What is a bone marrow transplant?
A bone marrow transplant replaces the spongy tissue inside your bones that is responsible for producing cells that eventually turn into the blood cells. Blood stem cells made in the bone marrow turn into white blood cells, red blood cells and blood platelets. Certain diseases such as congenital neutropenia, sickle cell disease, thalassemia and aplastic anaemia and blood cancer affect how these blood cells are produced, as do some cancer treatments such as radiation therapy and chemotherapy.
A bone marrow transplant is a type of stem cell transplant, which is why you may hear this procedure referred to as such. More specifically, a bone marrow transplant takes healthy material from the bone marrow while a blood stem cell transplant removes stem cells from the blood. As bone stem cells are usually found in the bone marrow the donor (either you or a person with a matching stem cell type) will need to take medication to push these bone marrow cells into the bloodstream.
The most common disease that is treated by way of a bone stem cell transplant is blood cancer. Blood cancer in its primary form begins in the cells of the blood, bone marrow and lymph nodes. Treatment involves the healing or replacement of the part of the body that produces new blood and lymph cells - the bone marrow. Bone marrow transplants must match the recipient’s cell type. Even so, only 30% of transplanted tissue is obtained from relatives. The other 70% is voluntarily donated by blood marrow donors.
Understanding bone marrow transplants means being aware of the role of the bone marrow. This is a sponge-like tissue found in the centre of some bones. Bone marrow comes in two types, red and yellow. While yellow bone marrow stores fat, red bone marrow produces the early forms of all blood cells. Red bone marrow is primarily found in the bones of the pelvis, sternum and femur (thigh bone). These small areas can produce approximately 500 billion cells every day in a manufacturing process known as haematopoiesis. As we grow older, the percentage of red bone marrow decreases.
Understanding bone marrow function:
Different types of blood cells – in fact, different types of all cells - are not immediately produced in their functional form but begin from a single, same cell. You may have heard about stem cells, and this is where they fit in. Stem cells can be found all over the body and are currently a topic of much discussion. If we can ensure this original cell type is not abnormal, perhaps all of the cells that follow can be normal, too. This could be the therapy that, in the future, contributes to the end of many illnesses; however, research is still very much in its infancy. Even so, stem cell therapy is an available treatment but should only ever be prescribed and carried out in an approved clinic. Currently, diseases and disorders such as cancer, multiple sclerosis, type I diabetes and even damaged knee cartilage are being successfully treated by way of stem cell transplants.
Furthermore, while we used to believe stem cells of the bone marrow only produced blood cells, we are now beginning to discover that these cells can change (differentiate) into different cell types. A stem cell of the blood can be engineered to produce heart muscle, for example. Even better than this, scientists can now turn mature (differentiated) cells back into stem cells by reprogramming their DNA. You may have heard of CRISPR. This is a particular method of cutting away tiny areas of DNA that control a particular cell function and introducing a different piece that can change the cell type. This also means that all that cell’s descendants will continue in this changed form. This field of research is called genome editing.
Stem cell therapy or regenerative medicine may have a long way to go for some diseases but it has been the basis of bone marrow replacement for many years. All blood cell types – red blood cells, white blood cells and blood platelets – originate from a single pluripotential stem cell that can be found in embryos, amniotic fluid or bone marrow. As scientific research using human embryos is neither ethically acceptable nor legal in most countries, new research paths such as converting adult cells into stem cells are becoming more advanced.
In the human body, a pluripotential stem cell of the bone marrow, also known as the haematopoietic stem cell (HSC), changes into one of two slightly more developed forms: a myeloid stem cell or a lymphoid stem cell.
The following phase (the progenitor phase) describes the next group of changes that turn myeloid and lymphoid stem cells into a number of letter-coded cells. These intermediate cells have no function as blood cells and must go through further changes.
These further changes form the precursor phase. Precursor cells are not functional and may be referred to as blasts. For example, a lymphoid stem cell will progressively become either a B lymphoblast or a T lymphoblast in the precursor phase.
Precursor blood cells then leave the bone marrow and become functional blood cells in the blood or lymph. Myeloid stem cells, through all the preceding stages, eventually become red blood cells (erythrocytes), blood platelets (to help the blood to clot) and white blood cells in the form of neutrophils, monocytes, eosinophils and basophils. Lymphoid stem cells become B and T lymphocytes (lymph cells).
