Marrow Cell Implantation

Introduction

Marrow cell implantation, also called bone marrow transplantation, is the process of implanting new marrow cells into the system or bones. Bone marrow transplantation is widely used to treat numerous systemic conditions affecting the marrow, like immunodeficiency syndrome, leukemia (reduced blood cell count), softening of the bone (osteoporosis), tumors, and various genetic disorders. In history, the first case of transplantation was done during the second world war for a 19-year-old girl from her brother for treating aplastic anemia. In 1957, the first few cases of human bone marrow transplantation through the intravenous (IV) routes were demonstrated by Thomas and his associates in Seattle. Although the trial continued till 1960 and showed rejection, the further progression of the trials gave a clear idea of transplantation immunology studies. The implantation of bone marrow cells is done when the marrow cells are taken from the own body of the individual (autologous marrow) or a donor site (allogeneic marrow).

What Is a Bone Marrow and What Are Its Components?

Bone marrow cells or hematopoietic stem cells of the body are specialized cells produced by the spongy tissues present inside the hollow bones, which can turn into different types of blood cells. The components of the blood are

• White blood cells (WBC) - The cells that fight against infection.

• Red blood cells(RBC) - The cells that deliver oxygen to the body

• Platelets - The cells that help in the clotting of blood

How Is Marrow Cell Implantation Done?

Marrow cell implantation or transplant is done by taking healthy stem cells from the bone marrow or blood. The donor is usually preferred from a close family member or the patient's own body. The process of extraction of stem cells takes place in the following method. The patients are made to run a few tests to know their health levels. The marrow cells are extracted from the donor site, and the body is conditioned with medications and radiation (chemotherapy and radiotherapy) to receive the extracted bone marrow. The new marrow cells are then transplanted into the receiver site. The patient is then monitored and advised for a recovery period until the marrow cells start to function. Stem cell or marrow cell transplantation can be procedural, intense, and skill-dependent, and hence patients need to be hospitalized until the recovery period.

What Are the Types of Marrow Cell Grafts And Implantation Methods?

Sources of Marrow Cells:

Bone marrow grafts can be extracted through a few sources where the cells are highly hemopoietic (cells that can form new blood cells), and they are:

• Bone Marrow Transplant (BMT)- Here the implantation cells are taken from the bone marrow.

• Blood Stem Cell Transplant- the implantation cells are derived from the bloodstream.

• Cord Blood Transplant- Here the cells are derived from the umbilical cord.

Types of Marrow Cells:

Marrow Cell Implantation is done to compensate for the loss of marrow cells killed during cancer therapy (myeloablative therapy). Here the implanted marrow cells begin to settle and grow to produce new blood cells, and this method is called engraftment. Bone marrow transplantation is done by two methods:

• Autologous Marrow- This is the method of self-transplanting marrow cells from one site to another. This is one of the preferred methods of transplantation as it is the most compatible source of grafting.

• Allogeneic Marrow- This is the method where the transplant is made from a related donor or marrow bank.

Why Is Marrow Cell Implantation Needed?

Bone Marrow cell implantation is needed to treat patients as a source of replenishments. It provides a source of nutrition for patients undergoing extensive chemotherapy and radiation therapy, as higher doses of medication and radiation can compromise the patient's immunity. The new stem cells are used to replace weak and inefficient marrow cells. Marrow cell implantation is also used as a targeted treatment as they help kill the cancer cells directly or indirectly.

What Are the Conditions in Which Marrow Cell Implantation Is Used?

The conditions in which marrow cell implantation is used for treatment include various tumors and anemic conditions, and they are:

• Aplastic Anemia - A rare medical condition characterized by the inability of the bone marrow to produce red blood cells.

• Acute Leukemia - It is a type of cancer of the blood and bone marrow.

• Chronic Leukemia - A type of cancer involving the blood and bone marrow.

• Hodgkin's Lymphoma - A type of cancer affecting the lymphatic system.

• Non-Hodgkin's Lymphoma - A type of cancer affecting the lymphatic system.

• Immune deficiencies like AIDS (acquired immunodeficiency syndrome).

• Neuroblastoma - Cancer of the immature nerve cells

• Multiple Myeloma - Cancer of the plasma cell.

• Metabolic disorders by birth.

What Are the Complications of Marrow Cell Implantation?

Marrow cell implantation is technique sensitive and requires a skilled team of surgeons. The complications involved during marrow cell implantation are carefully monitored to prevent graft rejection. Some of the complications in marrow cell implantation are:

• Graft rejection: It is essential to find the exact match for the graft as the patient's body might sometimes reject the newly placed cells, called graft-versus-host-disease. This causes serious adverse effects, including joint pain, soreness, shortness of breath, rashes, scarring under the graft, diarrhea, nausea, and vomiting.

• Anemia: Reduced number of blood cells may cause iron deficiency anemia.

• Tiredness.

• Sickness.

• Hair loss.

• Infertility.

What Are the Benefits of Marrow Cell Implantation?

Following are some benefits of marrow cell implantation.

• It is used as a safety measure while undergoing intensive chemotherapy.

• Aids in wound healing.

• Provides nourishment for the body.

• Strengthens against weakness.

• Helps in better recovery and treatment outcomes.

What Are the Disadvantages of Marrow Cell Implantation?

The disadvantages of marrow cell implantation are:

• Technique sensitive and needs a skilled team.

• Requirement of a large isolated working field.

• Expensive.

• The procedure can be discomforting and painful for both the donor and the receiver and requires a recovery period.

Conclusion

Marrow cell implantation is a procedure where we infuse new marrow cells into the bloodstream to provide a viable source of nutrients and an enriched field for new cell growth and development. Marrow cell implantation has been a recurring technique since the second world war and has been widely accepted around the globe for more than two decades. Although the procedure is technique sensitive, needs a skilled team, and is cost-effective, the recovery rate and success of the treatment are very well established with a successful prognosis. They have become a preferred treatment method for various systemic conditions like anemia, tumors, and cancers.