A bone marrow transplant is a procedure that transplants healthy bone marrow into a patient whose bone marrow is not working properly. A bone marrow transplant may be recommended for several conditions including hereditary blood diseases, hereditary metabolic diseases, hereditary immune deficiencies and various forms of cancer.

The healthy bone marrow may be taken from the patient prior to chemotherapy or radiation treatment (autograft), or it may be taken from a donor (allograft).

Bone marrow is a soft, fatty tissue inside the bones. This is where blood cells (red blood cells, platelets, and white blood cells) are produced, and where they develop. Red and white blood cells and platelets are needed for blood clotting, carrying oxygen and fighting off diseases and infection. In a disease of the blood cells - especially cancers such as leukemia - high doses of chemotherapy may be required to destroy the cancer. However, this also destroys normal blood cells.

In other cases in which hereditary or acquired disorders cause abnormal blood cell production, transplantation of healthy bone marrow may correct these problems. Transplanted bone marrow will restore production of white blood cells, red blood cells, and platelets.

A bone marrow transplant may be recommended for:

• Cancer such as leukemia, lymphoma and myeloma
• Immune system disorders
• Bone marrow deficiency disease caused by:
  • Abnormal red blood cell production, such as thalassemia or sickle cell disease
  • Aggressive cancer treatments (chemotherapy, radiation therapy), especially for leukemia or lymphoma
  • Lack of normal blood cell production (aplastic anemia)

Bone marrow transplants use stem cells, immature cells that help produce blood cells.

There are no alternatives to a bone marrow transplant though there are a few different types of bone marrow transplants. In each type of transplant, immature cells known as stem cells help blood cells develop. The following are three types of transplants:

• Autologous Stem Cell Transplants - transplants that use stem cells from your own blood.
• Allogeneic - transplants that use stem cells from a genetically-matched donor such as a family member.
• Umbilical Cord Transplant - transplants that use stem cells taken from an umbilical cord directly after the birth of a child.

You will be given high doses of chemotherapy or radiation before the transplant. Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.

Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:

• Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids, only, for one or several days prior to surgery.
• Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
• Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
• Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

Recovery from a bone marrow transplant is lengthy and can take up to six months to resume normal activities, including returning to full-time work. In the first several weeks, you will be weak and tired and will want to sleep and rest frequently. You will return to the medical center for frequent follow-up visits for medication, blood transfusions and monitoring.

During the first three months after the transplant, you will be vulnerable to complications due to the fact that your white blood cell counts will be very low and incapable of providing normal protection against every day viruses and bacteria. You should refrain from going to crowded public places such as movie theatres and grocery stores to avoid contact with potential infection.

The most common complications occur in the first few months after a bone marrow transplant. Your doctor will watch your progress closely for any of the following:

• Infection - during and after transplant you will be vulnerable to viral, bacterial and fungal infections.
• Heart and lung problems - high doses of chemotherapy may affect your heart and lungs.
• Hepatic veno-occlusive disease (VOD): a common complication that affects the liver and kidneys keeping them from functioning properly.
• Bleeding
• Graft-versus-host-disease (GVHD): This occurs when new stem cells reject your body.
• Graft failure: The transplanted cells do not grow new blood cells for the recipient.

A variety of factors may influence the cost of the surgery. They include:

• Insurance coverage
• Pre-existing health
• Insurance co-pay
• Location of the facility

These factors vary depending on you and your situation.

The cost of each procedure can vary dramatically based upon age, location, gender, and insurance coverage. HealthGrades provides detailed cost estimates which include the costs of the procedure, drugs, hospital stay, and more. Each cost estimate is easy to understand and provides medical terms you need to know.

The detailed cost estimate for Bone Marrow Transplant, includes costs for:

• Bone marrow or stem cell transplant treated from patient or from outside donor
• and Bone marrow or stem cell transplant treated with lymphocyte infusions.