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Encyclopedia > Bone marrow transplant

Bone marrow transplantation or hematopoietic stem cell transplantation (HSCT) is a medical procedure in the field of hematology and oncology that involves transplantation of hematopoietic stem cells (HSC). It is most often performed for people with diseases of the blood or bone marrow, or certain types of cancer. Hematology is the branch of medicine that is concerned with blood and its disorders. ... Oncology is the medical subspecialty dealing with the study and treatment of cancer. ... Transplant redirects here. ... Note that some complexity is omitted from the diagram. ... Human blood smear: a - erythrocytes; b - neutrophil; c - eosinophil; d - lymphocyte. ... Grays Anatomy illustration of cells in bone marrow. ... Cancer is a class of diseases or disorders characterized by uncontrolled division of cells and the ability of these cells to invade other tissues, either by direct growth into adjacent tissue through invasion, or by implantation into distant sites by metastasis. ...


Bone marrow transplantation was pioneered at the Fred Hutchinson Cancer Research Center from the 1950s through the 1970s by E. Donnall Thomas, whose work was later recognized with a Nobel Prize in Physiology and Medicine. Dr. Thomas' work showed that bone marrow cells infused intravenously could repopulate the bone marrow and produce new blood cells. His work also reduced the likelihood of developing a life-threatening complication called Graft-versus-host disease. However it remains a risky procedure and it is reserved for patients with life threatening diseases. The Fred Hutchinson Cancer Research Center is an institution in the Cascade neighborhood of Seattle, Washington engaged in scientific research towards the prevention and treatment of cancer. ... // Recovering from World War II and its aftermath, the economic miracle emerged in West Germany and Italy. ... The 1970s decade refers to the years from 1970 to 1979, inclusive. ... Dr. Edward Donnall (Don) Thomas (b. ... Nobel Prize medal. ... A blood cell is any cell of any type normally found in blood. ... Graft-versus-host disease is a common complication of allogeneic bone marrow transplantation. ...

Contents

Principles

Most recipients of HSCTs are leukemia patients or others who would benefit from treatment with high doses of chemotherapy or total body irradiation. Other patients who receive bone marrow transplants include pediatric cases where the patient has an inborn defect such as severe combined immunodeficiency or congenital neutropenia and was born with defective stem cells. Children or adults with aplastic anemia have lost their stem cells after birth and may not require such high doses of chemotherapy and irradiation prior to a transplant. In this case there is a greater need for immunosuppressive agents. Other conditions that bone marrow transplants are considered for include thalassemia major, sickle-cell disease, myelodysplastic syndrome, lymphoma, Hodgkin's disease, and multiple myeloma. More recently non-myeloablative, or so-called "mini transplant," procedures have been developed which do not require such large doses of chemotherapy and radiation. This has allowed HSCT to be conducted in older patients and without the need for hospitalization. HI CAMOIN thIS IS YOUR FRIEND CJ Leukemia (leukaemia in British English) is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation of blood cells, usually white blood cells (leukocytes). ... Chemotherapy is the use of chemical substances to treat disease. ... Total Body Irradiation (TBI) is a radiotherapy technique used to ablate the bone marrow and immune system prior to bone marrow transplantation or peripheral blood stem cell transplantation. ... Pediatrics (also spelled paediatrics or pædiatrics) is the branch of medicine that deals with the medical care of infants and children. ... Severe Combined Immunodeficiency, or SCID, is a genetic disorder in which both arms (B cells and T cells) of the adaptive immune system are crippled, due to a defect in one of several possible genes. ... It has been suggested that Agranulocytosis be merged into this article or section. ... Aplastic anemia is a condition where the bone marrow does not produce enough, or any, new cells to replenish the blood cells. ... Irradiation is the process by which an item is exposed to radiation. ... Immunosuppressive agents are a class of drugs which act to suppress the normal activity of the immune system. ... Thalassemia (American English) (or Thalassaemia in British English) is an inherited disease of the red blood cells, classified as a hemoglobinopathy. ... Sickle-cell disease is a general term for a group of genetic disorders caused by sickle hemoglobin (Hgb S or Hb S). ... Lymphoma is a variety of cancer that originates in lymphocytes or, more rarely, of histiocytes. ... Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahlers disease after Otto Kahler) is a type of cancer of plasma cells which are immune system cells in bone marrow that produce antibodies. ...


