Bone marrow transplantation, or BBMT, is, by many, thought to be a marvel of modern medicine. A marvel, of course it is, the procedure of transplanting bone marrow for cancer sufferers has saved countless lives across the world. But, maybe not as modern as people might think.
In the Journal of the American Medical Association of 1896, W.M.E. Quine explored the use of extracting, and transplanting bone marrow from healthy donors as a potential cure for cancer sufferers. It was in New York in 1956 when Nobel Prize winner, Dr. Edward Donall, performed the first successful bone marrow transplant, performing the procedure on identical twins, one of which had leukemia.
Dr. Edward Donall’s work throughout the 1950s and through to the 1970s has led to BMT being a standard treatment for numerous blood diseases. Today, patients with both malignant and non-malignant diseases benefit from what may otherwise be a fatal condition.
Many serious conditions are now routinely reversed by means of BMT, however, there are still challenges to be faced with bone marrow transplants. Almost half of all BMT patients experience graft-versus-host disease complications, challenging the expertise of the skilled medical teams. Additionally, in some patients, BMT results in just a short-term cure.
It is through the development and progression of BMT that has led to Samitivej Hospital opening its dedicated BMT unit. This specialist center is at Samitivej Hospital’s Srinakarin campus. This state-of-the-art facility started treating patients in September 2004 and is now a globally recognized center of excellence for procedural bone marrow transplants.
As with all of Samitivej Hospital’s specialist centers, it is a modern, state-of-the-art facility. The center is known to operate at the highest levels of professionalism, hygiene, and patient care. The center is staffed by highly qualified doctors and nurses, each one specialized in their areas of medicine. These individuals come together as a synchronized, multi-skilled team of professionals that are unequalled in the field bone marrow transplants.
Explaining BMT
In short, bone marrow transplantation is the replacement of abnormal stem cells in the bone marrow with healthy ones from suitable donor marrow. The donated marrow may come from the patient or from a separate donor. Following a successful transplant, healthy red and white blood cells will develop, along with platelets and other healthy tissues.
The end goal is to aid the patient’s body in building a new, stronger immune system. The treatment is also used as a cure for numerous diseases and cancers. Patients also benefit from BMT following therapy that required high doses of radiation by restoring the normal functions expected from the bone marrow.
The exact type of BMT that will be undertaken on a patient varies from whence the donor marrow is sourced. Autologous BMT is where healthy stem cells are harvested from the transplant patient. Allogeneic BMT uses stem cells from another person, the donor can be related or unrelated. Where one of a pair of identical twins requires bone marrow and is donated from the other healthy twin, this is known as Syngeneic BMT.
Samitivej Hospital BMT Procedure
Prior to undertaking BMT it is essential for the center to conduct a number of procedural tests to ascertain the patient’s general level of health, and as preparation for the transplant procedure. As part of the preparation procedure, a long narrow tube is implanted into a large vein in the patient’s neck or chest, this is known as the central line. Thorough preparation for BMT is vital and can take several days.
Prior to the patient receiving the transplanted stem cells, the donor must also undergo procedural treatment. Firstly, 5 days prior to the donation the donor will be given filgrastim, via injections, which will increase the number blood-forming cells in the bloodstream.
Following the course of filgrastim injections, the donor will have blood removed from an arm. This blood will be passed through a machine which separates the vital blood-forming cells from the remainder of the blood, which is then returned to the donor via their other arm.
The donor will undergo a minor surgical procedure to extract the one marrow. Lying face down, hollow needles are inserted through very small incisions in the skin and into the pelvic bones, it is from here that the marrow is taken. The marrow is then filtered, stored in a special solution, and frozen. The procedure is minimally invasive and lasts up to 2 hours.
At the required time, the marrow will be allowed to thaw, once thawed the marrow will be infused into the patient’s bloodstream through the central line already inserted in the patient’s vein. The entire procedure is painless, and the patient will remain awake throughout.
As part of the center’s standard BMT practice they undertake to minimize the risk of graft versus patient disease, commonly referred to as GvHD. They do this using a painless, non-invasive procedure called photopheresis. This procedure has been specifically developed to stimulate the body’s immune response reaction and increase its ability to fight the progression GvHD. Combating GvHD has increased the center’s success rate of BMT, with a one-year survival post BMT rate of 96%.
BMT Treatable Diseases
Ordinarily people associate bone marrow transplants as a treatment for cancer, and there are many cancers that are treatable with BMT. Lymphomas, germ cell ovarian cancer, multiple myeloma, leukemias and some solid-tumor cancers are routinely treated at the center.
However, non-cancerous conditions are also a part of the BMT program at Bone Marrow and Stem Cell Transplantation Center in Bangkok. These may include severe aplastic anemia, immune deficiency disorders, inborn errors of metabolism, and sickle cell anemia.
There are also many less familiar health conditions treatable at the center with BMT. Some of these are essential thrombocytosis, Diamond-Blackfan anemia, Fanconi anemia, medulloblastoma, neuroblastoma and myelofibrosis, along with testicular and ovarian cancers.
Since 2004 The Bone Marrow and Stem Cell Transplantation Center in Bangkok has been treating patient from within the kingdom, and with increasing numbers of foreign visitors due to its exemplary standards and ever-increasing rates of success in treating serious diseases.
