What is the role of bone marrow transplant or stem cell transplant for aplastic anemia and what are the success rates?
Aplastic anemia is a potentially serious bone marrow failure disorder that is characterized by low cell count in blood and bone marrow. Hematopoietic stem-cell transplantation or bone marrow transplant (BMT) is the treatment of choice for young patients who have a genetically matched sibling donor. stem cell transplant has success rate up to 80% to 90% of the time, if cells are from a matched related donor are used.
For people older than 30 or 40, many doctors prefer using immune therapy as the first treatment. In order for transplant to be an option, patient needs to have a donor who is genetically matched .
Many doctors recommend using a non-related donor only if immune suppression treatments don’t work and unable to find a genetically matched related donor . Results of bone marrow transplantation from unrelated and mismatched donors in case of non availability of genetically matched donor are improving. Efforts are currently underway to both improve immunosuppressive regimens and to expand the application of bone marrow transplantation.
How do i find a matching donor for bone marrow transplant in aplastic anemia and what is haploidentical bone marrow transplant?
- Genetic matching is determined by a type of test called HLA typing, which is done in the laboratory. If there is no match from a brother or sister, sometimes an unrelated donor will match.
- Recent development of haploidentical bone marrow transplant technique in aplastic anaemia allows transplant to be performed unmatched related donor safely.
- A transplant from a matched-unrelated donor is riskier than using a sibling match. Another option is to use stem cells from the umbilical cord of a newborn baby.
- Usually registry are available for potential stem cell donors and stored umbilical cord blood in many countries patients can contact these banks to find a suitable donor.
What is the procedure in bone marrow transplant for aplastic anemia?
For a stem cell transplant, patient will first receive chemotherapy and drugs to suppress your immune system, is also given. Some patient may also get a low dose of radiation therapy to your whole body.
Soon after patient will receive a transfusion with blood forming stem cells from a donor. The stem cells can be obtained from the donor by removing bone marrow in the operating room under general anesthesia.
Sometimes a procedure called apheresis is used to remove stem cells from the bloodstream.
What are the side effects or complications in bone marrow transplant for aplastic anemia?
Stem cell transplantation is a major procedure with many risks and side effects. The most serious side effects often occur during the first few weeks after the transplant. But with advances in this treatment, death from these early side effects is less common.
In the first few weeks after the transplant patient may develop nausea, vomiting, diarrhea, and mouth sores from chemotherapy or radiotherapy treatment. Very low blood counts, serious
infections are common. All of these problems generally go away in 3 to 4 weeks when the transplanted blood-forming stem cells start to produce normal blood cells.
A very serious side effect of a stem cell transplant is acute graft-versus-host disease . More common with unrelated or mismatched donors and in older patients and can occur very early after the transplant. chronic graft-versus-host disease develops later lasts for a long time and is treatment is suppressing the immune system with medication.
Final word on hematopoietic stem-cell transplantation in aplastic anemia .
Aplastic anemia is a serious disorder , Tough Hematopoietic stem-cell transplantation or bone marrow transplantation is expensive & risky procedure . It is only hope for a cure young in patients, gives an opportunity for the patients to live a healthy and productive life disease free life .
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Summary
Aplastic anemia is a potentially serious bone marrow failure disorder that is characterized by low cell count in blood and bone marrow. Hematopoietic stem-cell transplantation or bone marrow transplantation (BMT) is the treatment of choice for young patients who have a matched sibling donor. stem cell transplant is successful up to 80% to 90% of the time if cells from a matched related donor are used.
Tough Hematopoietic stem-cell transplantation or bone marrow transplantation is a expensive , risky procedure , It is only hope for a cure young patients , gives an opportunity for the patients to live a healthy and productive life disease free life .
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Clinical management of aplastic anemia
Amy E DeZern, Robert A Brodsky
Success of allogeneic marrow transplantation for children with severe aplastic anaemia
Lauri M. Burroughs, Ann E. Woolfrey, Barry E. Storer, H. Joachim Deeg, Mary E.D. Flowers,
Johanna Konopacki, Raphaël Porcher, Marie Robin, Sabine Bieri, Jean-Michel Cayuela, Jérôme Larghero, Aliénor Xhaard, Anna Lisa