BMT- Aplastic Anemia

Overview

Aplastic anemia is a severe form of bone marrow failure, which is treated with a bone marrow transplant. It is primarily a disease among young adults and children, but it can attack people of any age.

The bone marrow, also called stem cell, is a kind of spongy tissues found inside the bone that produce blood cells. There are three types of blood cells- red blood cells, white blood cells and platelets.

The blood cells play a special role in supplying oxygen and nourishment to the organs and tissues in the body. The old blood cells gradually get replaced by new blood cells that form in the bone marrow. However, in aplastic anemia, the bone marrow is unable to produce new cells, making the body susceptible to infection and bleeding.

Aplastic anemia can be inherited or acquired. In most cases, it is acquired which is linked to autoimmune disorders that attack the body’s immune system. Reasons for aplastic anemia has been pinned down on several environmental factors, including radiation, chemicals, viruses, drugs, etc.

In patients with aplastic anemia, the three types of blood cells are much lower in count than normal indicating specific symptoms like unexplained infections, fatigue, unexpected bleeding, etc. Other symptoms of aplastic anemia include headache, fever, recurring infections, flu-like symptoms, small red dots on the skin that indicate bleeding, shortness of breath, etc.

Aplastic anemia is a serious disorder that requires immediate medical attention. Diagnosis of aplastic anemia is done by examining blood cells of the bone marrow under the microscope and if the number of white blood cells, red blood cells and platelets are normal.

The treatment options for aplastic anemia depend upon the disease severity. A stem cell transplant (also called bone marrow transplant) is necessary for severe aplastic anemia patients, while there is no standard of care for patients with moderate aplastic anemia. Before going through a bone marrow transplant, these are the preparations to be taken:

Before the treatment

• You will have to fix appointments with your doctors several days before the procedure. A series of tests and physical examinations are done to assess your general health. This is to help determine the status of your health and whether you are physically prepared for the transplant. The evaluation process continues until the doctor approves of the BMT procedure for you.
• Specific blood tests for human deficiency disease, hepatitis virus and other infectious agents are carried out to test your physical condition.
• You are asked to visit the hospital in order to let your doctors inject chemotherapy or administer radio therapy to destroy the diseased stem cells affected by severe aplastic anemia. High doses of chemos and radiotherapy, or a combination of both helps to kill the non-functioning bone marrow cells before the transplant.

How it is performed

• The procedure is mostly performed on an outpatient basis. The patient is asked to lie down. An intravenous channel is created in the arm through which blood transfusion is given. Doctors collect healthy bone marrow cells from a matching donor, store and freeze them and use the same to inject it into the patient’s body.
• The donor’s stem cells travel through the blood stream into the bone marrow where they begin producing new blood cells that include red blood cells, white blood cells and platelets.
• After the bone marrow transplantation procedure, you are likely to be given IV fluids to help get rid of the preservatives that were used to protect the cells when they were stored. Not getting rid of the preservatives may develop signs of nausea, headache, shortness of breath, etc. It should, however, be noted that not everyone faces the side effects.
• The transplant infusion is absolutely painless and the patient stays awake during the procedure.

Recovery

After the bone marrow transplantation for aplastic anemia is complete, the new stem cells travel to the bone marrow and start multiplying and developing into new cells. This takes several weeks before the newly produced blood cells start to return to normal. You are kept under close observation after the transfusion procedure.

You will have to go through other blood tests and in case of any infections, you are required to stay in the hospital for treatment. Recovery from BMT aplastic anemia varies from person to person. Several factors like the severity of the side effects, physical condition of the patient before the transplant may impact your recovery time.