Introduction received a bone marrow transplant because the

Introduction

A stem cell transplant is a treatment
for some types of cancer. For example in the case if person might have
leukemia, multiple myeloma, or some types of lymphoma. It also treat some blood
diseases with stem cell transplants. During those day, patients who needed a
stem cell transplant received a bone marrow transplant because the stem cells
were collected from the bone marrow but today stem cells are usually collected
from the blood instead of the bone marrow. This is reason why now more commonly
called as stem cell transplants. Stem cell
transplants are used to replace bone marrow that has been destroyed by cancer
or destroyed by the chemo or radiation that is used to
treat the cancer and cancers, such as certain leukemias, multiple myeloma, and some
lymphomas. Stem cell transplant can be an important part of treatment. High
doses of chemo sometime work better than standard doses to kill cancer cells.
But when high doses are use than it can also kill all the stem cells and cause
the bone marrow to completely stop making blood cells in which need to live.
The transplanted stem cells replace the body stem cells after the bone marrow
and its stem cells have been destroyed by treatment. Transplant lets doctors
use much higher doses of chemo to try to kill all of the cancer cells. Blood
cells in body start out as young or is immature cells called hematopoietic stem cells. Even though
they called stem cells but
they are not the same as the embryo stem cells that are studied in cloning and
other types of research. Stem cells mostly live in the bone marrow at the
spongy center of certain bone and this is where they divide to make new blood
cells. Once blood cells mature, they leave the bone marrow and enter the
bloodstream. A small number of stem cells also get into the bloodstream and these
are called peripheral blood stem
cells. Stem cell transplants are used to give back stem cells when the
bone marrow has been destroyed by disease chemotherapy or radiation.

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History

First human bone marrow transfusion
was given to a patient with aplastic anemia in 1939. This patient received
daily blood transfusions and attempt to raise her leukocyte and platelet
counts. It was made using intravenous injection of bone marrow. After World War
II and the use of the atomic bomb, researchers tried to find ways to restore
the bone marrow function in aplasia caused by radiation exposure and in the
1950s, it was proven in a mouse model that marrow aplasia secondary to
radiation can be overcome by syngeneic marrow graft. In 1956, Barnes and
colleagues published their experiment on two groups of mice with acute leukemia
and both groups were irradiated as anti leukemic therapy and both were salvaged
from marrow aplasia by bone marrow transplantation. The first group received a
syngeneic marrow ( from mice of the same strain ) however, most of the mice
died from leukemia relapse. The second group received an allogeneic marrow from
a different strain and none of the mice in this group experienced disease
relapse. Another breakthrough took place with the
first transplantation done from an HLA matched unrelated donor. Hematopoietic
stem cell transplantation from an unrelated donor dramatically increased the
odds for finding a match. For example, it rose from 25% to 75% for Caucasian
patient. International collaboration was mandatory for the establishment of
transplantation centers around the world and for a global donor registry. In
1972 the International Bone Marrow Transplant Registry ( IBMTR ) was established
for documenting HSCT outcome data and by that time, transplantations were done
in 12 centers performing about 50 procedures a year altogether. In 1974, the
European Group for Blood and Marrow Transplantation ( EBMT ) was established
for European collaboration in the field of HSCT. The first unrelated donor
transplantation inspired in 1986 the foundation of the National Marrow Donor
Program ( NMDP ), and in 1988 Bone Marrow Donors Worldwide ( BMDW ) was
founded, this organization unifies more than 23 million donors registered in 73
countries and 600,000 cord blood units from cord blood banks in 32 countries

Discussion

Stem cells make the
3 main types of blood cells. Red blood cells, white blood cells, and platelets
and we need all of these types of blood cells to keep us alive. For these blood
cells to do their jobs, need to have enough of each type in blood. Red blood cells ( RBC ) carry
oxygen away from the lungs to all of the cells in the body and they bring
carbon dioxide from the cells back to the lungs to be exhaled. A blood test
called a hematocrit show
how much of blood is made up of RBC. The normal range is about 35% to 50% for
adults. People that have hematocrit below this level have anemia ( Low level of RBC ). This can
make them look pale and feel tired, short of breath, and weak. White blood cells ( WBC ) help
fight infections caused by fungi, viruses and bacteria. There are different
type of WBC that is neutrophils are
the most important type in fighting bacterial infections. Absolute neutrophil
count(ANC) is a measure of the neutrophils in blood. When ANC drops below 1,000
per cubic millimeter (1,000/mm3) means patient might have neutropenia, and have a higher risk
of infection. The danger is greatest when levels are below 500/mm3. Next is lymphocytes are another type of
white blood cell. There are different kinds of lymphocytes, such as T
lymphocytes, B lymphocytes, and natural killer cells. Some lymphocytes make
antibodies to help fight infections and the body depends on lymphocytes to
recognize its own cells and reject cells that are foreign to the body. Example
are invading germs or cells that are transplanted from someone else. Platelets are pieces of cells
that seal damaged blood vessels and help blood to clot, both of which are
important in stopping bleeding. A normal platelet count is between 150,000/cubic
mm and 450,000/cubic mm. A person whose platelet count drop below normal is
said to have thrombocytopenia,
and may bleed longer, bruise more easily, and have bleeding gum or nosebleed.
Spontaneous bleeding ( bleeding with no known injury ) can happen when a person
platelet count drops lower than 20,000/mm3. Can be seen in
hemorrhagic dengue fever. This are dangerous if bleeding occurs in the brain or
if blood begins to leak into the intestine or stomach.

Source

There
are two major sources of stem cells. The type that gets
into all forms of media daily are embryonic stem cells which are over
hyped and  are never used clinically
because illegal. The legal, moral and ethically correct type of stem cells are
bone marrow derived stem cells and umbilical cord stem cells that almost never
receive any publicity. All forms of stem cells are essentially very similar and
differ only in fairly minor ways. Adult Stem Cells have been found in nearly
every tissue in the body. In addition, umbilical cord stem cells are
categorized as adult stem cells because they have grown beyond the embryonic
stage and adult stem cells in fact have been used in transplants for over 30
years

Storage,collection and
processing

blood stem cells can be moved or mobilized out of
the bone marrow into the bloodstream ( peripheral blood ) where they can be
easily collected. Most transplants these days use stem cells collected from the
bloodstream. Receive injections of a drug such as filgrastim or plerixifor over
a four to five day period. These drugs move stem cells out of the bone marrow
into the bloodstream. Most people tolerate these drugs well although mild flu
like symptoms are common. Symptoms end a few days after the injections stop. If
collecting stem cell for own transplant, chemotherapy drugs may be used to help
move the stem cells out of  bone marrow
into the bloodstream. Procedure
used to collect bone marrow for transplant is called a bone marrow harvest. It
is a surgical procedure that takes place in a hospital operating room and
typically done as an outpatient procedure because only takes 30 minutes to be
done.
While under anesthesia, a needle will be inserted
into rear pelvic bone where a large quantity of bone marrow is
located. The bone marrow will be extracted with a syringe,
several skin and bone punctures are required to
extract sufficient bone marrow for transplant. There are no surgical incisions involved and only
skin punctures where the needle was inserted. A sterile bandage will be applied to the site when
the collection end.

Risk

 After the surgery might feel tired or weak and
have trouble walking for a few days. The area where the bone marrow was taken
out might feel sore for a few days but doctor will ask patient to take a pain
reliever for the discomfort. Normal cases, likely be able to get back to normal
routine within a couple of days but it may take a couple of weeks before feel
fully recovered. Because of newer modern technologies and past experience, a
fatal risk are minimize.