BONE MARROW TRANSPLANT -
Verb: A procedure used to treat Aplastic Anaemia , Myelodysplasia , Acute Leukaemia and some rare birth disorders with varying success. Healthy bone marrow is taken from the donor and infused into the bloodstream of the recipient: from here, it 'homes' in on the bone marrow, where it will grow. There is only a one in four chance that a full brother or sister will be a match.

Bone marrow transplantation is a risky procedure but success rates as high as 80% have been reported when the donor is a closely matched brother or sister. See graft-versus-host disease for a full appraisal of the risks.

The other major risk is that the immunosuppressant drugs used to control GVHD make the patient more susceptible to infections.

Patients with aplastic anaemia should be transplanted without the use of irradiation. Rejection of the graft is prevented by using a drug called cyclophosphamide often together with antibodies including antilymphocyte globulin which immunosuppress the recipient. The risk of graft failure, that is rejection of the bone marrow transplant, is greater for patients with aplastic anaemia than for patients with leukaemia .

There are some clear recommendations for treatment choices. Children, adolescents and young adults with brothers or sisters who are matched donors should be transplanted. Patients who have no brothers or sisters who are able to donate should be treated with immunosuppressive drugs. High risk patients, who have very low neutrophil counts, should receive intensive supportive treatment of blood and platelets prior to treatment.

For older patients who have brothers or sisters who are able to donate their bone marrow, the opinion is more divided. Some specialists recommend transplantation for any patient below the age of 50 years. In Europe, I am told they only will recommend it for patients below the age of 40 years. Other experts have recommended an initial trial of immunosuppressive drugs followed by a bone marrow transplant if the immunosuppressive drugs fail to work or if myelodysplasia or leukaemia later develop. Patients who fall into this group should discuss the choices carefully with their specialist before arriving at a decision on treatment.

Any patient diagnosed with severe aplastic anaemia or myelodysplasia should have rapid HLA tissue typing performed to identify possible marrow donors. Blood transfusions from prospective marrow donors should be avoided.

This site looks much better in a browser that supports current web standards, but it is accessible to any browser. Download one now