Life Expectancy After Bone Marrow Transplant

People have more probability of surviving for another 15 years after a bone marrow transplant, who’s been able to survive for at least 5 years after hematopoietic cell transplant without any signs and symptoms of relapse of the original disease.

What is a Bone Marrow Transplant?

Bone marrow is a soft tissue present inside the bones consisting of stem cells that produce WBCs, RBCs, and platelets. Blood stem cells or blood-forming cells are immature cells that grow into red blood cells, white blood cells and platelets.

Transplantation can be used to treat certain types of cancer, such as leukaemia, myeloma, and lymphoma, and other blood and immune system diseases that affect the bone marrow. Under certain conditions, these stem cells lose their ability to produce normal and healthy blood cells.

A bone marrow transplant is also called a stem cell transplant or a hematopoietic stem cell transplant.

A bone marrow transplant replaces the diseased or non-functional bone marrow with healthy stem cells. When they’re mature, they leave the marrow and enter the bloodstream.

Where to get these stem cells?

  • Bone marrow: Spongy tissue inside of bones. These stem cells can be derived from the patient’s body or a full-match or half-match donor.
  • Cord blood cells: In a few cases, these stem cells can also come from the cord blood cells preserved at the time of the patient’s birth.
  • Peripheral blood stem cells (PBSC): Blood-forming cells from the circulating blood.

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What conditions need a Bone Marrow Transplant?

  • To replace diseased and non-functioning bone marrow with healthy bone marrow for better functioning.
  • After high doses of chemotherapy or radiotherapy are given to treat malignancy BMT is performed to reinstate the normal function.
  • In case of leukaemia or residual leukaemia or other cancer, which were not treated by chemotherapy or radiation during a transplant BMT helps to regenerate the immune system.
  • BMT treats blood cancers like leukaemia or lymphoma, bone marrow diseases like aplastic anaemia, Other immune system or genetic diseases like sickle cell disease
  • To prevent any damage from any other genetic disease a genetically healthy functioning bone marrow replaces the existing impaired marrow.

Bone Marrow Transplant: Is It Even a Major Surgery?

A bone marrow transplant does not involve major surgery; rather, it’s likewise to a blood transfusion. BMT is like receiving blood or medicine through an IV.

  • In a bone marrow transplant, bone marrow cells are collected from a donor’s bloodstream through a needle.
  • They are then injected into a bone, characteristically a pelvic bone.
  • The new cells go into the bloodstream through an intravenous (IV) catheter or tube. Consequently, the cells find their way into the recipient’s marrow.

However, it’s an entire medical course as before the transplant, chemotherapy (chemo) is administered and sometimes radiation is to terminate the diseased cells and marrow. Then, the healthy cells are given.

Different Types of Transplants

There are different types of bone marrow/stem cell transplants. The 2 main types are:

Autologous transplant

  • Stem cells for an autologous transplant come from the patient’s own body. In cases where cancer is treated with high-dose, intensive chemotherapy or radiation therapy treatment damages the patient’s stem cells and their immune system. That’s why doctors remove, or rescue, the patient’s stem cells from their blood or bone marrow before starting the cancer treatment.
  • After chemotherapy, the stem cells are injected back into the body, restoring the immune system and the body’s ability to produce new blood cells and combat infection. This process is also called an AUTO transplant or stem cell rescue.

The process

  • The patient will receive a daily dose of injections that will stimulate stem cell production at a faster and higher rate. These injections contain growth factors that supplement stem cell formation and differentiation.
  • After a few days, the patient will visit the hospital for a process known as ‘apheresis.’
  • Apheresis is a technique to draw blood from the patient’s body, circulate it in a specialised machine, separate stem cells from the blood, and finally, direct the blood back to the patient.
  • The collected stem cells are purified and frozen for further use.

Allogenic transplant

  • Stem cells for an allogenic transplant typically, come from another person, called a donor. The donor’s stem cells are injected into the patient after the patient has chemotherapy and/or radiation therapy. This is also known as an ALLO transplant.
  • Many people have a “graft-versus-cancer cell effect” during an ALLO transplant. ALLO transplants treat cancer when the new stem cells recognize and destroy cancer cells that are still in the body.

The process

  • The stem cells from an allogeneic source can be collected in two different ways – through apheresis or surgery.
  • The doctor will suggest the option that works best for the donor as well as the patient.
  • If the doctor advises apheresis, the donor will undergo a similar procedure listed above. But, if the doctor deems surgery to be a more suitable choice, the donor will have to undergo one.

