Bone Marrow Transplant Service
About Bone Marrow Transplantation
What is BMT? What is HSCT?
The term "bone marrow transplantation" (or BMT) dates back a long way. Nowadays, we prefer using the term "haemopoietic stem cell transplantation", or HSCT, since bone marrow stem cells can now be obtained in a number of different ways. The stem cells can be collected from the donor's bone marrow by using needles to suck marrow from the back of the donor's pelvis under a general anaesthetic (bone marrow harvest). An alternative way is to make the marrow stem cells multiply and circulate in the bloodstream by giving the donor injections of a growth factor (G-CSF, or Granulocyte-Colony Stimulating Factor). Using this method we can collect large numbers of marrow stem cells from a donor's blood over 3-4 hours while they are awake (sometimes 2 collection days are needed).
Finally, if a matched adult donor can't be found, blood from umbilical cord can often be used as a stem cell source. In this setting a higher degree of tissue type mismatch is acceptable. There are cord banks storing frozen cord blood both in Australia and worldwide.
After collection the stem cells are given intravenously, like a blood transfusion. The stem cells will then gradually settle down in the bone marrow and, over a period of 2-4 weeks, start to produce red cells, platelets and white blood cells.
Infusion of the stem cells is preceded by a period of pre-treatment (or "conditioning therapy") of the patient with a combination of chemotherapeutic drugs, sometimes also involving radiotherapy.
For further information, see also our patient information brochure, or link to the Leukaemia Foundation.
When BMT or HSCT used?
Diseases treatable by HSCT include leukemias, lymphoma, multiple myeloma, and bone marrow failure syndromes (including myelodysplasia and aplastic anemia). In addition, allogeneic transplantation is being evaluated as an experimental treatment for some solid tumours, such as renal cell carcinoma.
There are treatment protocols for each of these diseases. Depending on a number of factors (type of disease, disease stage, response to chemotherapy, relapse, age, availability of a matched donor, etc), HSCT may be the preferred treatment option either as part of initial treatment programs, or later if conventional treatments fail.
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Last updated: 10th July, 2007