Stem cell collection

Types of donors

There are two major types of bone marrow transplantation. Autologous bone marrow transplantation involves isolation of HSC from a patient, storage of the stem cells in a freezer, medical treatment of the patient that destroys stem cells remaining in the body, and return of the patient's own stored stem cells to their body. Autologous transplants have the advantage of a lower risk of graft rejection, infection and graft-versus-host disease. Allogeneic bone marrow transplantation involves two people, one is the (normal) donor and one is the (patient) recipient. Allogeneic HSC donors must have a tissue (HLA) type that matches the recipient and, in addition, the recipient requires immunosuppressive medications. Allogeneic transplant donors may be related (usually a sibling) or unrelated volunteers. The human leukocyte antigen system (sometimes human lymphocyte antigen) (HLA) is the general name of a group of genes in the human major histocompatibility complex (MHC) region on human chromosome 6 (mouse chromosome 17) that encodes the cell-surface antigen-presenting proteins. ... Immunosuppression is the medical suppression of the immune system. ...


Donor selection

A major limitation of allogeneic bone marrow transplantation is a shortage of donors. To avoid rejection of the transplanted stem cells or severe graft-versus-host disease, the donor should have the same human leukocyte antigens (HLA) as the recipient. About 25 to 30 percent of potential HSCT recipients have an HLA-identical sibling. For other recipients, registries of volunteer unrelated donors can be quickly searched in order to find a potential HLA match. If an exact match cannot be found, a partially matched donor can be used. However, the use of mismatched donors may increase the risk of graft rejection or severe graft-versus-host disease. Transplant rejection occurs when the immune system of the recipient of a transplant attacks the transplanted organ or tissue. ... Graft-versus-host disease is a common complication of allogeneic bone marrow transplantation. ... The human leukocyte antigen system (sometimes human lymphocyte antigen) (HLA) is the general name of a group of genes in the human major histocompatibility complex (MHC) region on human chromosome 6 (mouse chromosome 17) that encodes the cell-surface antigen-presenting proteins. ... Graft-versus-host disease is a common complication of allogeneic bone marrow transplantation. ...


A compatible donor is found by doing additional HLA-testing from the blood of potential donors. The HLA genes fall in two categories (Type I and Type II). In general, mismatches of the Type-I genes (i.e. HLA-A, HLA-B, or HLA-C) increase the risk of graft rejection. A mismatch of an HLA Type II gene (i.e. HLA-DR, or HLA-DQB1) increases the risk of graft-versus-host disease. In addition a genetic mismatch as small as a single DNA base pair is significant so perfect matches require knowledge of the exact DNA sequence of these genes for both donor and recipient. Leading transplant centers currently perform testing for all five of these HLA genes before declaring that a donor and recipient are HLA-identical. The structure of part of a DNA double helix. ... Base pairs, of a DNA molecule. ...


Race and ethnicity are known to play a major role in donor recruitment drives, as members of the same ethnic group are more likely to have matching genes, including the genes for HLA. [1] To meet Wikipedias quality standards, this article or section may require cleanup. ... This article or section should be merged with ethnic group Ethnicity is the cultural characteristics that connect a particular group or groups of people to each other. ...

Bone marrow harvest
Bone marrow harvest

Image File history File linksMetadata Download high-resolution version (2000x1312, 1167 KB) A bone marrow harvest. ... Image File history File linksMetadata Download high-resolution version (2000x1312, 1167 KB) A bone marrow harvest. ...

