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What Is a Bone Marrow Transplant?
Replaces unhealthy cells with healthy ones
Mary Kugler, MSN, RN,BC
Guide to Rare/Orphan Diseases
What is a bone marrow transplant?
A bone marrow transplant is when special cells (called stem cells) that are normally found in the bone marrow are taken out, filtered, and given back either to the same person or to another person.
Why is it done?
Bone marrow produces stem cells. These stem cells develop into the body's blood cells. Bone marrow is a critical part of the body because it is the body's main blood cell "factory." If something is wrong with the marrow a person can become very ill, even die.
In diseases such as leukemia and aplastic anemia, the bone marrow is unhealthy. The purpose of a bone marrow transplant is to put healthy marrow cells in place of the unhealthy ones. This can treat or even cure the disease.
Whom do the stem cells come from?
Autologous bone marrow transplant - The donor is the person him/herself.
Allogeneic bone marrow transplant - The donor is another person whose tissue has the same genetic type as the person needing the transplant (recipient). If no one in the recipient's family has the same tissue type, then the national bone marrow registries' databases are checked for a tissue type match. The chances of a minority person in the United States finding a registry match is lower than that of a white person (see article, Minority Marrow Matches Fewer).
Sources of bone marrow stem cells
Bone marrow harvest: Collecting stem cells by taking them directly out of the bone.
Apheresis: Collecting stem cells by filtering the blood.
Umbilical cord blood: Stem cells are filtered from blood in the umbilical cord after a baby is born.
What the donor experiences
If stem cells are collected by bone marrow harvest, the donor will go to the operating room and while asleep under anesthesia, a needle will be inserted into either the hip or the breastbone to take out some bone marrow. After awakening, he/she may feel some pain where the needle was inserted.
If stem cells are collected by apheresis, the donor is connected to a machine by a needle inserted in the vein (like for blood donation). Blood is taken from the vein, filtered by the machine to collect stem cells, then returned back to the donor through a needle in the other arm.
What the recipient experiences
Bone marrow transplant is a difficult procedure to go through. Usually the person receives high doses of chemotherapy and/or radiation to eliminate whatever bone marrow he/she has left and make room for the new marrow transplant. Once this is done, the new stem cells are put into the person intravenously, like a blood transfusion. The stem cells will then find their way to the bone and start to grow and produce more cells (called engraftment).
Serious problems can occur during the time that the bone marrow is gone or very low. Infections are common, as is anemia, and low platelets in the blood can cause dangerous bleeding internally. Recipients often receive blood transfusions to treat these problems while they are waiting for the new stem cells to start growing.
Are you willing?
If you'd like to become a volunteer donor, the process is straightforward and simple. Anyone between the ages of 18 and 60 and in good health can become a donor. There is a form to fill out and a blood sample to give; you can find all the information you need at the NMDP Web site. You can join a donor drive in your area or go to a local Donor Center to have the blood test done.
rarediseases.about.com/library/weekly/aa081002a.htm
Hikers with a purpose
Mother-daughter pair crossing nation to battle disease
By Yvonne Corral, Rocky Mountain News
July 13, 2006 - In five months, Robin Grapa and her mother have worn out 12 pairs of hiking boots between them.
On Feb. 4, the mother-daughter team embarked on a 5,000-mile journey across the country - from Delaware to California - to bring awareness to aplastic anemia, a deadly bone marrow disease that Grapa was diagnosed with in 1997.
"Our feet hurt, but it's not even close to what pain the (people diagnosed with this disease) are in," Grapa, a graphic designer from Wisconsin, said in a telephone interview.
Despite the pain, Grapa, 26, and her mother, Patty Laatsch, 48, who are now in Denver, plan to continue walking - and wear out a few more pairs of hiking boots.
So far, they've hiked through Delaware, Maryland, the District of Columbia, West Virginia, Ohio, Indiana, Illinois, Missouri, Kansas and eastern Colorado.
By the time they complete their journey, over what is known as the American Discovery Trail, they will have crossed 12 states on foot, with 35 pounds of gear on their back.
They expect to reach their destination - Point Reyes National Seashore north of San Francisco - by October.
If they finish, Grapa and Laatsch are believed to be the first mother-daughter team to conquer the American Discovery Trail, according to the Aplastic Anemia & MDS International Foundation.
The idea for the hike started when Grapa and her husband, Adam, started talking about having children.
Grapa said she got "a little freaked out" and began to evaluate where she was headed in life. She remembered the joy she experienced in the outdoors when she went on a three-day hike in high school.
Then one day, her husband joked about walking to Hollywood.
"And before I knew it, I found the American Discovery Trail (online)," Grapa wrote on www.ourhike.com, a Web site devoted to the mother-daughter duo. "I thought it would be cool to just go for it all and hike one of the biggest trails out there."
Grapa, who learned she had aplastic anemia as a sophomore at the University of Wisconsin, said she thought the hike would be a "perfect opportunity to spread the word" about bone marrow diseases.
"I'm known to have big ideas," said Grapa.
No matter how rough the hike gets, Grapa, who is now in remission, said she and her mother are determined to reach the West Coast.
"(My health) is really good right now. I feel great. I've never felt better or been in better shape," she said. "My mom feels the same way, too. Walking is a great exercise."
The pair hope to raise $1 million during their walk to pay for research to fight bone marrow diseases.
For more information or to make a donation, go to www.ourhike.com.
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