Blood and Bone Marrow Stem Cell Transplant: the differences
For people with a bone marrow deficiency disorder or whose bone marrow has been destroyed by chemotherapy to treat another cancer, a stem cell transplant can be the only chance of survival.
The terms Bone Marrow Transplant (BMT) and Peripheral Blood Stem Cell Transplant (PBSCT) are often interchangeable, although they are actually fairly different. So what is the difference? And which type of transplant is best?
The difference between the two transplants is in the source of the stem cells that are transplanted. The end transplant procedure is exactly the same, with the harvested stem cells being transfused into the patient’s blood in a process similar to a blood transfusion.
Bone Marrow Stem Cells are harvested from the bone marrow, the very source of blood producing stem cells. There is a rich supply of blood-producing (hematopoietic) stem cells in the bone marrow, particularly in the hip bones. This can be an uncomfortable procedure and is usually done under general anesthetic, although some patients choose to have a local anesthetic.
Peripheral Blood Stem Cells are removed from the patient’s blood. Stem cell production is stimulated prior to the procedure so that more hematopoietic stem cells are released into the blood stream. Then the patient’s blood is extracted using an intravenous line, passed through a machine where the stem cells are separated from the other blood cells in a process called Leukapheresis. The blood is then returned to the patient’s other arm, minus the extra stem cells.
Essentially, the only difference between BMT and PBSCT are the methods of harvesting stem cells. But each type of donation has pros and cons. This is why, although PBSCT may seem the simpler procedure, the type of transplant used for each patient will depend on their situation.
Weighing the Pros and Cons
A recent study set out to look at the pros and cons of harvesting stem cells from peripheral blood versus bone marrow. Researchers found that both have different benefits as well as the same survival rates. However, the two types of stem cells are not interchangeable; using the right stem cell source for the right patient can increase transplant success.
The study showed that bone marrow stem cell transplant patients were less likely to develop chronic graft-versus-host disease (GVHD), a serious potential complication of stem cell transplants. However, peripheral cells are more likely to engraft, meaning that the chances of initial success are higher.
Much of the decision on which stem cell transplant is best for the patient will be down to the patient and their risk factors, the disease and the experience of the doctor. Whilst some doctors feel that bone marrow stem cells are the most effective in the long term, others claim that the side effects are more severe. The harvesting procedure makes a difference too; whilst the bone marrow harvesting procedure is much less uncomfortable than it used to be, there is no doubt that peripheral blood harvesting is much simpler, with lower risks and can be performed outside of the operating theater. This means that more people are willing to donate peripheral blood stem cells. If only bone marrow cells were used, stem cell banks and registered donor lists could find a dramatic drop in willing unrelated donors.
At Hospital Angeles Lomas we are experienced in performing all types of stem cell transplants, using cells from donated or the patient’s own bone marrow or blood stem cells and donated umbilical cord blood. We closely examine the needs of every patient and talk through the options with each individual so that we can come up with the best possible treatment program for each patient. Our priority is to consider the wishes and needs of each patient, treating each one on an individual basis.
If you would like to talk to one of the Bone Marrow Treatment Mexico doctors about Stem Cell Transplants and how they can help you or a loved one, contact us now and someone will call you back.