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Bone Marrow Transplant Frequently asked Questions
1. What is a bone marrow transplant?
A bone marrow transplant is a potentially life-saving treatment for people with leukemia, lymphoma and many other diseases. Patients undergo chemotherapy and sometimes radiation to destroy their diseased marrow. After which a donor's healthy blood-forming cells are given directly into the patient's bloodstream, where they can begin to multiply and function. For a patient's body to accept these healthy cells, the donor's tissue type needs to match the patient's type as closely as possible. Patients who do not have a suitably matched donor in their family may search for an unrelated bone marrow donor or donated umbilical cord blood unit.

2. Why does a patient need a bone marrow transplant?
The purpose of Bone Marrow Transplantation (BMT) in cancer treatment is to enable patients to safely receive very high doses of chemotherapy and/or radiation therapy. High doses of chemotherapy and radiation therapy will destroy cancer cells and some healthy cells. BMT replaces healthy stem cells that were destroyed by these treatments. The healthy, transplanted stem cells can restore the bone marrow's ability to produce blood cells needed, giving the patient a new immune system.

3. Why this procedure is performed?
A bone marrow transplant replaces bone marrow that is either not working properly or that may have been destroyed (ablated) by chemotherapy or radiation. Doctors believe that for many cancers, the donor's white blood cells can attach to any remaining cancer cells, similar to when white cells attach to bacteria or viruses when fighting an infection. We may recommend a bone marrow transplant if you have: • Cancers like leukemia, lymphoma, and multiple myeloma. • Disease that affects the production of bone marrow cells, such as aplastic anemia, congenital neutropenia, severe immunodeficiency syndromes, sickle cell anemia, and thalassemia. • After chemotherapy that may have destroyed your bone marrow.

4. What are the risks involved?
A bone marrow transplant may cause the following symptoms:
    • Chest pain
    • Chills
    • Drop in blood pressure
    • Fever
    • Flushing
    • Funny taste in the mouth
    • Headache
    • Hives
    • Nausea
    • Pain
    • Shortness of breath

5. What are the possible side effects?
The major risk of the treatment is an increased susceptibility to infection and bleeding as a result of the high-dose cancer treatment. Patients who undergo this procedure may experience short-term side effects such as nausea, vomiting, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions. Additionally, patients receiving BMT may experience nausea and vomiting while receiving the transplant, and chills and fever during the first 24 hours after the transplant. Potential long-term risks include infertility, cataract, secondary (new) cancers, and complications in the liver, kidneys, lungs, and/or heart. The likelihood and severity of complications are specific to each patient's treatment and should be discussed with your doctor.

6. Where do blood-forming cells used in a transplant come from?
Blood-forming cells can come from three sources: bone marrow, peripheral (circulating) blood, and the blood in the umbilical cord and placenta after a baby's birth.
Bone marrow produces blood-forming cells for the body. It is a spongy tissue found inside larger bones. In a surgical procedure, doctors make several small incisions through the skin over the back of the pelvic bone to draw out the marrow.
Peripheral blood stem cells (PBSC) are blood-forming cells found in the bloodstream. Normally, the bone marrow releases only a small number of blood-forming cells into the bloodstream. To donate PBSC, a donor is given injections of a medication that makes the blood-forming cells move from the bone marrow into the blood. The cells are collected from the blood during an outpatient procedure, similar to plasma or platelet donation.
Umbilical cord blood is collected from the umbilical cord and placenta after a baby is born. This blood contains a large number of blood-forming cells. (These are not embryonic stem cells.) If the cord blood meets standards for transplant, it is stored at a public cord blood bank for future use.