- Breast Cancer: Bone Marrow Transplantation Center
- Breast Cancer Slideshow
- Take the Breast Cancer Quiz
- Breast Cancer Screening
- Find a local Oncologist in your town
- What is bone marrow?
- Who is a candidate for a bone marrow transplant?
- Where does the transplanted bone marrow come from?
- What happens before the transplant?
- Central Venous catheter placement
- Stimulating your white blood cells
- Bone marrow harvesting
- Chemotherapy and/or radiation therapy
- What happens during the transplant?
- Will my insurance provider cover my bone marrow transplant?
A bone marrow transplant may be used to treat patients with certain forms of cancer, such as leukemia, lymphoma, or breast cancer. The goal of such a 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 replace the damaged cells with healthy ones.
What Is Bone Marrow?
Bone marrow is the spongy tissue found inside bone. 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.
Who Is A Candidate For A Bone Marrow Transplant?
The decision to prescribe a bone marrow transplant is always made on an individual basis. Your doctor will consider your age, general physical condition, diagnosis, and stage of disease. Your doctor will also make sure you understand the potential benefits and risks of the transplant procedure.
Where Does The Transplanted Bone Marrow Come From?
Bone marrow given during a transplant either comes from you or from a donor whose bone marrow "matches" yours.
The matching process is called human leukocyte antigen testing (HLA testing). A series of blood tests evaluate the compatibility or closeness of tissue between the donor and recipient. These test results are used to help the tissue-typing lab match a bone marrow transplant donor to you.
What Happens Before The Transplant?
A number of tests are performed before the bone marrow transplant procedure to make sure you are physically able to undergo a transplant. These tests also help the transplant team identify and treat any potential problems before the transplant.
Your heart, lungs and kidney function will be tested. Your doctor may also order blood tests, a CAT scan, and a bone marrow biopsy. A complete dental examination is required before the procedure to minimize your risk of infection, and other precautions will be taken as necessary to minimize the risk of infection.
The tests required before the bone marrow transplant are usually done on an outpatient basis. Your transplant coordinator will help arrange these tests for you.
Central Venous Catheter Placement
Before the bone marrow transplant can be performed, a central venous catheter is inserted through a vein in your chest during a simple surgical procedure. 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 your bloodstream without repeatedly having to insert a needle into your vein. The catheter can also be used to collect blood samples.
Stimulating Your White Blood Cells
"Colony-stimulating factors," which are hormone-like drugs, are given before your bone marrow transplant to help your 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 your blood.
Bone Marrow Harvesting
Bone marrow is withdrawn through a needle inserted into a bone in the hip. This procedure is performed in the operating room and the patient is given general anesthesia (pain-relieving medication that puts you to sleep). If your own bone marrow cannot be used for transplantation and if a donor is not found, stem cells may be harvested from your circulating blood.
Chemotherapy And/Or Radiation Therapy
Very high doses of chemotherapy and/or radiation therapy are given to destroy the abnormal stem cells and blood cells. The high-dose therapy essentially "wipes out" your normal bone marrow. As a result, your blood counts (number of red blood cells, white blood cells, and platelets) quickly fall to low levels.
During this phase of treatment, you will be given intravenous (IV) fluids to flush out your kidneys and minimize the damage from chemotherapy. You will also be given medications to control nausea, since chemotherapy often causes nausea and vomiting.
Because you will be in a fragile state of health and won't have enough white blood cells to protect you from infection, you will be isolated in your hospital room until after the new bone marrow begins to grow. Your healthcare providers will give you specific guidelines about the isolation procedure.
What Happens During The Transplant?
The day you receive your bone marrow transplant, the harvested bone marrow is infused into a vein through an intravenous tube. The bone marrow looks like dark, thick blood. It migrates to the large bone cavities (breast bone, skull, hips, ribs and spine), and begins producing normal blood cells after several weeks.
Will My Insurance Provider Cover My Bone Marrow Transplant?
Insurance reimbursement for bone marrow transplantation is not automatic. Many insurance companies require precertification letters of medical necessity.
