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Stem Cell Therapy Answers – Bone Marrow Stem Cell Transplant

Excerpt: Adult stem cells may be harvested from various tissue in your body. Bone marrow has proven to be a good location to find healthy pluripotent adult stem cells. Fat tissue is also used. This article discusses bone marrow adult stem cell therapy.

faq Stem Cell Therapy Answers   Bone Marrow Stem Cell Transplant – Bone Marrow Stem Cell Transplant Therapy

Q: What is bone marrow and what are stem cells?

educat1 Stem Cell Therapy Answers   Bone Marrow Stem Cell Transplant

Bone marrow is the soft, sponge-like material found in the bones.  Its main function is to produce primitive or immature cells called stem cells (also called “progenitor cells”).  These cells have the ability to divide into more stem cells or into white blood cells (WBCs), red blood cells (RBCs), and platelets, depending upon the body’s needs at that moment.

White blood cells (also called “leukocytes”) help the body defend itself against infection and other disease, by destroying “foreign” substances such as bacteria or viruses.  When infection is present, the body increases the production of the WBC.  When the number of WBC in the blood is low, the body has a more difficult time warding off infection.

Red blood cells (also called “erythrocytes”) carry oxygen, with the aid of a protein called hemoglobin, from the lungs to cells in all parts of the body.  Oxygen helps process the nutrients from the food that we eat. RBCs also carry back carbon dioxide (considered “waste material”) from the cells to the lungs.  When the number of RBC in the blood is low, a condition called anemia results.

Platelets help the blood to clot and thus, preventing bleeding.   Low number of platelets in the blood (a condition called thrombocytopenia) may cause easy bruising and bleeding.

In adults, stem cells can be found mostly in marrows of the bones of the skull, back, chest, hips and upper arms and legs.  In children, they can be found throughout most of the marrows.  Stem cells, however, can also be found circulating in the blood throughout the body and are called peripheral blood stem cells.

Q: How are bone marrow and stem cells obtained for the transplant?

Bone marrow and stem cells can be obtained or “harvested” from the patient (autologous) or from another individual (allogeneic), but are always collected before very high doses of anti-cancer drugs (chemotherapy) and/or high energy rays (radiotherapy) are administered.

Bone marrow is usually taken from the hip bones (pelvis) using a large needle or a special syringe inserted several times into the pelvic bone through small incisions to draw out the marrow. The “harvested” marrow is then processed to remove blood and bone fragments. This process of obtaining stem cells is also called aspiration, which may require local or general anesthesia, and is usually done in the operating room.  It may require the patient to stay in the hospital for 1-2 nights, but some hospitals can perform a bone marrow harvest as an outpatient.  The site of the needle puncture will be tender for about a week with slight scars forming.   The patient or donor may feel some mild stiffness and soreness but can be lessened through exercise and pain medication.

A newer method of collecting or harvesting stem cells is called apheresis or leukapheresis.  Blood is obtained through a line (central venous catheter) inserted into a large vein and passed through a machine that removes stem cells.   The rest of the blood is returned to the patient.  The process may take 2 to 4 hours, and usually does not require staying in the hospital overnight.  There are fewer stem cells circulating in the blood when compared to those found in the marrow.   Transplant physicians are therefore looking into ways to increase the number of stem cells that can be harvested. By giving the patient “growth factors” (substances that are naturally produced by the body but can also be made in laboratories), the transplant physicians help stimulate the body to make more stem cells.  Since only a small amount of marrow or stem cells are removed, the procedure seldom poses significant problems or results in bad side effects.

Q: How are stem cells used for the transplant?

Once the stem cells are obtained, the marrow or stem cells are either preserved and frozen until needed (in an autologous transplant) or are given to the recipient almost immediately (in an allogeneic transplant).

The patient is then given very high doses of anti-cancer drugs and/or radiation (called “conditioning”) to get rid of the cancer cells throughout the body; to make space for the new marrow and; in an allogeneic transplant, to reduce the risk of the patient rejecting the cells or marrow taken from another person.  The bone marrow or stem cells that were previously collected are given to the patient through a central venous catheter to help re-grow normal blood cells and reduce the chance of severe infection, bleeding, or anemia.

