Rishi Kapoor to Undergo Bone Marrow Transplant: What Is It?

Bone marrow transplant is a procedure where chemotherapy is given to the patient through a drip.

Recently, actor Rishi Kapoor finally disclosed that he was battling with cancer since the last eight months and is now free of the disease. However, he will be undergoing bone-marrow transplant over the next two months to ensure good health.

Here is everything that you need to know about bone marrow transplant.

What Is Bone Marrow Transplant?

Bone marrow is a soft, spongy material found inside bones. The main function of bone marrow is to produce blood cells. When abnormal immature blood cells are produced in the bone marrow, they continually divide and enter the bloodstream causing harm to the patient.

A bone marrow transplant is a procedure that infuses healthy stem cells into your body to replace the damaged or diseased bone marrow. 

These stem cells then produce new blood cells, providing immunity to the body and aiding the production of normal cells. Patients suffering from leukemia (blood cancer), lymphoma (cancer of the lymphatic system) and myeloma (cancer of the plasma cells) may need to undergo a bone marrow transplant. This is because these types of cancers interfere with stem cell growth hindering their development or causing defects in them. One might also need a bone marrow transplant in case of other uncommon blood disorders such as thalassemia or sickle cell anemia.

Is the Procedure Painful?

The procedure does not cause any pain to the patient. Bone marrow transplant is a procedure where chemotherapy (which is good to kill the cancers cells) is given to the patient through a drip. Since this type of high dose chemotherapy also kills all the patient’s own stem cells, an external stem cell source (own of some one else’s) is needed to re start the bone marrow function.

Treatment Process

The process begins with destroying the diseased marrow with a combination of chemotherapy, radiotherapy and immunosuppressant treatments.

Chemotherapy and radiotherapy act on cells that are dividing. Post this, the healthy marrow is infused into the patient to fill the “space” created. The re-infusion process is direct and is administered intravenously through a drip line, the same as a unit of blood. The cells naturally find their way to the marrow cavity where they grow over the next 2 - 4 weeks, providing a new source of healthy blood cells This process is called engraftment.

Choosing a Transplant

There are 2 types of bone marrow transplant-Autologous and Allogeneic transplant.

Autologous transplant involves the use of the patient’s own stem cells. These cells are harvested before undertaking chemotherapy or radiation treatment. The healthy cells are stored and used in transplantation. However, this can only be done if the patient has healthy bone marrow. Allogenic transplant is a more commonly used procedure that requires cells from a donor. The donor must be a close genetic match most often a compatible sibling. However, one can also seek help from a donor registry. The success of this transplant depends on how closely the donor cells match that of the patient’s.

Post-Procedure Care

In the interim period of engraftment, the patients are low on immunity and may be susceptible to a variety of problems such as experiencing headaches, pain, nausea, shortness of breath, fever, or a drop-in blood pressure. 

While these symptoms are transient, complications may arise depending on age, overall health and the specific cancer one is being treated for.

The patient must be put on medications to suppress the immune system so that the body doesn’t attack and reject the new cells. The progress of the engraftment process must be regularly monitored. The first sign of engraftment is a rising white blood cell count which shows that the transplant is leading to the generation of new blood cells. It may take anywhere between 6 months to a year for the patient to fully recover. During this time the risk of infection, bleeding, and skin problems increase.

Precautionary Measures in the Post-Operative Period

• The medication can lead to dry mouth or sores which can increase bacterial infection. Therefore, flossing is a must along with rinsing with saline water to maintain oral hygiene
• Avoid sugary products
• Be careful when eating out; avoid eating raw vegetables, meat or fish from unhygienic places
• Keep the household clean and avoid crowded places
• Consume a well-balanced diet with adequate proteins and calories
• Regular follow-up with the doctor for the first three months is mandatory

(Dr Nitin Sood is the Associate Director, Medical and Haemato Oncology , Cancer Institute, Medanta, The Medicity)