As soon as you know that a bone marrow transplant is a possibility, contact your insurance carrier. Don't assume your insurance will cover any or all costs associated with your transplant. It is essential to know your rights as a patient, understand your insurance policy, enlist the support of your employer, and have your physician work closely with you and your insurer to cover your bone marrow transplant.
Reviewed by the doctors at The Cleveland Clinic Taussig Cancer Center.
Edited by Charlotte E. Grayson, MD, WebMD, February 2004.
Portions of this page copyright © The Cleveland Clinic 2000-2004
Latest Cancer News
Health Solutions From Our Sponsors
Top Bone Marrow Transplantation for Breast Cancer Related Articles
Bone Marrow Transplant Risks and Survival RateThe life expectancy, survival rate and quality of life after a bone marrow transplant have improved considerably with more accurate genetic matching with donors, following up transplantation with an antibiotic regimen to control infections, and improved post-transplant care, in general.
Breast cancer is an invasive tumor that develops in the mammary gland. Breast cancer is detected via mammograms, breast self-examination (BSE), biopsy, and specialized testing on breast cancer tissue. Treatment of breast cancer may involve surgery, radiation, hormone therapy, chemotherapy, and targeted therapy. Breast cancer risk may be lowered by managing controllable risk factors.
Breast Cancer and Coping With StressBeing diagnosed with breast cancer is stressful. Learning relaxation techniques, exercising, eating well, getting adequate sleep, receiving psychotherapy, and maintaining a positive attitude can help you cope. Creating documents, such as an advance directive, living will, and durable power of attorney will outline your wishes in the event that you are no longer able to make decisions regarding your care.
Breast Cancer and LymphedemaLymphedema is a common chronic, debilitating condition in which excess fluid called lymph collects in tissues and causes swelling in them. It is common after a mastectomy, lumpectomy or breast cancer surgery and radiation therapy.
Breast Cancer Clinical TrialsBreast cancer clinical trials are research programs designed to evaluate new medical treatments, drugs, or devices for the treatment of breast cancer. Clinical trials are designed to test the safety and efficacy of new treatments as well as assess potential side effects. Clinical trials also compare new treatment to existing treatments to determine if it's any better. There are many important questions to ask your doctor before taking part in a breast cancer clinical trial.
Breast Cancer During PregnancyBreast cancer occurs in about 1 in every 1,000 pregnant women. Treatment of breast cancer during pregnancy involves surgery, but it is very difficult to protect the baby from the dangerous effects of radiation and chemotherapy. It can be an agonizing to decide whether or not to undergo breast cancer treatment while one is pregnant.
Breast Cancer in Young WomenAbout 5% of cases of breast cancer occur in women under the age of 40 years old. Some risk factors for breast cancer in young women include a personal history of breast cancer or breast disease, family history of breast cancer, prior radiation therapy, and the presence of BRCA1/BRCA2 gene mutations. Breast self-exams, clinical breast exams, and screening mammograms may help detect breast cancer. Treatment may include surgery, chemotherapy, radiation, and hormone therapy.
How Long a Person Can Live With Multiple Myeloma?Since 2000, the percentage of patients living five years after diagnosis has been on the rise. With improved treatment, survival results are likely to be better. According to the American Cancer Society, the median survival rates are 62 months for Stage I, 42 months for Stage II, and 29 months for Stage III.
Is Multiple Myeloma Cancer Curable?There is no cure for multiple myeloma. Treatment for multiple myeloma can only reduce the severity of its symptoms and extend the patient’s survival by a few months or two to three years. The best treatment for multiple myeloma varies from patient to patient and is often a combination of various therapies, including immunomodulators, steroids, chemotherapy drugs, bisphosphonate therapy, blood or platelet transfusions, plasmapheresis (filtering the blood), radiation therapy, surgery, and bone marrow transplant.
What Are Open Reduction and Internal Fixation of Distal Femoral Fractures in Adults?In certain types of femur fractures (displaced fractures), the trauma knocks the broken thigh bone pieces out of alignment. Femur fractures that occur near the knee (distal femur) are known as distal femoral fractures. Open reduction and internal fixation (ORIF) is a common surgery to fasten the broken femur together with hardware that allows it to heal correctly.