Finding a donor

  • A match is a healthy donor whose blood proteins, called human leukocyte antigens (HLA), closely match the patients’ i.e., HLA typing.
  • Siblings from the same parents are often the best match, but another family member or an unrelated volunteer can be a match too. If your donor’s proteins closely match, the chances to get a serious side effect called graft-versus-host disease (GVHD) are less. In this condition, the healthy transplant cells attack the patient’s cells.

When a donor match is not found:

Umbilical cord blood transplant: stem cells from umbilical cord blood, which connects a fetus to its mother before birth are used for the transplant. After birth, it becomes obsolete.
Parent-child transplant and haplotype mismatched transplant: Cells from a parent, child, brother, or sister are a 50% match. These types of transplants are, however, more often used, to expand the use of transplantation as an effective cancer treatment.

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Bone Marrow Transplant Procedure

The Initial Phase

  • Patient’s eligibility for the procedure- a thorough physical evaluation, including routine blood tests and functional analysis of the heart, lungs, and liver.
  • Deciding which type of surgery is best suited to the patient. Accordingly, find a donor match.
  • Implanting an intravenous catheter- into a vein in the neck or the chest. This catheter will stay put during the treatment to infuse transplanted stem cells and medication into the patient’s body.

During The Procedure

  1. Collection of stem cells
  2. Conditioning
  3. Reduced-intensity conditioning
  4. Bone marrow transplant

Post-Operative Procedure

  • After the transplant into the patient’s body, the stem cells gradually reach the bone marrow via blood. With time, these stem cells differentiate and start producing different types of blood cells. This process is called engraftment and can take anywhere between 2 and 4 weeks.

Cost of Bone Marrow Transplant

Type of TransplantAutologous BMTAllogenic BMT
  Full Match (HLA testing >80%)Half Match (HLA testing <80%)
CostUSD 15,000USD 22,000USD 40,000
DonorNot RequiredRequired
ChemotherapyRequiredRequired
Stay in Hospital25 – 35 Days1 Month
Stay in Country2 Months2 Months
Accommodation CostStarting 20 USD/DayStarting 20 USD/Day


Risks And Side-Effects

During this period, the patient will remain susceptible to multiple risks and complications, including

  • Infections
  • Mucositis or Mouth sores
  • Veno-Occlusive Disease of the Liver (VOD)
  • Interstitial Pneumonia Syndrome (IPS)
  • Graft-versus-Host Disease
  • Graft Failure
  • Cataracts
  • Infertility
  • New cancers

Success rate of bone marrow transplants for patients with non-malignant diseases

  • With a matched sibling donor – 70%-90% survival.
  • With unrelated donors – 36%-65% survival.

The survival rates after transplant for patients with acute leukemia in remission are:

  • With related donors – 55% to 68%
  • With unrelated donors – 26% to 50%

In case of Autologous Bone Marrow transplant along with chemotherapy has improved survival rates with certain cancers such as:

  • Ewing sarcoma
  • Wilms tumor
  • Germ cell tumor
  • Neuroblastoma

Autologous transplants have not enhanced the survival rates with:

  • Paediatric malignant cancers
  • Metastatic Ewing sarcoma.

Transplants of younger patients have a higher chance of success.

Survival rates are higher in case both the donor and recipient are cytomegalovirus (CMV) negative

Life expectancy after a Bone Marrow Transplant

People have more probability of surviving for another 15 years after a bone marrow transplant, who’s been able to survive for at least 5 years after hematopoietic cell transplant without any signs and symptoms of relapse of the original disease. However, a normal life expectancy is not completely achieved.

No matter whether BMT has a great success rate, however, there may be factors on the life expectancy depends are

  • Age and overall health of the patient.
  • Any underlying disease and its chances of recurrence.
  • Presence of any other medical condition.
  • Type of transplant.
  • Preparations are done before the transplant.
  • The health of the donor.

Recovery post Bmt

  • Recovery from a bone marrow/stem cell transplant takes a long time and has stages, starting with intensive medical monitoring after the transplant day.
  • There has to be a schedule of regular medical check-ups over the coming months and years, which must be followed most religiously.
  • The exhaustive chemotherapy treatments that are administered before the transplant damage the immune system so that the body could accept the transplant without attacking the stem cells.
  • Infections are likely to surface, and are quite common. Regular blood test and many other tests rule out emergencies, check immunity and keep a check if the donor cells have been accepted and responding properly.
  • In case of an ALLO transplant, the medications will include drugs to prevent and/or manage GVHD.

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