What is a Bone Marrow Transplant?
Bone marrow transplant or stem cell transplant (Bone Marrow Transplant : BMT) is a treatment process that uses stem cells or progenitor cells from bone marrow or blood to replace abnormal or destroyed blood progenitor cells caused by disease or treatment with drugs and radiation. These stem cells help produce new red blood cells, white blood cells, and platelets, restoring the blood and immune systems to normal function.
What is Bone Marrow?
Bone marrow (Bone Marrow) is the tissue inside the bone cavity that plays an important role in producing blood cells, including
- Red blood cells that help transport oxygen
- White blood cells that help fight infections
- Platelets that help with blood clotting
The proper functioning of bone marrow is therefore essential to the blood and immune systems of the body.
What are Stem Cells or Progenitor Cells?
Stem cells (Stem Cells) are progenitor cells that can develop into various types of cells, especially hematopoietic stem cells which can produce new red blood cells, white blood cells, and platelets to replace worn-out cells.
Diseases that can be treated with Bone Marrow Transplant as an option
Diseases or conditions that can be treated with bone marrow or stem cell transplant (Bone Marrow Transplant / Stem Cell Transplant) as a treatment option are those related to the blood system, bone marrow, and immune system. Doctors will carefully evaluate and consider the suitability of treatment on a case-by-case basis, with decisions depending on the discretion of the specialist physician in each case.
The groups of diseases commonly treated with bone marrow transplant are as follows
1. Blood Cancers
- Acute leukemia (Acute Leukemia: AML, ALL)
- Chronic leukemia (Chronic Leukemia: CML, CLL)
- Lymphoma (Lymphoma: Hodgkin / Non-Hodgkin)
- Multiple myeloma (Multiple Myeloma)
2. Bone Marrow Failure Disorders
- Aplastic anemia
- Myelodysplastic syndrome (MDS)
- Myeloproliferative disorders
3. Genetic Disorders
- Thalassemia
- Sickle cell disease
- Certain metabolic disorders such as Hurler’s syndrome
4. Immune Deficiency Disorders
- Severe Combined Immunodeficiency (SCID)
- Other severe immune deficiency conditions
Types of Bone Marrow or Stem Cell Transplants
Bone marrow or stem cell transplant (Bone Marrow / Stem Cell Transplant) is an important treatment approach for blood diseases and some genetic disorders. The goal is to replace the function of abnormal bone marrow or restore the blood and immune systems to near normal. This treatment has several forms, which can be divided as follows
Transplant Types Based on Stem Cell Source
1. Autologous Stem Cell Transplant
This involves using the patient’s own stem cells that were collected and stored in advance. The patient then undergoes chemotherapy or radiation to eliminate abnormal cells, followed by reinfusion of the stored stem cells back into the body.
- Advantages include reduced risk of graft rejection (Graft versus Host Disease: GVHD) because the cells come from the patient’s own body.
- Commonly used for lymphoma, multiple myeloma, and some types of blood cancers.
2. Allogeneic Stem Cell Transplant
This involves using stem cells from another person who is genetically compatible (HLA matching), such as siblings, family members, or unrelated donors with genetic compatibility.
- Advantages include the new stem cells helping to restore the blood system and potentially eliminating remaining cancer cells.
- Precautions include the risk of GVHD, requiring immunosuppressive drugs.
- Commonly used for leukemia, thalassemia, aplastic anemia, and some genetic disorders.
Transplant Types Based on Stem Cell Storage Source
Besides classification by donor, transplants can also be classified by the source of stem cell collection, including
- From bone marrow collected by puncturing the bone to extract stem cells
- From peripheral blood stem cells (PBSCs) collected using a machine to separate stem cells from circulating blood
- From umbilical cord blood collected from the umbilical cord and placenta after birth
Steps of Bone Marrow or Stem Cell Transplant
Bone marrow or stem cell transplant (Bone Marrow / Stem Cell Transplant) is a complex process requiring close care from a specialized medical team. Generally, it can be divided into 4 main steps as follows
1. Patient Preparation (Conditioning)
Before transplant, the patient undergoes a detailed health evaluation, including blood tests, assessment of vital organ function, and donor compatibility testing (in the case of Allogeneic)
- The patient receives chemotherapy or radiation to eliminate abnormal bone marrow cells and reduce the risk of rejecting the new stem cells.
- This preparation also helps prevent cancer cells from regrowing.
2. Stem Cell Collection from Patient or Donor
Stem cells can be collected from various sources, including
- From bone marrow collected by puncturing the pelvic bone
- From peripheral blood stem cells collected using a cell separator machine
- From umbilical cord blood collected after childbirth (in some cases)
3. Stem Cell Transplantation
The collected stem cells are infused into the patient’s body through a vein similar to a blood transfusion. These stem cells travel to the bone marrow and begin producing new blood cells.
4. Engraftment & Recovery
- After transplant, the patient must stay in a clean, sterile environment.
- The body begins to regenerate new blood cells within 2–4 weeks.
- The medical team continuously monitors blood function, immunity, and organ function.
- Patients may receive infection prevention medication and immunosuppressants if stem cells are from another person.
Possible Complications
- Increased risk of infection due to weakened immunity
- Graft-versus-Host Disease (GVHD) in cases of transplant from another person
- Side effects from chemotherapy such as nausea, hair loss, and fatigue
- Organ dysfunction such as liver or kidney problems
Doctors will closely monitor symptoms and provide treatment to reduce these risks.
Post-Transplant Care
- Take medications exactly as prescribed by the doctor
- Avoid crowded places or environments with high infection risk
- Eat cooked and clean food
- Engage in light exercise to help recovery when permitted by the doctor
- Attend regular follow-up health check-ups
Comprehensive Care at the Bone Marrow Transplant Center, Phyathai Hospital 2
For those seeking evaluation or treatment with bone marrow transplant, services are available at the Bone Marrow Transplant Center, Phyathai Hospital 2, which provides holistic care from diagnosis, treatment planning, to continuous follow-up.
Patients receive care from
- A specialized team of pediatric hematology and oncology doctors with experience in bone marrow and stem cell transplantation
- A multidisciplinary team including nurses, pharmacists, and trained staff
- Close care in a warm, family-like atmosphere
With strict and continuous treatment and follow-up standards, Phyathai Hospital 2 has a high 1-year survival rate after bone marrow transplant compared to international standards, giving patients and families hope and improved quality of life.
Assoc. Prof. Dr. Usnaras Anurathaphan
Pediatric Hematology and Oncology Specialist
Phyathai Hospital 2
