Autologous bone marrow transplant

Autologous bone marrow transplant, also known as autologous stem cell transplant, is a process of replacing the damaged or diseased bone marrow with healthy blood stem cells from the patient’s own body.

Bone marrow is the spongy, soft tissue found inside the bones. 
The bone marrow contains the hematopoietic stem cells, which are special cells that make copies of themselves and change into several different types of cells that the body needs, such as red blood cells, white blood cells, and platelets.

Symptoms

A bone marrow transplant may be done in the following conditions:

• To replace stem cells that were destroyed during chemotherapy, which is a form of drug treatment for cancer
• To replace diseased bone marrow that is not capable of making its own stem cells
• To add donor cells which can help in finding and killing the cancer cells
• A person may need a bone marrow transplant if he/she has any of the following conditions:
• Multiple myeloma (cancer of plasma cells, which are a type of white blood cells in the bone marrow)
• Hodgkin lymphoma or Non-Hodgkin lymphoma (cancers affecting the lymphatic system, which is a part of the immune system of the body)
• Leukemia (a type of blood cancer)
• Germ-cell tumors (growths of cells that are created from reproductive cells), which includes testicular cancer
• Neuroblastoma (cancer found in the small glands on top of the kidneys, known as the adrenal glands)
• Soft tissue sarcoma (a condition in which malignant or cancer cells form in the body’s soft tissues)
• Multiple sclerosis (a condition in which the body’s immune system eats away the protective nerve covering)
• Scleroderma (chronic or long-term tightening and hardening of the connective tissues and skin)
• Autoimmune disorders like lupus (inflammatory disease that occurs when the immune system attacks the body’s own tissues)
• Certain types of cancer treatments, like chemotherapy or radiation (use of high-powered energy beams to kill cancer cells) 

Diagnosis

The following diagnostic tests may be performed before an autologous bone marrow transplant:

1. Physical examination: The doctor will do a complete physical health checkup of the patient and inquire about the medical history and symptoms of the patient.
2. Blood tests: The various blood parameters and certain underlying medical conditions can be diagnosed using blood tests.
3. Urine analysis: Certain underlying medical infections can be evaluated using a urine test.
4. Bone marrow aspiration and biopsy: The doctor will remove a small amount of fluid from the bone marrow and send it to the laboratory for evaluation.
5. Chest x-ray: The condition of the heart and lungs can be checked by the doctor using a chest x-ray.
6. Pulmonary function tests: The function of the lung can be evaluated using pulmonary function tests.
7. CT scan: It is a type of imaging test performed to obtain a clear image of the internal portion of an organ.
8. Electrocardiogram (ECG): The electrical activity of the heart can be measured using an ECG.
9. Echocardiogram: It helps the doctor in obtaining a clear image of the heart and its valves, and checking the function of the heart.
10. Sinus x-rays: Underlying sinus infections can be detected using sinus x-rays.
11. Lumbar puncture: A needle is inserted by the doctor in the spinal canal to collect the cerebrospinal fluid and sent to the laboratory for diagnostic testing.

Treatment

After the completion of chemotherapy and radiation therapy (if required), you will be ready for a bone marrow transplant.
The doctor delivers the healthy stem cells using an intravenous catheter (a thin tube inserted into a vein).
The stem cells travel through the bloodstream to reach the bone marrow.
The stem cells here produce new blood cells to replace the abnormal ones.
This procedure is known as engraftment and may take a couple of weeks.
You may be given growth factor injections to hasten the process.
You may need to remain in the hospital till your blood cell count returns to safe levels.

Risks

The complications associated with an autologous bone marrow transplant may include the following:

• Infection
• Bleeding
• Skin rash
• Low count of blood cells
• Diarrhea
• Cataract
• Fertility issues
• Leg cramps
• Muscle spasms
• Numbness in the legs or arms
• Liver problems
• Kidney problems
• Lung problems 
• Painful inflammation in the digestive tract and mouth
• Organ damage
• Breathing difficulty
• Chances of developing cancer later on in life

After Procedure

Until the engraftment procedure occurs, your immune system (body’s disease-fighting system) will be weak as chemotherapy destroys all your blood cells. This may increase the risk of developing infections, and it is, therefore, important to stay in the hospital during the initial period of recovery.
It is normal to feel some fatigue and tiredness after going home. It may take many months to recover completely.
It is normal to have certain emotional and physical side effects during the recovery period.
The medications provided may affect your looks and self-image. Counseling may help in making things a little easier.
The success of autologous bone marrow transplant depends on several factors, like the type of condition present and the severity of the condition.
You should avoid foods and drinks carrying a higher risk of foodborne illness. 
You should eat a healthy, well-balanced, nutrient-rich diet.
Avoid alcohol and tobacco consumption.
Limit the consumption of sodium.
Take supplements or multivitamins as recommended by the doctor.
You should avoid direct exposure to sunlight, as your skin could be more sensitive.
Avoid getting a tattoo or body piercing.
Take good care of your dental health and avoid the formation of dental cavities.
Contact the doctor immediately if you notice any signs of infection after the procedure.