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Indication: Inside your bones there is a spongy tissue called the bone marrow which contains immature cells called the stem cells. These stem cells mature to form red blood cells, white blood cells and the platelets.
When these stem cells become diseased, they need to be replaced with healthy marrow cells. This procedure is called bone marrow transplantation. This procedure is indicated if you are having any of the below mentioned conditions -
Severe blood diseases such as thalassemias, aplastic anemia, and sickle cell anemia
Certain immune deficiency diseases
will be done in a hospital or a medical centre specialized for this.
The transplant procedure begins with high doses of chemotherapy and
possibly radiation which destroys the faulty stem cells in your bone
marrow and also suppresses your body's immune system so that it does not
attack the new stem cells after the transplant.The transplant is of 3
bone marrow transplant/rescue transplant: Stem cells are removed from
you before high-dose chemotherapy/radiation, they are frozen and after
the chemotherapy/radiation stem cells are put back in your body to make
normal blood cells.
bone marrow transplant:Stem cells are taken from another person called
the donor who is chosen after a special blood test (most commonly
brother/sister make a good match but sometimes parents, children or
other relatives may be chosen) and are introduced into your body.
cord blood transplant:Stem cells are removed from the umbilical cord
of a newborn baby. They are frozen until they are needed for a
Procedure: Which type of
transplant you will have to undergo is decided by your oncologist
(cancer specialist) after a detailed examination of your condition and
disease status. The stem cells are delivered into your bloodstream
usually through a tube called a central venous catheter which is similar
to getting a blood transfusion and approximately takes 1-5 hours. The
stem cells travel through the blood into the bone marrow and produce new
white blood cells, red blood cells, and platelets in about 2-4 weeks.
Full recovery might take few months to a year or two.
During BMT you
will receive medications to prevent or treat infections, including
antibiotics, antifungals, antiviral drugs and also graft-versus-host
disease. You may need many blood transfusions and also you will be fed
through a vein until you can eat and tolerate by mouth.
duration you will have to stay in the hospital depends on the type of
chemotherapy or radiation you have received. The BMT may completely or
partially cure your disease.
Do's and Don'ts after bone marrow transplantation:
Oral hygiene is very important. Brush your teeth 2-3 times a day with a toothbrush having soft bristles. Use fluoride toothpaste.
Rinse your mouth 4 times a day with a home made salt-and-baking-soda solution (mix one half teaspoon of salt and one half teaspoon of baking soda in 8 ounces or 1 cup of water). Avoid mouth rinses that contain alcohol.
If you are having a central line, keep it dry and clean. You have to change the dressings once a week or sooner if it gets dirty which your doctor/nurse will teach you when you are getting discharged.
You can take a shower after 7-10 days of central line insertion, but make sure the line stays in place and the dressing does not get wet.
You can use lip care products to keep your lip moist and avoid cracking
If you are wearing dentures keep it clean and wear them only when you are eating
Common things to expect at home: You need minimum of 6 months to 1 year to recover from the transplant procedure
You may feel weak and become easily tired so take as much rest as possible
Your appetite may be very low but make sure you maintain your nutrition by forcefully having at least liquids
Nausea, vomiting, loss of appetite, taste changes, and a sore or dry mouth are expected after the transplant as a result of high doses of chemotherapy/radiotherapy received. Your doctor will have prescribed you medications during discharge, to control these symptoms. Take them regularly. Continue them even if you are not having any symptoms.
If your platelet counts have come down you may have a higher tendency to bleed. Check for bleeding spots regularly. If you notice bleeding put pressure on it and apply ice pack to slow the bleeding. If bleeding does not stop, contact your doctor immediately.
Keep your house clean and dirt free
Avoid handling flowers, plants and also pets as the chances of infection are very high with these.
If you have visitors having cold, instruct them to wear a mask before coming to meet you
Avoid crowded places and gatherings.
Make sure you wash your hands with soap and water after being outdoors, touching body fluids, such as mucus or blood, changing a diaper, using the telephone, doing housework, going to the bathroom or before handling food
Chest pain, drop in blood pressure, shortness of breath
Fever, flushing, funny taste in the mouth, headache, chills
Nausea, vomiting, diarrhea
Rare complications include:
Bleeding in the lungs, intestines, brain, and other areas of the body
Inflammation and soreness in the mouth, throat, esophagus, and stomach, called mucositis
Mild exercises are always encouraged but only make sure your blood counts are normal or at least within the accepted range. Some tips regarding the exercises are:
Start walking and you can gradually increase the distance depending on your energy levels
Avoid contact sports but you can try a stationary bicycle
Avoid lifting heavy weights and also carrying or moving heavy objects
If you feel weak or unsteady, use appropriate support (for example, a walker or cane), and do not get out of bed unless there is someone to help you.
You can try simple exercises like head rotation, elbow and shoulder flexion and extension. Similarly try the same for hip, knees and foot. When you are doing standing exercises make sure you are having adequate support.
Stop exercising if you notice any of these symptoms like fatigue, shortness of breath, leg cramping, exercise intolerance, light-headedness or dizziness, rapid heart rate, gait disturbance, tingling or numbness in arms or legs
Maintain good posture so that muscles and ligaments are not over strained