Two myeloid cell types then differentiate further when they leave the blood or lymph to enter tissues. These are monocytes that become bacteria-digesting cells called macrophages, and B lymphocytes that become plasma cells.
The four types of white blood cells have specific functions that explain the symptoms of leukaemia. Neutrophils are the first cells to reach the scene when the body senses infection or toxins and when healthy, these cells can stop you from becoming ill. The monocytes that turn into macrophages travel into the tissues to destroy dead cells, toxins and even cancer cells. Eosinophils help us to fight viruses and parasites but also release chemicals that contribute to inflammation and allergic reactions. Finally, basophils contribute to inflammation and allergic reactions and help to stop the blood from clotting.
The two types of lymphocyte cells (a little confusingly, these are also white blood cells but originate from a different stem cell) are essential for our immunity and explain why many blood-related diseases cause a higher rates of infection. B-lymphocytes connect to previously-produced antibodies. Antibodies are substances manufactured in the body that can recognise harmful substances. When a B-lymphocyte connects with an antibody, it becomes a plasma cell. Plasma cells produce and release thousands of antibodies.
T-lymphocytes (the second type of lymphocyte) cause inflammation, help B-lymphocytes turn into plasma cells and assist with the design and manufacture of antibodies. This is why the early stages of bone marrow transplant lead to an inability to fight certain infections and why you may have to be isolated from other people.
Blood platelets are more like shards of cells rather than cells themselves. They do not contain DNA so you cannot have direct cancer of the platelets. However, if your bone marrow is not functioning as it should, less platelets may be produced and it will be difficult for your blood to clot naturally. If too many platelets are present through badly-functioning bone marrow, you may need to take blood-thinning medication to prevent blood clots.
Finally, red blood cells are responsible for carrying oxygen throughout the body and also remove poisonous carbon dioxide gas. These cells do not contain DNA so you cannot have cancer of the red blood cells. However, if the bone marrow is not functioning as it should you may experience anaemia; some parts of your body may not receive enough oxygen and you will feel extremely tired and short of breath.
Are there different types of bone marrow transplant?
Bone marrow is referred to using various terms that either describe how the bone marrow is collected from the donor or the cells that are replaced. In essence, all bone marrow transplant procedures are the same. A bone marrow transplant, blood and marrow transplant, hematopoietic cell transplant or blood stem cell transplant all refer to the same procedure.
What does differ is from whom donated bone marrow is collected. An autogeneic transplant uses your own stem cells and is usually only possible in the case of people who know they will be undergoing radiotherapy or chemotherapy for non-blood cancers. Blood stem cells are removed before treatment and replaced after these treatments are complete.
An allogeneic transplant refers to the transplanting of blood-forming cells donated by someone other than you. The donor may be a relative (a related donor) or a stranger (a matched unrelated donor or MUD). It is also possible to receive blood-forming cells by way of umbilical cord blood collected after a baby is born. This type of donation is known as a cord blood unit or CBU.
If you will be receiving a bone marrow transplant from a donor you will first need to undergo a blood test that looks at a protein found on the surface of the majority of your body’s cells. This protein is called the human leukocyte antigen or HLA. Best results occur when your cell HLA closely resembles or completely matches that of the donor. This is not as simple as it seems as there are countless HLA marker types. Most tests select between 8 to 10 different markers and your donor will need to match as many of these as possible. Cord blood units need to match at least 65% of your HLA markers.
It is always best to look at the HLA of family members as they will be more likely to have closely matching surface proteins. Your direct brothers and sisters – if you have any – will have a 25% chance of completely matching your HLA type. Even so, most people who need a bone marrow transplant (approximately 70%) do not have family members with close HLA matches. It is then important that you doctor signs you up for a bone marrow donation registry to find a matching donor as soon as possible. Depending on your ethnicity and HLA type, this can sometimes be a long wait. Remedazo works with haematologists who use the largest local bone marrow donor registries such as DATRI and MDRI as well as international concerns including Be The Match, Hadassah BMDR and the Nigerian Bone Marrow Registry. We do everything we can to increase your chances of finding a near-complete match.
If a full match is not found, a half-matched or haploid identical transplant may be an option. Usually, these matches are found in your parents or children.
Which diseases are treated by bone marrow transplant?
The majority of bone marrow transplants are carried out after long-term chemotherapy and radiotherapy treatments for non-blood cancers as these therapies significantly damage the bone marrow. Blood cancers including juvenile and adult lymphoma, leukaemia, neuroblastoma, myelodysplastic syndrome, familial erythrophagocytic lymphohistiocytosis and multiple myeloma are treated with bone marrow transplants when the receiving person is in relatively good health – bone marrow transplant has little effect on the donor but asks much of the patient.