Sources of HSC

In the case of a bone marrow transplant, the HSC are removed from a large bone of the donor, typically the pelvis, through a large needle that reaches the center of the bone. The technique is referred to as a bone marrow harvest and is performed under general anesthesia because hundreds of insertions of the needle are required to obtain sufficient material. The pelvis (pl. ... Different bevels on hypodermic needles Syringe on left, hypodermic needle with attached color-coded luer lock on right. ...


Peripheral blood stem cells are now the most common source of stem cells for HSCT. They are collected from the blood through a process known as apheresis. The donor's blood is withdrawn through a sterile needle in one arm and passed through a machine that removes white blood cells. The red blood cells are returned to the donor. The peripheral stem cell yield is boosted with daily subcutaneous injections of filgrastim (Neupogen). Whole blood enters the centrifuge on the left and separates into layers so that selected components can be drawn off on the right. ... White Blood Cells is also the name of a White Stripes album. ... Human red blood cells Red blood cells are the most common type of blood cell and are the vertebrate bodys principal means of delivering oxygen to body tissues via the blood. ... Insert non-formatted text hereGranulocyte-Colony Stimulating Factor (G-CSF) is a glycoprotein, growth factor or cytokine produced by a number of different tissues to stimulate the bone marrow to produce granulocytes. ... Granulocyte-Colony Stimulating Factor (G-CSF) is a glycoprotein, growth factor or cytokine produced by a number of different tissues to stimulate the bone marrow to produce granulocytes. ...


Umbilical cord blood is obtained when a mother donates her infant's umbilical cord and placenta after birth. Cord blood has a higher concentration of HSC than is normally found in adult blood. However, the small quantity of blood obtained from an umbilical cord (typically about 50 mL) makes it more suitable for transplantation into small children than into adults. Newer techniques using ex-vivo expansion of cord blood units or the use of 2 cord blood units from different donors are being explored to allow cord blood transplants to be used in adults. In placental mammals, the umbilical cord is a tube that connects a developing embryo or fetus to its placenta. ... The placenta is an ephemeral (temporary) organ present only in female placental vertebrates during gestation (pregnancy). ... Umbilical cord blood is human blood from the placenta and umbilical cord that is rich in hematopoietic stem cells. ...


Storage of HSC

Unlike other organs, bone marrow cells can be frozen for prolonged time periods (cryopreserved) without damaging too many cells. This is necessary for autologous HSC because the cells must be harvested months in advance of the transplant treatment. In the case of allogeneic transplants fresh HSC are preferred in order to avoid cell loss that might occur during the freezing and thawing process. Allogeneic cord blood is stored frozen at a cord blood bank because it is only obtainable at the time of childbirth. To cryopreserve HSC a preservative, DMSO, must be added and the cells must be cooled very slowly in a control rate freezer to prevent osmotic cellular injury during ice crystal formation. HSC may be stored for years in a cryofreezer which typically utilizes liquid nitrogen because it is non-toxic and it is very cold (boiling point -196°C.) Umbilical cord blood is human blood from the placenta and umbilical cord that is rich in hematopoietic stem cells. ... A cord blood banks is a place that stores umbilical cord blood for future use. ... Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy with the emergence of a newborn infant from its mothers uterus. ... Dimethyl sulfoxide (DMSO) is the chemical compound (CH3)2SO. This colorless liquid is an important dipolar aprotic solvent. ... Osmosis is the net movement of water molecules across a semipermeable membrane from a region of low solute potential to an area of high solute potential (or equivalently, from a region of high solvent potential to a region of low solvent potential). ... General Name, Symbol, Number nitrogen, N, 7 Chemical series nonmetals Group, Period, Block 15, 2, p Appearance colorless Atomic mass 14. ...


