Introduction
Over the past 40 years or so, bone marrow transplantation has been increasingly used to treat many malignant and non-malignant diseases. Bone Marrow Transplant (BMT) initially uses very high doses of chemotherapy alone or with radiation therapy (RT) to kill tumor cells. Bone marrow transplant also "wipes out" normal bone marrow. New stem cells are then used to repopulate the bone marrow. This engraftment by new stem cells is called "rescue."
To learn about a very personal perspective on bone marrow transplant, read the New York Times articles written by Suleika Jaouad. She was just starting her adult life when she was diagnosed with leukemia. Her diagnosis and her brother’s role as her bone marrow donor have affected her entire family.
New York Times: Life, Interrupted: A Family Gets Cancer
Bone marrow transplant is also used to treat genetic diseases.
Stem cells are pluripotent cells capable of:
- Self-renewal (unlimited ability to replicate and divide themselves)
- Differentiation (can become a number of tissues).
Hematopoietic Stem Cells (HSCs) specifically have the ability to differentiate into the variety of different blood cell types such as:
- White cells including granulocytes and their precursors
- Megakaryocytes which become platelets
- Red cell precursors which become mature red cells
- Immune cells (such as B and T lymphocytes)
Sources of stem cells include bone marrow, cord blood and peripheral blood stem cells (PBSCs).
HSCs can be harvested from individuals and transplanted.
There are three types of transplants:
- Autologous: patients receive their own stem cells.
- Syngeneic: patients receive stem cells from their identical twin
- Allogeneic: patients receive stem cells from a sibling or parent. A person who is not related to the patient (a matched unrelated donor or MUD) also may be used.
Links:
One Match: Stem cell and marrow network
New York Times: Life, Interrupted: A Family Gets Cancer
