There are many risks and complications involved in the bone marrow transplant process.
These risks can surface both during and after the bone marrow transplant is complete.
The complications on different patients vary depending on the health of the patient, the stage of cancer, doctor's diagnosis, requirement, and the type of bone marrow transplant. To reduce these complications and risks it would be better to go for the best oncologists in India who will provide treatment with low or no risk.
Graft vs Host Disease- GVHD (Allogeneic transplant only):
Graft-versus-host disease is when the new donated stem cells attack the recipient because it detects the host’s cells as foreign Stem cells.
And vice-versa in the Host-versus-graft disease, the recipient’s stem cells attack the new donated cells because perceiving it as a foreign body.
This is a very serious complication and in such cases, the whole transplant might fail and may prove fatal to the patient.
It is quite common to have lung problems after an allogeneic transplant. This includes BOS (Bronchiolitis Obliterans Syndrome) and BOOP (Bronchiolitis Obliterans Organizing Pneumonia).
BOS might occur if there is GVHD in any part of the patient’s body or if the patient has lung problems prior to the transplant. And it might also occur if they are older or have respiratory viral infections. It affects the tiniest airway in the lungs called the bronchiole and causes damage and inflammation leading to shortness of breath, dry cough, fatigue, etc.
BOOP, a GVHD associate can occur even without active GVHD. It also affects the small airways such as bronchioles and alveoli causing them to inflame and stiffen which leads to shortness of breath, dry cough, etc.
There are two possible causes for bone pain, Osteoporosis and Avascular necrosis (death of bone tissue due to a lack of blood supply).
Osteoporosis: It is most likely to occur after a stem cell transplant in older patients, patients with multiple myeloma and women suffering from early menopause. Though not generally painful it causes your bones to weaken and fracture easily.
Avascular necrosis: It occurs when bones in the joints break because of poor blood flow. It is known to occur in younger patients who have received lots of steroid medicines. Pain is primarily based in the hips, knees, shoulders, wrists, etc.
As your infection-fighting cells are in the recovery stage for the months following the transplant you are very susceptible to infections. So it is very important to have your consultations and health check regularly, even after your recovery.
This problem affects your vision and can be surgically removed. Usually, it occurs when you get total body irradiation or due to the extended use of steroids.
Mostly, chemotherapy-related treatments cause infertility in women as it damages their eggs. Generally, this depends on the age of the patient, the types of drugs used, and the doses.
Risk of developing new cancers:
There is a risk of developing new cancer due to the treatments in the conditioning stage. Chemotherapy and radiation increase this risk.
Because of this, you will be constantly monitored and screened for the development of any new cancer.
Further, you will have to be more vigilant about any changes in your body.
Death is always a major risk as bone marrow transplant is a complex procedure and your health is very weak throughout the span of the treatment as the immunity cells present in the body are low to non-existent depending on your treatment, stage of cancer, type of disorder and overall health.
With the above known risks should you still go ahead with BMT?
Yes, since it the last resort which can give you a fighting chance to save your life. Like every medical procedure, there are complications and risks involved but there are also medications and methods to overcome them.
With every passing year, medical science is bringing in newer research and innovation in the bone marrow transplant procedure. The success rate of bone marrow transplant has risen substantially since its inception in 1956. It has improved and developed with the addition of new methods of transplant.
With the discovery of HLA matching and its importance, it has improved the survival chances and reduced the risks of relapse or infection and graft rejection after the procedure.
Proper hygienic care and constant consultations with the doctor following the completion of your treatment will help you lead a normal and healthy life.
Other than the above-mentioned risk, the patient might suffer from the following side effects at different stages during the treatments.
While undergoing chemotherapy and radiation before the bone marrow transplant to kill all the cancer cells, you might experience some of these side effects:
- Hair loss
- Skin problems
- Swelling of the brain (increased intracranial pressure)
- Earaches or difficulty hearing if the ear is in the treatment area
- Easy bruising and bleeding
- Anemia (low red blood cell counts)
- Nausea and vomiting
- Appetite changes
- Mouth, tongue, and throat sores and pain while swallowing
- Nerve and muscle numbness, tingling, and pain
- Dry skin and nail color changes
- Urine and bladder changes and kidney problems
- Weight loss
- Mood changes
Further, listed below are the immediate side effects you might experience after the bone marrow transplant:
- Mouth Sores
- Nausea and vomiting
- Low platelet levels, might decrease effective blood clotting
- Low levels of red blood cells, can cause anemia
If you’re undergoing autologous stem cells, in rare cases you may also experience:
- Shortness of breath
- Chest pain or tightness
- Urine may appear red in color
Frequently Asked Questions
1. Is CAR T-cell treatment same as the bone marrow transplantation?
No. Immunotherapy is a form of chimeric antigen receptor (CAR) T-cell treatment. It fights cancer by using your immune cells (which have been taken, changed, and reintroduced into your body).CAR T-cell therapy takes its name from the fact that it modifies your body's T cells (part of your immune system) to destroy cancer cells. Adults with some severe lymphomas and children with acute lymphoblastic leukaemia (blood cancer) are now treated with CAR T-cell therapy.
2. What is the purpose of a bone marrow transplant?
Bone marrow transplants are used to treat cancer, sickle cell disease and other blood and bone marrow disorders by replacing harmful stem cells with healthy ones. BMT can save a person's life if their bone marrow has been damaged by chemotherapy or radiation treatment. It is also used to treat disorders that cause a person's bone marrow to cease working.