Conditioning regimens

The chemotherapy or irradiation given immediately prior to a transplant is called the conditioning or preparative regimen. The purpose is to help eradicate the patient's disease prior to the infusion of HSC and to suppress immune reactions. Chemotherapy drugs and radiation both damage DNA in the cell nucleus which kills rapidly dividing cells by triggering a self-destruct mechanism called apoptosis. Bone marrow cells divide frequently and are particularly sensitive to this treatment. The bone marrow can be ablated at doses that cause minimal injury to other tissues. In allogeneic transplants a combination of cyclophosphamide with busulfan or total body irradiation is commonly employed. This treatment also has immunosuppressive effect which prevents rejection of the HSC by the recipients immune system. Autologous transplants may also use these conditioning regimens but many other chemotherapy combinations can be used depending on the type of disease. The structure of part of a DNA double helix. ... The eukaryotic cell nucleus. ... The cell cycle, or cell-division cycle (CDC), is the series of events in a eukaryotic cell between one cell division and the next. ... A cell undergoing apoptosis. ... Cyclophosphamide (the generic name for Cytoxan, Neosar) is a nitrogen mustard alkylating agent, used to treat various types of cancer and some autoimmune disorders. ... Irradiation is the process by which an item is exposed to radiation. ...


Non-myeloablative allogeneic HSCT is a newer treatment approach which uses lower doses of chemotherapy and radiation which are too low to eradicate all of the bone marrow cells of a recipient. Instead non-myeloablative transplants rely on the graft versus tumor effect for their benefit. They do require high doses of immunosuppressive agents in the early stages of treatment. This leads to a state of mixed chimerism early after transplant where both recipient and donor HSC coexist in the bone marrow space. Decreasing doses of immunosuppressive therapy then allows donor T-cells to eradicate the remaining recipient HSC and to induce graft-versus-host disease and the graft versus tumor effect. Immunosuppressive agents are a class of drugs which act to suppress the normal activity of the immune system. ... In zoology, chimera is an animal which has two or more different populations of genetically distinct cells that originated in different zygotes; if the different cells emerged from the same zygote, it is called a mosaicism. ... T cells belong to group of white blood cells known as lymphocytes and play a central role in cell-mediated immunity. ... Graft-versus-host disease is a common complication of allogeneic bone marrow transplantation. ...


Non-myeloablative (or "mini") allogeneic transplants, because of their gentler conditioning regimens, are associated with a lower risk of transplant-related mortality and therefore allow patients who are considered too high-risk for conventional allogeneic HSCT (because of age or other comorbidities) to undergo potentially curative therapy for their disease.


Transplantation and engraftment

HSC are infused into the blood stream of the recipient through an intravenous (i.v.) catheter, like any other i.v. fluid. The HSC briefly circulate in the blood stream and then into the bone marrow spaces where they grow and start to produce blood cells. After several weeks of growth in the bone marrow, expansion of HSC and their progeny is sufficient to normalize the blood cell counts and alleviate the need for red blood cell and platelet transfusions. An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... Human red blood cells Red blood cells are the most common type of blood cell and the vertebrate bodys principal means of delivering oxygen from the lungs or gills to body tissues via the blood. ... A 250 ml bag of newly collected platelets. ...


Side effects and complications

Bone marrow transplantation is associated with a fairly high mortality (10% or higher), which limits its use to conditions that are themselves essentially life-threatening. Major causes of complications are sepsis, graft-versus-host disease and veno-occlusive disease. Sepsis (in Greek Σήψις, putrefaction) is a serious medical condition, resulting from the immune response to a severe infection. ... Graft-versus-host disease is a common complication of allogeneic bone marrow transplantation. ... Veno-occlusive disease (VOD) is a disease affecting the liver. ...


Regimen-related toxicity

Regimen-related toxicities are side-effects of the high dose chemotherapy or irradiation used in ablative HSCT.


