WHAT
IS BONE MARROW?
Bone marrow is a spongy tissue found inside your bones. The bone marrow in the breast bone, skull, hips, ribs and spine contains stem cells that produce the body's blood cells. These blood cells include white blood cells, which fight infection, red blood cells, which carry oxygen to and remove waste products from organs and tissues, and platelets, which enable the blood to clot.
Bone marrow is a spongy tissue found inside your bones. The bone marrow in the breast bone, skull, hips, ribs and spine contains stem cells that produce the body's blood cells. These blood cells include white blood cells, which fight infection, red blood cells, which carry oxygen to and remove waste products from organs and tissues, and platelets, which enable the blood to clot.
WHAT
IS LYMPHOMA?
Lymphoma is cancer of the lymphatic system, which is a connecting network of glands and vessels that manufacture and circulate lymph throughout the body. Lymph is a colorless, watery fluid that contains white blood cells (which help fight infection). Along the network of vessels are groups of small, bean-shaped organs called nodes. Lymph nodes are clustered in the neck, under the arms, in the groin and abdomen. The lymph nodes make and store infection-fighting cells. The spleen and tonsils are also part of the lymph system. Lymphomas are diseases of the body's cells. Healthy cells grow, divide, and replace themselves in an orderly manner. When lymphoma occurs, cells in the lymphatic system grow abnormally. They divide too rapidly and grow without any order or control. Too much tissue is formed and tumors begin to grow. Because there is lymph tissue in many parts of the body, the cancer cells may spread to other organs such as the liver or spleen or into the bone marrow.
PREPARING FOR A BONE MARROW
TRANSPLANTLymphoma is cancer of the lymphatic system, which is a connecting network of glands and vessels that manufacture and circulate lymph throughout the body. Lymph is a colorless, watery fluid that contains white blood cells (which help fight infection). Along the network of vessels are groups of small, bean-shaped organs called nodes. Lymph nodes are clustered in the neck, under the arms, in the groin and abdomen. The lymph nodes make and store infection-fighting cells. The spleen and tonsils are also part of the lymph system. Lymphomas are diseases of the body's cells. Healthy cells grow, divide, and replace themselves in an orderly manner. When lymphoma occurs, cells in the lymphatic system grow abnormally. They divide too rapidly and grow without any order or control. Too much tissue is formed and tumors begin to grow. Because there is lymph tissue in many parts of the body, the cancer cells may spread to other organs such as the liver or spleen or into the bone marrow.
Before the "conditioning" chemotherapy or total body irradiation (TBI) can start, a catheter (sometimes called a "Hickman") or "central line" will need to be inserted into a large vein in the patient's chest, just above the heart. The purpose of the central line is to enable the medical staff to adminster drugs and blood products to the patient without the need for an IV, or constant "pokes" to draw blood.
The conditioning chemo is designed to kill as many diseased cells as possible, without major damage to the patient's organs and tissues. The drugs used in the conditioning chemo are many times the same drugs used in standard chemo, only in much higher doses, which are more effective in destroying the cancerous cells. This conditioning chemo also destroys a patient's bone marrow.
For patients undergoing a donor transplant, the patient must also receive agents that suppress the patient's immune system. These "immunosuppressive" agents also help prevent the patients' body from rejecting the donated bone marrow (called "graft rejection"). TBI, and/or drugs are commonly used to prevent graft-rejection.
TBI (total body irradiation) is used to suppress the immune system and make space for the new, healthy bone marrow, and to kill the diseased cells.
BONE MARROW HARVEST:
The bone marrow harvest usually takes place under general anesthesia. It involves little risk, and little discomfort. While the donor is under general anesthesia, a needle is inserted into the cavity of the rear hip bone where a large quantity of marrow can be found. The bone marrow is a thick, red liquid that is extracted with a needle and syringe. Several punctures on each hip and numerous bone punctures are usually needed to extract the proper amount of marrow. There are no incisions or stitches needed. Only skin punctures where the needle was inserted.
The amount of bone marrow harvested depends on the size of the patient and the concentration of bone marrow cells int he donor's blood. Usually one to two quarters of marrow and blood are harvested. This may sound like a lot, but it actually is only about 2% of a person's bone marrow, which the body will replace in approximately four weeks.
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