Overview
Bone marrow in our bones is responsible for blood cell production. In truth, all blood cells are produced by a subpopulation of bone marrow cells known as "haematopoietic stem cells" or simply "stem cells." These stem cells have unique features, including the ability to replenish themselves and evolve into any form of blood cell. Nowadays, haematopoietic stem cells can be collected from peripheral blood after treatment with certain growth factors and from the umbilical cord. Thus, "Haematopoietic stem cell transplantation" is now also known as "bone marrow transplantation," in which stem cells from the bone marrow that create red blood cells, white blood cells, and platelets are infused into a recipient following a brief course of chemotherapy known as conditioning. Today, this is a viable treatment option for various disorders, and with continued research, success rates have increased significantly.
Types of Bone Marrow Transplant (BMT)
Depending on who donates the bone marrow or stem cells, there are two basic types of transplants: allogenic and autologous.
Allogeneic bone marrow transplant: The donor and recipient are two separate people, and the transplant uses the donor's stem cells. It might be
Matched Related, where the donor is an HLA-matched relative, typically a sibling.
Matched Unrelated, where the donor is not a relative of the patient and is typically obtained from one of several national or international registries.
Partially Matched Related, where the donor is from a patient's family but partially matched (haploidentocal).
Cord blood was collected from a registry.
Autologous Bone Marrow Transplant: The donor and recipient are identical persons, and the transplant is performed using the patient's own stem cells. The method entails administering high-dose chemotherapy to the patient in order to eradicate the primary disease. Following that, an autologous transplant is performed to salvage damaged bone marrow. This type of transplant has few complications and is recommended for conditions such as multiple myeloma/lymphoma.
You are likely to experience ups and downs during your post-transplant period. During this time, you can do a few things to aid in your recovery and healing. After a transplant, your immune system is unable to adequately protect you, and it may take months to resume normal function. Some infections are trivial, while others are life-threatening. Here are a few pointers that may help you, but always seek the opinion of your transplant specialist.
Protecting yourself from infection
Keep your hands clean.
Washing your hands is the most effective way to reduce infection. Wash your hands when:
You're back home.
You touch a shared object, such as a phone.
Before eating and after using the toilet.
Please be strict with visitors and insist on using hand rubs before they touch you.
Other tips
Other important things you can do to reduce infection include bathing daily, using a separate towel, changing bed sheets (at least once a week), and changing clothes daily.
Keeping your mouth clean
Taking good dental care of the mouth and gums can help prevent infections and mouth ulcers. Some general recommendations include:
Clean your teeth at least twice a day with a soft brush, and use alcohol-free mouthwash as directed.
Do not floss your teeth, and consult your doctor before undergoing any dental procedures.
Keep your surroundings clean.
Avoid dust, plants, flowers, and large gatherings until your immune system has fully recovered. This is because all of these activities expose you to fungal spores, which can cause infection.
Ask a family member or friend to mop your room rather than sweep it. Avoid being in the room where cleaning is being done.
Inhale clean air. This is a problem, particularly in metros. HEPA filters can be utilized but are not required. Avoid first- or second-hand smoke. Avoid new construction in your home, as well as incense sticks and oil lamps.
Avoid having visitors with the illness, loose motion, or vomiting. Avoid contact with anyone who had a live vaccine during the last 2-4 weeks.
Protect yourself when you go out.
When you move out, you need to take some measures. Consult your transplant doctor about visiting public areas and when to wear a mask.
Avoid crowds by visiting places like malls and movie theaters on weekdays when they are less crowded.
Avoid swimming in public pools and oceans, and wear protective gloves and wipes.
Keep an eye out for signs of infection
You understand your body better than anyone else, so you are the ideal person to look for indications of infection. Some symptoms and indicators to look out for include fever or chills, diarrhoea, frequent urination and blood in the stool or urine, abdominal discomfort, severe exhaustion, bleeding, coughing, shortness of breath, and lightheadedness. Jaundice, loose stools, abdominal pain, loss of appetite, skin rash, fever, and other GVHD signs must be monitored closely. If you still have loose stool, you can try home cures for loose motion, or please call your transplant team right away if you have any of the following.
Conclusion
Life after a bone marrow transplant is a path of perseverance and adaptation, with both hardships and significant milestones. From regaining physical health and managing long-term consequences to fostering emotional well-being and rediscovering purpose, each stage necessitates patience and assistance. Celebrating little triumphs and focusing on gradual progress can make rehabilitation more empowering. With the help of a solid support system, a commitment to self-care, and a good attitude, post-transplant life can provide newfound hope, strength, and the potential to build a full and purposeful life.
Dr. Satyendra Katewa, Director & Head of Department
Blood & Marrow Transplant and Cellular Therapies
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