Severe liver injury is termed hepatic veno-occlusive disease (VOD). Elevated levels of bilirubin, hepatomegaly and fluid retention are clinical hallmarks of this condition. Initially thought to be a specific form of Budd-Chiari syndrome (i.e. thrombosis of the liver veins). There is now a greater appreciation of the generalized cellular injury and obstruction in hepatic vein sinuses, and it has thus been referred to as sinusoidal obstruction syndrome (SOS). Severe case are associated with a high mortality. Anticoagulants or defibrotide may be effective in reducing the severity of VOD but may also increase bleeding complications. Ursodiol has been shown to help prevent VOD, presumably by helping the flow of bile. Veno-occlusive disease (VOD) is a disease affecting the liver. ... Bilirubin is a yellow breakdown product of heme catabolism. ... Hepatomegaly is the condition of having an enlarged liver. ... In medicine (gastroenterology and hepatology), Budd-Chiari syndrome is the clinical picture caused by occlusion of the hepatic vein. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... An anticoagulant is a substance that prevents coagulation; that is, it stops blood from clotting. ... Defibrotide is a deoxyribonucleic acid derivative (single stranded) derived from cow lung or porcine mucosa. ... Ursodiol (trade names Actigall, Ursofalk, Urso Forte) is a bile acid found in large quantities in bear bile; it also occurs naturally in human bile in smaller quantities. ... Bile (or gall) is a bitter, greenish-yellow alkaline fluid secreted by hepatocytes from the liver of most vertebrates. ...


Mucositis is the injury of the mucosal lining of the mouth and throat and is a common regimen-related toxicity following ablative HSCT regimens. It is usually not life-threatening but is very painful, and prevents eating and drinking. Mucositis is treated with pain medications plus intravenous infusions to prevent dehydration and malnutrition.


Infection

Bone marrow transplantation usually requires that the recipient's own bone marrow is destroyed ("myeloablation"). Prior to "engraftment" patients may go for several weeks without appreciable numbers of white blood cells to help fight infection. This puts a patient at risk of infections, sepsis and septic shock despite prophylactic antibiotics. The immunosuppressive agents employed in allogeneic transplants for the prevention or treatment of graft-versus-host disease further increase the risk of opportunistic infection. Immunosuppressive drugs are given for a minimum of 6-months after a transplantation, or much longer if required for the treatment of graft-versus-host disease. Transplant patients lose their acquired immunity, for example immunity to childhood diseases such as measles or polio. For this reason transplant patients must be re-vaccinated with childhood vaccines once they are off of immunosuppressive medications. White Blood Cells is also the name of a White Stripes album. ... An infection is the detrimental colonization of a host organism by a foreign species. ... Sepsis (in Greek Σήψις, putrefaction) is a serious medical condition, resulting from the immune response to a severe infection. ... Septic shock is a serious medical condition causing such effects as multiple organ failure and death in response to infection and sepsis. ... This page is a candidate to be moved to Wiktionary. ... Staphylococcus aureus - Antibiotics test plate. ... Immunosuppressive agents are a class of drugs which act to suppress the normal activity of the immune system. ... Opportunistic infections are infections caused by organisms and usually do not cause disease in a person with a healthy immune system, but can affect people with a poorly functioning or suppressed immune system. ... A scanning electron microscope image of a single human lymphocyte. ... Poliomyelitis (polio), or infantile paralysis, is a viral paralytic disease. ... A bottle and a syringe containing the influenza vaccine. ...


