An autologous bone marrow transplant is a transplant of bone marrow in which the recipient acts as the donor. The bone marrow is harvested in advance and stored until it is needed. This procedure may also be known as a rescue transplant or stem cell transplant, a reference to the stem cells in the bone marrow which are the critical part of the transplant. Such procedures can be used in the treatment of bone marrow cancer, anemia, lymphoma and a number of other conditions.
There are two ways in which a patient can provide stem cells for an autologous bone marrow transplant. The first is through cord blood. When an infant is born, stem cells can be harvested from the umbilical cord and stored for future use. After infancy, bone marrow for transplant can be collected through apheresis, in which patients receive medication to encourage bone marrow to enter the blood so that it can be collected, or with bone marrow collection, in which a needle is inserted into the hip to draw out bone marrow while the patient is anesthetized.
With cells on hand for transfusion, the patient can be given treatments such as chemotherapy and radiation. The patient's existing bone marrow will be killed off entirely by the treatment, which will eliminate cancerous cells from the body. Treatment is usually difficult and the patient must be careful because he or she is vulnerable to infection. Once the patient's treatment is finished, the autologous bone marrow transplant can take place.
The transplant is performed by infusing stem cells through an intravenous line. These cells migrate into the bone, a process known as engraftment, and start producing new cells. The donor's bone marrow reserves slowly build back up if the transfusion is successful. After autologous bone marrow transplant, the patient can experience symptoms like chills, fever, and nausea, which resolve as he or she becomes healthier.
It is possible for cancers to return after an autologous bone marrow transplant. Even when the cells are carefully treated to remove cancerous cells, cancer may arise spontaneously on its own, or a cluster of cancer cells may survive and start replicating again. However, the patient is less likely to experience rejection or graft versus host disease. If a patient is a candidate for autologous bone marrow transplant, his or her doctor will discuss this option along with its potential risks and benefits, which can vary depending on the patient and the disease being treated.