Some inherited blood disorders can be successfully treated with bone marrow transplants. These include sickle cell anaemia, beta thalassemia major, congenital neutropenia, aplastic anaemia, Fanconi anaemia, pure red cell aplasia, Krabbe disease and congenital thrombocytopenia.
Finally, inherited immune system disorders such as severe combined immunodeficiency disorder and Wiskott-Aldrich syndrome can also use bone marrow transplant as a therapy.
Can I prevent needing a bone marrow transplant?
If you have been diagnosed with one of the above disorders or have undergone cancer therapy that has damaged your bone marrow, a transplant is the best way to help you to recover. For most individuals, it is not fear of the effects of the therapy but the difficulty in finding a close match that prevents a transplant. International registries are composed of up to 75% Caucasian donors and other ethnic groups are very much under-represented. There have been consistent drives to increase the numbers of donors for every ethnicity and even though registries are expanding on a daily basis, waiting times can range from weeks to years.
Where a matching donor is not possible or not immediately available, a cord blood transfusion may be used; these do not require such a strict HLA match. The immune system of a new-born is undeveloped and there is less chance of transplant rejection – a topic which will be described later on in this article. It is thanks to Tata Memorial Centre's Cancer Research Institute in Mumbai that umbilical cord blood transplants are becoming a secondary option for those unable to find a close bone marrow match.
Why do I need a bone marrow transplant?
If your bone marrow is not functioning properly, you will not be able to produce the right amount of quality blood cells. This can mean low levels of red blood cells, white blood cells or platelets - or low levels of all three. Blood is life. Its cells supply oxygen and remove carbon dioxide; they protect us from infection and stop our blood from leaking out when injured. When bone marrow no longer functions as it should, we suffer from extreme fatigue, a build up of toxins, pain, blood clotting disorders and low resistance to infection. Where blood cancer is present, faulty cells gradually overwhelm the healthy blood cell populations. No doctor will recommend a bone marrow transplant without good reason.
A bone marrow transplant is a long-term commitment, combining therapies that themselves cause damage to healthy cells. By consulting an empathic, knowledgeable and experienced haematologist or oncologist who is extremely familiar with effective therapy pathways and up to date with current clinical trials, your treatment can be personalised to achieve the best possible outcome. A holistic approach in combination with world-renowned physicians, excellently equipped hospitals, evidence-based therapies and regular follow-ups is guaranteed at Remedazo. Our goals include ensuring your complete comfort during this time, meaning you can concentrate all energies on your recovery.
How do I prepare for a bone marrow transplant? What can I expect?
Approximately 2 weeks before the first stages of your bone marrow transplant you will be asked to supply the results of your blood and diagnostic tests and copies of any applicable imaging results (CT, MRIÂ and/or PET). These reports will apply to the disorder for which bone marrow transplant is required but should also include test on other organs such as the kidneys and liver. This means we can evaluate your level of health and closely monitor any changes during and after treatment. We will also need any information regarding medication use.
Preparation for a bone marrow transplant depends on where the donated material comes from. If you have the opportunity to arrange an autologous blood stem cell transplant this may be a slightly shorter journey as you will not need to wait for the results of HLA tests before beginning preparatory treatment. Both autologous and allogeneic transplants require significant preparation with out or inpatient treatment. You will need to remain close to the hospital during this time.
As the transplant stage requires a long stay in or near a hospital, you should arrange time off work and, where necessary, request assistance from family members and friends or employ childcare or housekeeping staff. Think about how you might spend your time in the hospital; the medications given during bone marrow transplant can make you feel tired but time will go by much more quickly with some distractions. Consider who you would like to accompany you if this is at all possible, and perhaps download favourite books, games and television shows on a laptop (paper versions of books and magazines are difficult to wash and could be a potential source of infection). Remedazo works together with outstanding hospitals that provide comfortable, well-equipped and private accommodation; however, it is always a good idea to bring along a personal selection of your favourite pastimes.
Try to avoid contact with people who are ill whenever possible. Maintaining your weight by eating a healthy diet will also lower your risk of infection until your bone marrow is able to produce enough white blood cells. It is now time to put yourself into Remedazo’s attentive hands. We can arrange every aspects of your stay according to your emotional, psychological and physical preferences and requirements, as well as according to your budget. With Remedazo, all you have to think about is your recovery.