Q: Is there any evidence of success for stem cell/bone marrow transplant?

As improvements are being made in the way the procedure is done, stem cell/bone marrow transplantation is becoming more commonly accepted and effectively used in treating many cancers and leukemias.  Researchers are finding better results in the use of stem cell/bone marrow transplant in patients with breast cancer, Hodgkin’s disease, non-Hodgkin’s lymphoma, leukemia, multiple myeloma, neuroblastoma and testicular cancer.

Reference:

Dr Maharaj, MD, FACP – South Florida Bone Marrow Stem Cell Transplant Institute

About Dr. Maharaj:

An Education dedicated to excellence.”I chose to study Hematology/Oncology to make a real difference in the quality of cancer care and to help change people’s lives for the better. My education helped shape me as a doctor and as a person. But for me, learning never ends. My patients are far too important.”

MB, ChB: University of Glasgow Medical School, Glasgow, Scotland (medical degree)
MD: University of Glasgow Medical School, Glasgow, Scotland (research doctorate)
Internship: Medicine and Surgery, University of Glasgow Medical School Western Infirmary, Royal Infirmary, Glasgow, Scotland
Residency: Internal Medicine, University of Glasgow Medical School Royal Infirmary, Glasgow, Scotland
Fellowship: Hematology, Oncology, Bone Marrow Transplantation, University of Glasgow Medical School Royal Infirmary, Senior Registrar and Lecturer/Instructor in Medicine, Glasgow, Scotland

Advanced certifications

“Earning advanced degrees and certifications is one way I express my dedication to my patients. My expertise, knowledge and skill become their ammunition in the battle with cancer”

Fellow:

  • Royal College of Physicians, Edinburgh, Scotland.
  • Royal College of Physicians, Glasgow, Scotland.
  • Royal College of Pathologists of the United Kingdom.
  • American College of Physicians.

Certified:

  • Internal Medicine, Royal College of Physicians of the United Kingdom.

Accredited:

  • Hematology with specialization in oncology and bone marrow transplantation, Joint committee on higher Medical Training, Royal Colleges of the United Kingdom.

Teaching Appointments”Whether through seminars or in university classrooms, teaching helps me reach out to my profession and students of hematology and oncology. Its exciting to share this information with the world”

Previous Lecturer:

  • Internal Medicine, Hematology, Bone marrow transplantation, University of Glasgow Medical School Glasgow, Scotland.
  • University of Newcastle on Tyne, Newcastle, England.
  • University of Miami, School of Medicine, Miami FL.
  • Nove Southeastern University School of Health Professions, FT Lauderdale.

Current Lecturer for Continuing Medical Education Seminars:

  • Topics in bone marrow transplantation presented at numerous universities and medical centers.

Professor: Charles E Schmidt College of Biomedical Science, Florida Atlantic University.Professional Memberships

“Professional memberships are an ideal way for me to stay in contact with my colleagues and exchange valuable information”

Member:

  • American Medical Association
  • American Society of Clinical Oncology
  • American Society of Hematology
  • International Bone Maroow Transplant Registry and transplantation
  • American Society of Internal Medicine.

A noted lecturer and innovator

“I want to be more than a doctor or caregiver; I want to contribute to the advancement of cancer therapies”

Previous National presentations:

  • Florida Atlantic University – Frontiers in Science
  • American Society for Blood Cell Transplantation
  • American Society of Hematology
  • American Society of Clinical Oncology

Previous International Presentations:

  • International Society for Hematology and Graft Engineering
  • International Blood Cell Transplantation Symposium
  • Scientific Meeting of the British Society for Hematology, Cambridge, England
  • British Society for Hematology and the Netherlands Society for Hematology, Antwerp, Belgium.

We have achieved excellent results with our program. The “day 100″ post-transplant mortality rate and patient success rate of being alive and disease free match or exceed those of nationally known transplant centers. The incidence of infections in our program is significantly lower than at inpatient transplant centers. That says a lot about trusted, quality care that you can feel good about.

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