What is a Bone Marrow Transplant?
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| (Left to right) Marlow Robinson, Emily Manion and Daniel Conway are living testaments to the success of the bone marrow transplant program at Cincinnati Children's. |
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It's not a surgical procedure. In other types of transplants, such as heart and liver transplants, a surgeon removes the diseased organ and replaces it with a healthy one. But a bone marrow transplant is different.
Stella Davies, MBBS, PhD, director of the Blood and Marrow Transplantation Program at Cincinnati Children's Hospital Medical Center, uses an analogy from gardening to describe bone marrow transplantation. "It's about growing things," she says. "We plant seeds and make them grow." The seeds are stem cells.
Healthy bone marrow contains stem cells that produce blood cells, including red blood cells that carry oxygen and white blood cells that fight infection. But the bone marrow can be destroyed by high doses of chemotherapy and radiation that are used to kill cancer cells. Bone marrow transplantation restores the marrow's ability to make blood cells.
BMT patients receive healthy stem cells that have been collected from a donor's bone marrow or blood, or from umbilical cord blood. The new cells are given through an intravenous (IV) line in a procedure similar to a blood transfusion.
The new cells circulate in the bloodstream and settle in the bone marrow. Like seeds that are planted, they begin to grow and to produce blood cells. This stage takes several weeks, but the process of fully rebuilding the bone marrow takes much longer.
As Dr. Davies explains, "Bone marrow is very complicated. It takes about a year for the immune system to become fully competent. It has to learn to recognize viruses and other infections, and it has to learn not to attack the child's own body. So it takes a long time. It's astonishing that it works."
Cincinnati Children's has one of the largest pediatric bone marrow transplant programs in the nation and is recognized for expertise in treating unusual disorders. In summer 2005, the program achieved a milestone, performing its 1,000th BMT since the transplant program was established in 1981.