Graft versus host

Graft-versus-host disease (GVHD)

Graft-versus-host disease is an inflammatory disease that is unique to allogeneic transplantation. It is an attack of the "new" bone marrow's immune cells against the recipient's tissues. This can occur even if the donor and recipient are HLA-identical because the immune system can still recognize other differences between their tissues. It is aptly named graft-versus-host disease because bone marrow transplantation is the only transplant procedure in which the transplanted cells must accept the body rather than the body accepting the new cells. Acute graft-versus-host disease typically occurs in the first 3 months after transplantation and may involve the skin, intestine, or the liver. Corticosteroids such as prednisone are a standard treatment. Chronic graft-versus-host disease may also develop after allogeneic transplant and is the major source of late complications. In addition to inflammation, chronic graft-versus-host disease may lead to the development of fibrosis, or scar tissue, similar to scleroderma or other autoimmune diseases and may cause functional disablity, and the need for prolonged immunosuppressive therapy. It has been suggested that this article or section be merged with Epidermis (skin). ... In anatomy, the intestine is the portion of the alimentary canal extending from the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine (or colon). ... The liver is an organ in some animals, including mammals (and therefore humans), birds, and reptiles. ... In physiology, corticosteroids are a class of steroid hormones that are produced in the adrenal cortex. ... Prednisone is a synthetic corticosteroid drug which is usually taken orally and can be used for a large number of different conditions. ... Scleroderma is a rare, chronic disease characterized by excessive deposits of collagen. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ...


Graft versus tumor effect

The beneficial aspect of Graft versus Host is known as "graft versus tumor" or "graft versus leukemia". For example, leukemia patients with chronic graft-versus-host disease after an allogeneic transplant have a lower risk of leukemia relapse. This is due to a therapeutic immune reaction of the grafted donor lymphocytes against the diseased bone marrow of the recipient. This lower rate of relapse accounts for the increased success rate of allogeneic transplants compared to transplants from identical twins, and indicates that allogeneic HSCT is a form of immunotherapy. Graft vs tumor is also the major mechanism of benefit of non-myeloablative transplants which do not employ high dose chemotherapy or radiation.


Conditions treated with bone marrow or HSC transplantation

Acquired

Acute lymphocytic leukaemia (ALL), also known as acute lymphoblastic leukaemia is a cancer of the white blood cells, characterised by the overproduction and continuous multiplication of malignant and immature white blood cells (referred to as lymphoblasts) in the bone marrow. ... Acute myelogenous leukemia (AML), also known as acute myeloid leukemia, is a cancer of the myeloid line of blood cells. ... Aplastic anemia is a condition where the bone marrow does not produce enough, or any, new cells to replenish the blood cells. ... Chronic myelogenous leukemia (CML) is a form of chronic leukemia characterized by increased and unregulated clonal production of predominantly myeloid cells in the bone marrow. ... Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahlers disease after Otto Kahler) is a type of cancer of plasma cells which are immune system cells in bone marrow that produce antibodies. ... The myelodysplastic syndromes (MDS, formerly known as preleukemia) are a diverse collection of haematological conditions united by ineffective production of blood cells. ... Non-Hodgkins lymphoma is a type of cancer. ... Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disease characterised by hemolytic anemia, thrombosis and red urine due to breakdown of red blood cells. ... Radiation Hazard symbol. ... Multiple myeloma (also known as MM, myeloma, plasma cell myeloma, or as Kahlers disease after Otto Kahler) is a type of cancer of plasma cells, immune system cells in bone marrow that produce antibodies. ... Chronic lymphocytic leukemia (or chronic lymphoid leukemia), known for short as CLL, is a type of leukemia in which too many lymphocytes are produced. ...

