Autologous bone marrow transplantation

Autologous bone marrow transplantation (ABMT) is a medical procedure wherein a patient's own bone marrow is extracted, preserved, and subsequently re-infused back into the same patient after they have undergone an intensive treatment, often including chemotherapy or radiation. This method offers a means to restore the patient's bone marrow after it has been compromised by treatments, especially those that are myeloablative.

Procedure Overview

The primary stages involved in ABMT are:

1. Extraction: Bone marrow is aspirated, typically from the patient's hip bone or iliac crest using a specialized needle.
2. Preservation: The harvested bone marrow is treated to eliminate any remaining malignant cells and is then frozen to maintain its viability until it's ready for reinfusion.
3. Intensive Treatment: The patient undergoes high-dose chemotherapy, radiation, or a combination of both. This aims to eliminate the underlying disease but can also destroy the remaining healthy bone marrow.
4. Reinfusion: Once the intensive treatment is completed, the preserved bone marrow is thawed and reintroduced into the patient's bloodstream through an intravenous (IV) line. It naturally migrates to the bone cavities and begins the process of repopulating the bone marrow.

Benefits

The main advantage of using ABMT over allogeneic bone marrow transplantation (using bone marrow from a donor) is the reduced risk of graft-versus-host disease (GVHD), a complication wherein transplanted bone marrow cells attack the patient's own body. Since the bone marrow is autologous (originating from the patient), there's a natural compatibility and reduced risk of rejection.

Risks and Considerations

While ABMT reduces the chances of graft rejection and GVHD, it's not devoid of risks. The patient remains susceptible to complications arising from high-dose treatments, such as infections due to weakened immunity. Additionally, there's a potential risk of reinfusing malignant cells that might have evaded the purification process during preservation.

Applications

Autologous bone marrow transplantation is widely employed in treating various cancers, notably multiple myeloma, lymphomas, and some types of leukemia. It aids in allowing patients to receive higher doses of chemotherapy or radiation, which might be more effective in eradicating the underlying malignancy.

See Also

• Bone Marrow
• Hematopoiesis
• Stem Cell Transplantation
• Chemotherapy
• Radiation Therapy

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