body in preparation for stem cell transplantation.
• The doctor collects stem cells from veins in both arms using a connected blood cell separator to distinguish stem cells from blood. During the procedure, blood will be drawn from one arm and directed into a blood cell separator, where it will be transfused back into the body through the other arm without causing pain. The doctor will collect enough stem cells to meet the needs of the bone marrow transplant and freeze them at -80 to -195 degrees Celsius until the day of the transplant.
• Before stem cell transfusion, the patient will undergo a conditioning regimen, which involves administering immunosuppressants to suppress the body's immune system to prevent unintended effects from bone marrow transplantation, such as graft-versus-host disease (GVHD), or a condition in which the body rejects bone marrow from others, and also create space within the bone marrow to allow new stem cells to engraft. For cancer patients, the doctor will administer high-dose chemotherapy and radiotherapy to kill any remaining cancer cells before proceeding with stem cell transplantation.

Intraoperative bone marrow transplant

• Cancer patients will be admitted to a sterile unit at the hospital to reduce the risk of catching infection. The doctor will give chemotherapy or radiation therapy to destroy cancer cells until they are completely eradicated from the body. Following treatment, the doctor will assess the treatment outcome as well as the side effects of the chemotherapy, as the chemotherapy can suppress bone marrow function, resulting in cytopenia.
• When the body is ready, the doctor will infuse stem cells through a central venous catheter. The procedure is similar to a blood transfusion and typically takes 2–3 hours. During stem cell infusion, the doctor will monitor for complications such as fever, chills, or any other side effects that may occur during the procedure.

Postoperative bone marrow transplant

• The recipient will rest and recover in the hospital for 3-4 weeks to allow the hematopoietic stem cells to grow and replace unhealthy blood cells while producing healthy blood cells for the body. During this engraftment period, the body will gradually recover from the disease and build a new immune system.
• The doctor will schedule periodic follow-up physical exams to check for side effects after a bone marrow transplant, including checking the body's recovery, signs of engraftment, the number of new blood cells, the total body’s blood cells, disease control, and overall patient health.
• Some patients may require periodic blood and platelet transfusions until the transplanted stem cells can produce enough blood cells to meet bodily needs.

What is the recovery time for the bone marrow transplant?

Typically, bone marrow transplants or stem cell transplants take 6 months to 1 year for the body to fully recover, accept the new stem cells, and produce healthy blood cells circulating in the body. During the first 100 days after treatment, the doctor will schedule follow-up appointments at the hospital to evaluate the treatment outcome.

What is a complication of the bone marrow transplant?

Complications from bone marrow transplants or stem cell transplants, including graft-versus-host disease (GVHD) or potential infection complications. To closely monitor symptoms after bone marrow transplantation, recipients must be monitored by a team of experienced doctors and clinical staff in a special sterile room at the hospital. This is to ensure that patients receive timely care if complications arise.

What are the advantages of bone marrow transplant?

Medically, bone marrow transplants or stem cell transplants are widely recognized as providing numerous advantages. Hematological cancer, inherited blood disorders, and many types of autoimmune diseases can be cured with this treatment.

Bone Marrow Transplant at MedPark Hospital

Light of Day Oncology Center at MedPark Hospital, Bangkok, Thailand, led by a team of seasoned hematologist-oncologists in collaboration with a multidisciplinary medical team to treat the full spectrum of blood-borne cancers, inherited blood disorders, or autoimmune diseases using blood or bone marrow transplants (stem cell transplants), covering various sources of bone marrow, including autologous stem cells or allogeneic stem cells to replace defective blood cells with healthy ones while stimulating the production of new quality blood cells, enabling patients to have good physical health and the chances of cure.

Pediatric Bone Marrow Transplant Program

Pediatric bone marrow transplant program at MedPark Hospital treats children of all ages, from infants to adolescents, with a variety of pediatric cancers, hemoglobinopathies, or other autoimmune diseases, such as neuroblastoma, leukemia, aplastic anemia, Hodgkin lymphoma and non-Hodgkin lymphoma, thalassemia, and others.
 
MedPark's bone marrow and stem cell transplant team consists of experienced hematologists, oncologists, and multidisciplinary clinical specialists who collaborate to ensure successful engraftment, prevent complications, and provide life-saving treatment for all recipients.

Adult Bone Marrow Transplant Program

Adult bone marrow transplant program at MedPark Hospital treats adults of all ages with hematological cancers, blood diseases, or other autoimmune diseases, such as leukemia, lymphoma, multiple myeloma, amyloidosis, aplastic anemia, myelodysplastic syndrome, and others. Our program uses state-of-the-art techniques for harvesting and transplanting hematopoietic stem cells to ensure a life-saving treatment and prevent graft-versus-host disease or other potentially life-threatening complications to deliver the best transplantation outcomes.

MedPark's bone marrow and stem cell transplant treatment program has performed bone marrow transplants, or stem cell transplants, including autologous stem cell transplantation and allogeneic stem cell transplantation, tailoring each patient to ensure the best possible treatment outcomes, overall health and well-being, and a better quality of life.