Bone marrow transplant preparation: HLA testing
Even if you are planning an autologous transplant, your cells will be tested for human leukocyte antigens in case your state of health changes before donation. This is a simple intravenous blood test which is often combined with other basic blood tests. Results can take up to 2 weeks to arrive. General clinical tests are also advised, the results of which can help your doctor to improve your levels of health before donation. If you are unable to provide your own blood stem cells and do not have matching family members (who will also need to give a blood sample for HLA testing) your results will be entered into various stem cell registers to find a matching donor.
For many, once HLA test results have been returned a waiting period is necessary before a matching donor is found and contacted. Once permission has been obtained by the donor, the next step can proceed.
Bone marrow transplant preparation:
collection
A significant quantity of healthy blood stem cells are necessary in order to carry out a successful bone marrow transplant. The more stem cells that are gathered, the more quickly the body will respond to treatment. Collection occurs in one of three ways: peripheral blood stem cell collection, bone marrow aspiration and cord blood.
Peripheral blood stem cell collection:
The majority of donor blood stem cells are collected via an intravenous line; it is possible to collect stem cells from the bone marrow but this is a more painful and complicated procedure that occasionally requires a general anaesthesia. Because of this, most blood stem cell collections are carried out via the bloodstream.
The method of blood cell collection from peripheral blood is known as peripheral blood stem cell (PBSC) collection. The way in which these specific cells are filtered from the blood is called apheresis. As stem cells are most commonly found in the bone marrow, you or your donor will need to take medication in order to mobilise the stem cells into the blood stream. The stage during which you or your donor takes medication is known as priming.
Priming involves an intravenous hormonal blood growth factor called granulocyte stimulating factor of G-CSF. G-CSF increases the number of produced stem cells and mobilises them into the blood stream. You or your donor will receive these injections daily over the course of 4 to 5 days. These injections can be given at home by a medical professional. During and for a few days after this treatment, you or your donor may feel nauseous and tired. As the spleen stores blood cells, it may increase in size and it is advised to avoid strenuous activity until the side effects abate. After further blood test results show sufficient numbers of blood stem cells for collection, the next stage of apheresis can begin.
It should also be mentioned that autologous transplants may require a single cycle of chemotherapy in addition to G-CSF. You will need to drink plenty of fluids during this outpatient treatment and for 2 to 3 days afterwards. Your white blood cell count will become quite low approximately a week to 10 days after treatment and this means your bone marrow will work hard to produce more. Further blood tests will show whether there are enough blood stem cells for collection. A positive result means apheresis can begin.
During apheresis, blood is removed from your vein through a series of 3 intravenous catheters and sent through a machine that is not unlike a kidney dialysis machine. You or your donor will be given anti-clotting medication that may cause a tingling sensation in the fingers, toes and/or lips. They will disappear after the collection has ended. Various filters are able to remove blood stem cells from the blood and return the filtered blood back into your or your donor’s vein. One intravenous line removes blood from the body, the second returns the filtered blood, and a third administers calcium as this mineral is also filtered out during apheresis. The procedure takes 6 to 8 hours and is repeated the next day and possible a third day to ensure enough blood stem cells have been collected. These cells are taken to a laboratory, tested and immediately frozen ready for transplant.
You or your donor may experience mild side effects such as headache, bone and muscle pain and a feeling similar to a cold for 2 to 3 days after apheresis. After collection, the role of the non-autologous donor is complete.
Bone marrow aspiration procedure:
Sometimes apheresis is not recommended, especially if the donor has certain blood-related disorders or if there are insufficient levels of stem cells in the blood. In this case, it is better to remove stem cells directly from the bone marrow by way of bone marrow aspiration. It is rare that a general anaesthetic is administered but this is certainly possible. Blood stem cells are collected from the hip bone in a sterile surgical setting. A local anaesthetic is always administered to make the procedure more tolerable. The doctor inserts a hollow needle directly into the bone marrow as the donor lies on his or her stomach. It is necessary to make small incisions in the skin so the needle can be applied directly to the bone. Approximately 1 litre of liquid bone marrow is removed and the procedure can take up to 2 hours. This is an outpatient procedure.
Recovery often takes longer after a bone marrow aspiration. Fatigue and soreness around the hip area are the most common side effects. A medical check-up 3 weeks after donation is recommended. Within 6 weeks your bone marrow will have replaced the donated material. The procedure is otherwise of low risk, although infection and nerve injury are possible. After collection, the role of the non-autologous donor is complete.
