The symptoms that indicate the necessity of a bone marrow transplant are-

• Chest pain
• Low Blood Pressure
• Fever and chills
• Headaches and Weakness
• Nausea 
• Shortness of breath

A complete blood count is necessary if these symptoms are observed. Blood and Laboratory Tests have to be carried out along with Bone Marrow aspiration and a Biopsy to assess cellularity qualitatively and quantitatively. A change in the number of blood cells indicates the possibility of blood cancers, anemia and several other diseases that may require a Bone Marrow Transplantation. The cells of the bone marrow are usually taken from the hip bone for a biopsy and are thoroughly examined under the microscope. Several imaging tests such as MRI scan and CT scan are also essential for diagnosis as they produce detailed pictures of the bones.  

There are several types of Bone Marrow Transplantations on the basis of the availability of the donor such as – 

• Autologous bone marrow transplant in which the stem cells used are of the patient himself. These stem cells would have been taken before chemotherapy or radiation therapy.
• Allogeneic bone marrow transplant in which the stem cells used are of another person, preferably a close relative. Several tests are carried out to check the compatibility of the stem cells.
• Umbilical cord blood transplant in which the stem cells have been taken from the umbilical cord immediately after birth. These immature cells can differentiate into whichever cells required.

The main risk involved in a Bone Marrow Transplant is Graft-versus-Host disease in which the donor cells start to attack those of the recipient and hence causes problems in relation to immunity. In addition to this, there is a chance of Graft rejection in which the donor stem cells do not function effectively in the recipient and fail to differentiate into blood cells. This would lead to thrombocytopenia and anaemia. The patient may also be prone to several infections after surgery and may experience nausea, vomiting, fatigue, weakness and diarrhoea. There are possibilities of damages to the liver, delayed growth in children, clotting in blood vessels and even bleeding in the essential organs of the body.

After a bone marrow transplant, the patient is monitored by the doctor for signs of graft rejection. A medication for GVHD is given to prevent it from occurring. Antifungals, antivirals and antibiotics are also given in order to prevent all sorts of infections. Regular blood tests are conducted in order to check if blood counts are back to normal and to check the functioning of the donor’s stem cells in the recipient. The patient may require blood transfusions in case of too much blood loss or slow recovery.