What Are the Pros and Cons of a Bone Marrow Transplant for Leukemia?

A bone marrow transplant for leukemia is an effective treatment, either curing the disease or extending the time that a patient lives disease free. While the effectiveness of the procedure cannot be denied, it is an invasive medical procedure with a long list of complications and side effects. It is important to discuss all options with a physician before deciding on a bone marrow transplant.

There are two different periods where complications can develop during a bone marrow transplant for leukemia. During the actual infusion process, it is common for the patient to experience hives, fever, chills, and pain. During the recovery period, the patient may also develop mouth sores, be extremely weak, develop nausea and diarrhea, and go through periods of confusion and emotional distress. The recovery period of a bone marrow transplant for leukemia includes weeks of staying in the hospital, extreme vulnerability to infection, the need for blood transfusions, and the requirement to stay in a sterile environment.

Complications that can arise include infections, low platelets and low red blood cell counts, fluid overload, respiratory distress, mouth pain, gastrointestinal pain, organ damage, graft failure and graft versus host disease. The side effects of these complications can be anything from discomfort to death. Graft failure develops when the immune system destroys the new bone marrow, leading to graft rejection. Graft versus host disease develops when the genetic material of the transplanted bone marrow is not close enough to the patient's genetic material, causing the body to treat the new bone marrow as a foreign body.

Leukemia is typically treated with chemotherapy. A bone marrow transplant for leukemia is typical if the patient has been in remission, but relapses or has leukemia that is refractory, or resistant to treatment. Relapsed or refractory leukemia may also be treated with radiation.

Three different types of bone marrow transplants exist: autologous, allogeneic, and syngeneic. Autologous procedures are rarely used for patients with leukemia. In an autologous bone marrow transplant, the patient donates his or her own bone marrow. A syngeneic transplant is bone marrow that is taken from an identical twin.

The final and most common type of bone marrow transplant for leukemia is the allogeneic transplant. This bone marrow comes from a donor, often a sibling or other family member other than an identical twin, although it can also come from a stranger. Blood tests are used to determine if the genetic material is a close enough match to make the person a good choice as donor.