A bone marrow transplant is a medical treatment that replaces bone marrow with healthy cells. Also known as a stem cell transplant, this process is used to treat a specific type of disease of the bone marrow. Similar to any cancer treatment, it has certain late complications as well. However, these complications depend largely on the transplant type, age, health, and other related factors. Although a few complications might not be seen until several months or years, some of them are resolved with time, and some need long-term attention. So, in this post, we will talk about the late complications after a bone marrow transplant.
What is Bone Marrow?
Almost every bone in the human body has many blood vessels present in the soft, spongy tissue. That soft and spongy tissue is bone marrow. In fact, there are two types of bone marrow. One is Yellow, and the other is red. Yellow bone marrow is made from fat and contains stem cells. On the other hand, the Redbone marrow has blood stem cells that become platelets, white blood cells, and red blood cells.
Types of Bone Marrow Transplant
So, basically, there are three types of bone marrow transplants. Moreover, each one is different from the other and comes with post complications.
- Autologous Bone Marrow Transplant
- Allogeneic Bone Marrow Transplant, and
- Umbilical Bone Marrow Transplant
Let’s have a look at these transplants and the complications related to them.
Before receiving high radiation therapy or chemotherapy doses, the doctor removes the stem cells. Then they store these cells in a freezer. After the radiation and chemotherapy, the stem cells are put back in the body to produce normal blood cells. This process is also called a rescue transplant.
Late Complications of Autologous BMT-
The most serious risks associated with autologous stem cell transplants include:
- Graft failure
- Second cancer
- Hepatic Veno-occlusive disease (VOD)
Allogeneic Bone Marrow Transplant
Allo refers to others. In this transplant, the surgeon removes the stem cells from the donor. Moreover, the donor’s genes should at least match partly to the recipient genes. The doctor performs some tests to see if the donor is compatible. Basically, a good match can be a sibling, children, parents, or relatives. Unrelated donors who match the recipient can be found at National Bone Marrow Registries.
Late Complications of Allogeneic Bone Marrow Transplant
The most common late complications of Allogeneic BMT include:
- Chronic Graft Versus Host Disease
- Secondary Tumor
- bronchiolitis obliterans
- Cardiovascular disease
- Avascular necrosis
- Prevalence of azoospermia
- Acute GVHD
Umbilical Cord BMT
This is a type of allogenic treatment in which a doctor removes stem cells from a newborn baby’s umbilical cord. Furthermore, the doctor then froze the stem cells and stored them until they were required for transplant. Also as the Umbilical cord blood cells are immature, so precise matching is hardly needed.
Late Complications of Umbilical Cord BMT
- Viral infections
- Bacterial Infections
- Fungal infections
- HHV-6 reactivation
Although the late complications after bone marrow transplant vary, cancer patients may experience
- Organ damage
- Secondary cancers
- Relapse cancer
- Lymph tissue abnormal growth
- Hormonal changes
The medication used in transplants can damage their body organs like kidneys, liver, bones/joints, nervous system, and heart. Therefore, it is vital to have a careful follow-up with treatment and close monitoring of the long-term organ issues. Also, it is crucial to discuss infertility before the transplant so you can easily prepare for them.
In fact, most people with stem cell transplant become infertile. This is due to a high dose of radiation or/and chemotherapy. So, this treatment affects both abnormal and normal cells that damage the reproductive organs.
Factors contributing to the Complications
Radiation therapy, Chemotherapy, and other agents used in transplantation can cause many complications. Moreover, the symptoms of each person vary differently. Therefore, it is important to understand that bone marrow transplant complications depend on numerous factors such as:
- Remission status and underlying disease
- Transplant Type
- Overall health
- Other medical conditions
- Conditioning Regimen
- Donor characteristics
Make sure to Discuss the Late Complication with the Transplant Team.
So, regardless of which transplant you may have, it is essential to discuss the side effects and complications of the transplant beforehand. In fact, during your initial consultation with the doctor or transplant team, make sure to ask every detail related to the bone marrow transplant cost in India, including the pros and cons. Moreover, this will prepare you for the consequences and the outcomes.
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