Friday, October 17, 2008

Blood and Bone Marrow Transplants

There are many different types of blood cell, but they all develop from stem cells. Most of these stem cells are found in the bone marrow (the soft inside part of the bone), although some are found in the blood (peripheral blood stem cells). Chemotherapy and/or radiotherapy damages normal cells as well as cancer cells. At high doses the bone marrow may be damaged or destroyed, and the patient may not be able to produce the necessary blood cells. In a Bone marrow transplant (BMT), marrow containing healthy stem cells is infused to replace those damaged by the high dose therapy, so that the patient can produce blood cells again. If it is not possible to use marrow, a peripheral blood stem cell transplant (PBSCT) may be given. There are 3 types of transplant: (1) Allogenic transplants are where marrow is donated by another person; (2) Autologous transplants involve cells being taken from the patient, stored, and then reinfused following high-dose therapy; and (3) Syngenic transplants are where the donor is an identical twin.

BMT may be given for certain types of cancer, and only under specific circumstances. BMT has been widely used to treat specific cancers such as leukaemia, lymphoma, and neuroblastoma. It is a relatively new treatment, and is still being evaluated for the treatment of some other types of cancer. There are various potential side effects associated with transplantation, these will largely depend on how well matched the donor's cells are to the patient's cells.

Surgery

Surgery is the main treatment for many types of solid tumour, especially when the cancer has not spread to other parts of the body. This involves surgical removal of all or part of the cancer. Sometimes surgery may be used in conjunction with chemotherapy and/or radiotherapy. The type of operation will depend on the location of the main tumour, its size and other factors.

Radiotherapy

Radiotherapy is the treatment of cancer and other diseases with high energy (ionising) radiation. Ionising radiation damages or destroys cells in the area being treated making it impossible for the cancer cells to continue to grow and multiply. Most radiotherapy is delivered from the outside of the body (external beam radiotherapy) usually in the form of high energy X-rays or sometimes as Gamma rays. For certain cancers a radioactive implant can be placed next to the tumour inside the body (internal radiotherapy). As radiotherapy can damage normal cells as well as cancer cells there can be potential side effects, these may depend on the radiotherapy dose, site(s) of treatment, age and other factors.

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