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1 What is a Bone Marrow Transplantation for Breast Cancer?

The goal of the bone marrow transplant in women with breast cancer is to allow them to undergo high-dose chemotherapy which aggressively attacks the cancer cells, but also damages normal blood cells - and then replaces the damaged cells with healthy ones.

Bone marrow is the soft material in the center of bones. The bone marrow in the breastbone, skull, hips, ribs, and spine contains stem cells that produce the body's blood cells. The three kinds of blood cells that the body needs to function (oxygen-carrying red blood cells, infection-fighting white blood cells, and clot-forming platelets) are all made in the bone marrow.

Bone marrow given during a transplant either comes from the patient or from a donor whose bone marrow "matches" patients. The matching process is called human leukocyte antigen testing (HLA testing).

A number of tests are performed before the procedure to make sure the patient is physically able to undergo a transplant. These tests (for example blood tests, a CAT scan, bone marrow biopsy) also help the transplant team identify and treat any potential problems before the transplant.

Before the transplantation procedure, very high doses of chemotherapy and/or radiation therapy are given to destroy the abnormal stem cells and blood cells. During this phase of treatment, the patient receives intravenous (IV) fluids to flush out kidneys and minimize the damage from chemotherapy and medications to control nausea.

Because the patient is in a fragile state of health and he/she doesn't have enough white blood cells to be protected infection, he/she will be isolated in the hospital room until after the new bone marrow begins to grow.

A central venous catheter is a slender, hollow, flexible tube that allows fluids, nutrition solutions, antibiotics, chemotherapy, or blood products to be delivered directly into the patient’s bloodstream without repeatedly having to insert a needle into their vein so it must be inserted into a vein in patient chest during a simple surgical procedure before the bone marrow transplant can be performed.

Also, "colony-stimulating factors," which are hormone-like drugs, are given before bone marrow transplant to help white blood cells recover from chemotherapy so that they can help fight the risk of infection. They also increase the number of stem cells in the blood.

During a procedure in the operating room, the patient is given general anesthesia and bone marrow is withdrawn through a needle inserted into a bone in the hip. If patient’s own bone marrow cannot be used for transplantation and if a donor is not found, stem cells may be harvested from the circulating blood.

On the day that the patient receives a bone marrow transplant, the harvested bone marrow is infused into a vein through an intravenous tube. It looks like dark, thick blood and it migrates to the large bone cavities (breastbone, skull, hips, ribs, and spine), and begins producing normal blood cells after several weeks.

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