Cord blood collection
Cord blood has already been collected immediately after the birth of a baby. Collection does not harm the baby in any way. Donated cord blood is tested and frozen before being put into storage at a stem cell bank. HLA results are posted on local or international registers. Adults are rarely offered cord blood as it is not possible to extract large quantities of blood from this source. Unless two or more blood cord units are close matches, most recipients are young children as children have less blood than adults.
Bone marrow transplant preparation: conditioning
It is always best to remove as many irregular blood cells and stem cells before transplant. In addition, space needs to be created in the bone marrow. For allogeneic transplants, lowering your levels of white blood cells before transplant also mean there is a lower risk of rejection, especially when the HLA types are not an extremely close match. In order to create a better environment for new bone stem cells to thrive – a process known as conditioning - a course of chemotherapy with or without total body irradiation is necessary.
High doses of chemotherapy are given for both autologous and allogeneic stem cells. This treatment lasts for 5 to 7 days and requires daily visits to the hospital or a hospital stay. Remedazo will arrange all transportation to and from your appointments, home help, nursing help and catering during this period.
As chemotherapy drugs can damage the lining of the veins through which they are administered, you will be given a Hickman catheter that is inserted into a major vein via a tony incision to the right upper chest. This can be done under a local anaesthetic, sometimes with a little sedation if you prefer. You will need to lie under a sterile drape during this time; an interventional radiologist will use X-rays to make sure the catheter is correctly positioned. A Hickman catheter also means that blood can be taken directly from it for blood tests - a much more comfortable process.
In some cases, total body irradiation is also advised. You will first need to visit the oncology centre for body measurements that allows the radiotherapist to select the correct dose of radioactivity. Special marks will be placed on your skin and an appointment will be made for treatment. Treatment takes up to 15 minutes on either side of the body. You will be able to communicate with the team during the process by way of a microphone and a buzzer. Total body irradiation or TBI requires two treatments a day for up to 4 days. Some individuals may require less. As it takes time to install you in the correct position, you can expect each session to take up to 1 hour.
Both chemotherapy and TBI are associated with significant side effects. These include nausea and fatigue, diarrhoea, loss of appetite, skin sensitivity, temporary hair loss and a sore mouth. Your personal physician will ensure you have effective anti-nausea and anti-diarrhoea medications until these side effects abate. In addition, Remedazo can provide skincare professionals, catering for nutrient rich and appetising foods, nursing care and home help to make this period as comfortable as possible. Those at a higher risk of infection may need to be kept in isolation in the hospital.
Reduced intensity conditioning
While reduced intensity conditioning (RIC) using lower levels of chemotherapy with or without radiotherapy are being used in preparation for bone marrow transplants, this route is only recommended for those with lower levels of health. The side effects are much less with RIC but the efficiency of subsequent transplant is reduced. However, the closer the HLA match the greater the possibility that a lower level of conditioning is required. You can discuss your eligibility with experienced oncologists during 1 or all of your 3 free Remedazo Second Opinions.
Bone marrow transplant during procedure:
Once all preparation has come to an end, it is time for stem cell infusion. You will know well beforehand when the procedure begins as each day of conditioning therapy is given a number that runs backwards towards zero. If you must first undergo a 7 day chemotherapy cycle, the first day of chemo will be called day 7, the next, day 6 and so on. Day zero – the day after your last chemotherapy - is the day of your bone stem cell transplant.
You will need to spend most of the day in hospital although the actual donation only takes about 1 hour. The autologous or allogeneic stem cells will have been defrosted before treatment and will be warmed before entering your circulation via the Hickman catheter. There are no unusual machines; the stem cells will be administered in the same way as a saline drip. You may return home the same day.
Bone marrow transplant recovery after transplant:
The first weeks after your stem cell transplant require regular visits to the hospital so your physician can keep a close eye on any potential complication, as well as monitor your blood cell counts. During the initial weeks you will be more predisposed to infection and should limit contact with people who are feeling unwell. Rest, good hygiene and good nutrition are essential. It can take up to 2 weeks for your infection-fighting white blood cells to return to healthy levels. Another risk is bleeding as the cells that help the blood to clot are also affected during conditioning. You may need 1 or more red blood cell or platelet transfusions until a successful transplant begins to take effect.
