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Aplastic Anemia
Bone Marrow and Stem Cell Transplantation
Bone Marrow Transplantation
Bone marrow transplantation - replacing diseased bone marrow with healthy bone marrow from a donor - may offer the only successful treatment option for people with severe aplastic anemia. For young patients in relatively good health prior to transplant, and who have a matched donor, more than half are successfully cured by bone marrow transplantation.
If a donor is found, the diseased bone marrow in the person with aplastic anemia is first depleted with radiation or chemotherapy. Healthy bone marrow from the donor is extracted through a surgical technique. The healthy marrow is injected intravenously into the bloodstream of the person with aplastic anemia, where it migrates to the bone marrow and may begin generating new blood cells in about two to four weeks. The procedure requires a lengthy hospital stay. After the transplant, you'll receive drugs to help prevent rejection of the donated marrow.
If no suitable bone marrow donor is available, treatment of severe aplastic anemia is with immune-suppressing drugs. If you're a candidate for bone marrow transplantation, your doctor may limit the number of blood transfusions you have before the procedure because they can increase the risks of bone marrow transplantation.
Stem Cell Transplantation
Until recently, stem cell transplantation was referred to as bone marrow transplantation because marrow was the only source of the stem cells used to treat a patient's disease. Stem cells can now be obtained from marrow, umbilical cord blood, or from a donor's circulating blood.
After a donor is located and a transplant is arranged, the patient will receive high doses of chemotherapy and/or radiation therapy to wipe out his or her deficient marrow. The donated stem cells are then infused into the patient, where they multiply and replace the patient's deficient marrow. Although stem cell transplantation offers a cure for aplastic anemia patients, the high doses of chemotherapy and/or radiation needed to prepare a patient for transplant are not well-tolerated by all patients.
Possible complications of a stem cell transplant include a serious post-transplant condition called graft-versus-host disease (GVHD). In this condition, the recipient's new immune system -- created by the donated stem cells -- attacks the recipient's body. Physicians distinguish between two types of GVHD: acute, when symptoms appear soon after transplant, and chronic, when symptoms develop slowly and may linger for months or years. Fortunately, there are drugs available to treat GVHD that can combat this serious complication.
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