Congenital

Adrenoleukodystrophy (ALD) is a degenerative disorder of myelin, a complex fatty neural tissue that insulates many nerves of the central and peripheral nervous systems. ... Griscelli syndrome is a rare autosomal childhood disorder characterised by hypopigmentation. ... Hurler syndrome, also known as mucopolysaccharidosis type I (MPS I) or Hurlers disease, is a genetic disorder that results in the deficiency of alpha-L iduronidase, which is an enzyme that breaks down mucopolysaccharides. ... Kostmann syndrome is a rare inherited form of neutropenia usually detected soon after birth. ... Krabbe disease (also known as globoid cell leukodystrophy or galactosylceramide lipidosis) is a rare, often fatal degenerative disorder that affects the nervous system. ... Metachromatic leukodystrophy (MLD) is the most common form of a family of genetic diseases known as the leukodystrophies, diseases which affect the growth and/or development of myelin, the fatty covering which acts as an insulator around nerve fibres throughout the central and peripherial nervous systems . ... Thalassemia (American English) or thalassaemia (British English) is an inherited disease of the red blood cells. ... Though Histiocytosis can refer to any of several specific diseases, the term is generally used to refer to a rare blood disease that is caused by an excess of white blood cells called histiocytes. ... Wiskott-Aldrich syndrome (WAS) is a rare X-linked recessive disease characterized by eczema, thrombocytopenia (low platelet counts), immune deficiency, and bloody diarrhea (due to the low platelet counts). ... Inborn errors of metabolism comprise a large class of genetic diseases involving disorders of metabolism. ...

References

  • Thomas ED, Lochte HL, Lu WC et al. Intravenous infusion of bone marrow in patients receiving radiation and chemotherapy. N Engl J Med 1957; 157: 491-496. PMID 13464965. Google Scholar
  • Socié, Gérard, et. al. (December 2001). "Busulfan plus cyclophosphamide compared with total-body irradiation plus cyclophosphamide before marrow transplantation for myeloid leukemia: long-term follow-up of 4 randomized studies". Blood 98(13): 3569-3574.Fulltext. PMID 11739158.
  • Richardson PG, et. al. (December 2002). "Multi-institutional use of defibrotide in 88 patients after stem cell transplantation with severe veno-occlusive disease and multisystem organ failure: response without significant toxicity in a high-risk population and factors predictive of outcome". Blood 100(13): 4337-43. PMID 12393437
  • Guglielmi, PT, et. al. (December 1995). "Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma". New England Journal of Medicine 333(23): 1540-5. PMID 7477169.
  • Barker JN, et. al. (December 2005). "Transplantation of 2 partially HLA-matched umbilical cord blood units to enhance engraftment in adults with hematologic malignancy". Blood 105(3): 1343-1347.Fulltext. PMID 15466923.

External links

Marrow Donor Registries

The National Marrow Donor Program (NMDP) is a nonprofit organization based in Minneapolis, Minnesota, that operates the largest national registry of volunteer hematopoietic cell donors in the United States. ...

Bone Marrow Recruitment Groups

Education for Patients

Experiences of Donors

  • Donating Bone Marrow: A detailed experience of donating marrow using traditional harvest
  • Mike's Marrow Donor Story
  • Bob's Donations
  • Lorenz's Donations
  • The Right Thing to Do
  • My Personal Experience as a Bone Marrow Donor
  • A Gift of Life
  • My Experience as a Bone Marrow Donor
  • Bone Marrow Donation: A Donor's Journal
  • My Marrow Donation Experiences

  Results from FactBites:
 
Bone marrow transplant - Wikipedia, the free encyclopedia (1969 words)
Bone marrow transplantation (BMT) or hematopoietic stem cell transplantation (HSCT) is a medical procedure in the field of hematology and oncology that involves transplantation of hematopoietic stem cells (HSC).
Bone marrow transplantation was pioneered in the 1970's by E.
In the case of a bone marrow transplant (BMT), the HSC are removed from a large bone of the donor, typically the pelvis, through a large needle that reaches the center of the bone.
Bone Marrow Transplant Information (2752 words)
The bone marrow is extracted from the patient prior to transplant and may be "purged" to remove lingering malignant cells (if the disease has afflicted the bone marrow).
The amount of bone marrow harvested depends on the size of the patient and the concentration of bone marrow cells in the donor's blood.
As the patient waits for the transplanted bone marrow to migrate to the cavities of the large bones, set up housekeeping or "engraft," and begin producing normal blood cells, he or she will be very susceptible to infection and excessive bleeding.
  More results at FactBites »

 
 

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