1. Good. afternoon

2. Bone Marrow Transplant

3.  Introduction  Causes  Need of BMT  Types of BMT  Alternative treatments  Before BMT procedure  Bone Marrow Transplantation  Risks and complications  After the procedure Contents

4. Introduction  A bone marrow or cord blood transplant, process of replacing unhealthy bone marrow with healthy bone marrow.  It is spongy, fatty, tissue inside bones.  Transplantation of blood stem cells, help to produce new blood cell & also promote growth of new BM.  Contains immature blood forming stem cells, hematopoietic stem cells  Contents:- RBC- carry Oxygen & nutrients throughout body WBC- fight against any type of infection Platelets- formation of clots

5. Causes It is performed when one's individual marrow isn't healthy enough to function well.  It could be due to chronic infection's & cancer treatment  These diseases prevent formation of blood cell that wok well. Certain cancer don't let to form certain type of wbc cells

6. Need to BMT Used to treat bone marrow diseases BMT helps can replace missing cell and help in production of blood cells Causes of BMT :- Aplastic anemia- BMT stops making new blood cells Cancers- leukemia,lymphoma, Due to chemotherapy Congenital neutropenia- causes recurring infections Thalassemia- inherited blood disorder where abnormal form of haemoglobin are formed.

7. Types of BMT  2 major types of transplant A- Autologous transplant Involve use of person's own stem cell. Stem cell is harvested before damaging by chemotherapy or radiation is done. Again returning of same harvested cells Can't always available, and reduces risk of some serious complication B- Allogenic transplant Stem cells are transfuse from donor, close genetic Is necessary if BMC are damaged and are given medication to suppress immune system Deepens on how closely donor cells matched.

8. Depending on BM diseases treatments may be available Canccers that affect BM are treated with - Surgery - Chemotherapy - Radiation therapy - Imminotherapy - Vaccine therapy Alternative treatment for blood diseases is blood transfusion through IV line Others medicine can also be used to treat severe blood disorders which - Prevent & treat infection. - Relieve pain - Stimulate bone marrow cell to produce blood cells - Supress immune system Most of bone marrow diseases require BMT to be cured Alternative treatments

9. In order to minimize rejection, donor stem cells are matched with subjects stem cell Reduces risk of graft attacking donor's stem cell to subject Suitable matches are found among family members Subject should be healthy enough before procedure Before transplantation chemotherapy and radiation are given It helps to destroy stem cells which are not efficiently producing blood cell. Before BMT procedure

10. Suppressor Also the patients are given with immune suppressor to prevent rejection of graft. A- Physical immunosuppressive agent Irradiation- breakage of nucleic acid replicating cell Surgical procedure- thymectomy, splenectomy, B- Chemical method Corticosteroids- suppress immune response, inhibiting IL-1 & IL-2. Cyclosporine- act by inhibiting production of Il-2

11. Bone Marrow Transplantation Subject will be awake and anaesthetized so that can be calm and relaxed. Is similar as blood transfusion. A needle, central venous catheter will be installed on upper right portion of heart. Allows fluid containing new stem cell directly to heart. Port is left in place cause BMT is done over several session for few days along with also receive blood, liquids and nutrients. Multiple session helps to new stem cells to integrate in body, known as engraftment. During this procedure subject is closely monitored for any complications

12. After BMT procedure  Should be hospitalized for weeks or month for gradual symptoms n check up  Success of BMT deepens on closeness of genetic match.  Typical recovery of BMT is 3 month.  Some of symptoms after engraftment will remain for life time.  Recovery deepens on chemotherapy, donor match, also where the transplant is done.  Regular monitoring should be done till 6-12 month.

13. Risk and complications  Immune system is weak after transplantation, decreases recovery period.  Lack of cleanliness causes infections.  infections can be prevented Maintaing proper hygiene Cleaning the area where central line enters body Washing hands oftenly. Graft vs host diseases (GVHD) sympoms are - Rash on palm and feet - Jaundice, yellowing of skin and eye. - Nausea, vomiting, and diarrhoea.

14. Thank you!