Your doctor is waiting for signs of engraftment that occur around 10 days to 1 month after the transplant. An engraftment refers to the integration of donor cells into your own system and their successful production of new blood cells. How quickly engraftment occurs depends on your condition, how well matched the donor transplant is and how intensive your conditioning treatment was. Typical recovery time for the side effects of bone marrow transplant is 3 months but some symptoms can last for many years.
After a bone marrow transplant you may need to be re-immunised for some illnesses. Your treating haematologist will be able to carry out the necessary tests and inform you which vaccines should be re-administered.
Benefits of blood cancer treatment:
The benefits of blood stem cell transplant very often include cure or remission, even in later-stage cancers. Disease-free results can be achieved by transplant recipients. Sickle cell cure rates can be as high as 85%; thalassemia has a 65% chance of cure and congenital neutropenia 76%. Such figures are extremely encouraging and far outweigh the side effects, risks and complications of the treatment. Leukaemia patients, if the disease has not recurred within 2 years after transplant, have an over 80% chance of remaining in complete remission for many years. In fact, all disease-free survival rates have significantly increased during the past 5 years. Research abounds, as do clinical trials, and our understanding of stem cells is increasing every day. Many scientists see stem cell transplants as the most important therapy of the future.
Side effects and risks of blood cancer treatment:
Most of the side effects of blood stem cell transplant are due to the conditioning treatments. Low immunity, anaemia, fatigue, nausea, bruising, irregular bowel movements and weakness are common experiences both before and during treatment. Many of these symptoms can be alieved with over the counter or prescribed medication; however, the negative effects of conditioning therapy should not be underestimated.
Another disadvantage of bone marrow transplant is the length of time required for treatment and maintenance. The period spanning collection to recovery can be anywhere between 2 to 4 months and follow-up appointments must continue throughout your life.
As already mentioned, low immunity is a side effect of transplant conditioning. It is often necessary to remain in isolation for a period of time to avoid the risk of infection. For many, this can be an extremely lonely experience even when modern technology allows us to enjoy video-chats. A lack of human contact can make a bone stem cell transplant a psychologically difficult time, as well as a physically demanding one.
When donor stem cells are allogeneic there is always the risk of graft versus host disease (GvHD). If all HLA markers – not only those that have been tested – are exactly the same as with an autologous transplant, the body does not recognise any foreign material. Donor stem cells, however, cannot be an exact match and the presence of unknown HLA proteins can cause your own white blood cells to attack the donor cells. This is why it is so important to undergo conditioning treatment before the transplant. GvHD can have mild to severe symptoms that range from diarrhoea and rashes to jaundice and difficulty breathing. Regular follow-ups until engraftment has taken place are absolutely essential. If you do present with any of the symptoms of GvHD, extracorporeal photopheresis or ECP is a viable treatment option. While you are connected to a machine that looks similar to the apheresis device, large quantities of your white blood cells are filtered out and removed over the course of approximately 2 hours. These cells are treated with a drug that is activated by shining ultraviolet light on the cells before they are returned to your body. This drug makes white blood cells less likely to attack foreign cells. You will therefore be more susceptible to infection until engraftment takes effect. In addition, you will need to wear dark glasses and avoid sunlight for 24 hours after treatment.
As GvHD can be acute or chronic (after 3 months) regular, lifelong attendance of follow-up appointments and a good awareness of all symptoms are essential.
Other long-term side effects of bone stem cell transplants may include an early menopause in women, thyroid dysfunction, higher risk of developing certain cancers, cataracts, infertility and lung or bone damage.
Blood disorder treatment alternatives:
It is possible that you have been given a choice of one or more alternative treatments or have not yet made an appointment for your free e-consult and are simply browsing the possibilities.
While bone stem cell transplant therapy is a shock to the system, there are very few alternatives that have fewer side effects. These alternatives are chemotherapy and radiation for malignancies, regular blood transfusions, iron chelation therapy for thalassemia and growth factors. None of these, however, can replace malfunctioning blood cells with normally functioning cells. This is why stem cell treatments are recommended for up to 70 different blood disorders. Complementary and alternative remedies are unproven and should not take the place of accepted treatment courses.
Of course, there is no alternative for professional medical advice. Please call us to arrange your e-consult and the opportunity to speak personally with specialist haematologists, oncologists, radiologists and paediatric oncologists to determine the best treatment type for you. You can discuss any blood disorder alternatives with them, ask for second or third opinions, and take the first step towards your personalised Remedazo holistic care package.
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