Ask Dr. K: Bone marrow can save a life

DEAR DOCTOR K: I have leukemia. Thankfully, a family member was a bone marrow match. Can you tell me what to expect during my bone marrow transplant procedure?

DEAR READER: A bone marrow transplant can be a life-saving treatment. To understand how it works, you need to understand how blood cells are created. And what leukemia is.

Your blood contains red and white blood cells. There are several types of white blood cells, which are a key part of your immune system. All your blood cells are made by blood stem cells, which live primarily in the spongy center of your big bones.

In the years before you got leukemia, each of your blood cells was programmed to live for a while, and then to die – only to be replaced by new, young cells.

When you developed leukemia, genetic changes in some white blood cells suddenly kept them from dying. As a result, the number of that type of white blood cell kept growing. An ideal treatment would kill just the cancerous white blood cells, and allow noncancerous new cells to replace them. The ideal treatment has not been discovered.

In a bone marrow transplant, all of your white blood cells – healthy and cancerous – are killed by drugs, radiation or both. Then healthy blood stem cells are infused into your blood. Those cells find their way to your bone marrow, and start to make healthy new red and white blood cells. The new cells will multiply. I’ve put an illustration of the transplant process on my website, AskDoctorK.com.

You will stay in the hospital for several weeks after the transplant. Until your bone marrow cells multiply to a certain level, you will be at increased risk of infection. Other serious risks include severe bleeding, liver problems and increased risk of developing another cancer.

Another possible problem is that cells from a donor might not match your cells well enough and the new donor cells will begin attacking the cells of your body. This is called graft-versus-host disease. You will take medications to reduce the risk of this happening. Despite the dangers, bone marrow transplantation is usually successful.