if someone with leukemia gets a bone marrow transplant .are they out or the woods?
- Anonymous1 decade agoFavorite Answer
The issue of rejectiom is backwards. You see, before the marrow is reinfused into the patient, the patient's immune system is killed. This is usually with a significant dose of radiation, a cytotoxin, or both. The patient's immune system having been removed, the patient no longer has the ability to reject anything. The rejection issue is graft-host rejection, i.e., if the transplant does not "take" correctly, the marrow may instead treat the recipient as a foreign body and reject all of the tissues of the recipient.
Graft-host rejection is one of the three major risks of bone marrow transplantation. The other two are (a) the host has no immune system and therefore cannot fight off infections; think of the most over-the-top case of full-blown aids you can imagine; fungal infections are especially lethal. (b) failure of the graft to develop immunocompetent T cells. That sometimes results because the mature T cells in the bone marrow inoculum have to be depleted to reduce the chance of graft-host disease and give the graft time to adapt to its new home. It's a tightrope: too much depletion and the patient dies of leukemia or an opportunistic infection; too little depletion, and the patient dies of graft-host disease.
It takes at least two to four weeks for the transplant to engraft itself...longer if the method involves delayed implantation of certain cells because of a perceived risk of graft versus host disease. It takes six months to a year before the patient settles down into a stable state.
I would say that a BMT patient is not out of the woods until the two- to four-week engraftment period has passed.
- InquisitiveLv 41 decade ago
If rejection occurs, then they may have some continued problems, but many many successful bone marrow transplants have been done on leukemia patients and which have given them a longer life expectancy!
- 1 decade ago
well maybe not because your body can reject the bone marrow