What is bone marrow harvest?
Bone marrow is the soft, spongy substance that fills the inner cavities of bones. It is where blood is produced.
Tiny spaces in the bone marrow hold blood and stem cells, the primitive cells that are able to grow into various types of blood cells. During a bone marrow harvest, a small portion of your bone marrow is collected, or harvested, to use for transplantation.
Bone marrow transplants have different names, depending on who is getting the marrow. An autologous bone marrow transplant is when you have your bone marrow harvested and frozen (cryopreserved) for future use. An allogeneic bone marrow transplant is when you have your bone marrow harvested for a relative, usually a brother or sister. For a syngeneic transplant, the marrow is harvested for an identical twin, and an unrelated bone marrow transplant is when you are donating through the donor registry.
What happens before the bone marrow harvest?
The procedure is performed in an operating room. General anesthesia, which induced sleep, is used for this procedure. Before the procedure, there may be some possible tests needed:
- Blood tests: Samples of blood will be drawn from a vein in your arm and the following laboratory tests will be performed: CBC (complete blood count), CMP (comprehensive metabolic panel), Pregnancy test (all females of child- bearing potential), Bleeding times, ABO blood type, Infectious disease tests (human immunodeficiency virus (HIV), cytomegalovirus (CMV), toxoplasmosis, hepatitis, Epstein-Barr virus (EBV), herpes, HTLV I/II, varicella, and syphilis).
- Electrocardiogram (a graph of the electrical impulses traveling through the heart to evaluate heart function)
- Chest X-ray (Picture of the lungs).
How is the bone marrow harvested?
When you are taken into the operating room, you will be placed on your stomach. A special needle is placed through the skin into the marrow cavity of the hipbone, where stem cells and blood are aspirated. Two or three skin punctures are made on each rear hipbone. Although the punctures will not show, there are bone punctures underneath the skin.
To obtain rich marrow, many small aspirations must be done. Once the procedure is finished, a bandage is placed over the needle marks to protect them.
About 1 to 2 quarts of bone marrow are collected during the harvest procedure. Although this might sound like a large amount, it is only about 5 percent of your total marrow cells. Collection generally takes about an hour, but each individual donation varies.
In addition to stem cells, many red blood cells also are harvested. These will be given back to you in the recovery room through your IV.
What happens to the bone marrow that is collected?
While you are in the operating room, the marrow is filtered to remove fat or particles of bone. The marrow is then taken to the laboratory for processing. It is then infused into the patient and takes about ½ hour.
Recovery and Outlook
What happens after the procedure?
Once the bone marrow harvest is complete, you will be taken to the recovery room. The recovery room nurse will help you wake up. The nurse will check your vital signs – including blood pressure and pulse – every 15 minutes until they are stable. The nurse will also check your hip bandage for bleeding. You will stay in the recovery room for about an hour.
You will likely feel tired. Your throat might be sore and dry from the tube used to help you breathe during surgery. You should not try to drink anything until the nurse tells you it is okay, and then you should start slowly. Let your nurse know if you become nauseated. When you can tolerate fluids, the IV will be removed.
After anesthesia, it is important to change positions, take deep breaths, and cough periodically. You may go to the bathroom with the nurse’s assistance.
When it is time for you to go home, you will meet with the discharge nurse, who will explain the home-going instructions and any other special instructions. Someone must be with you to drive you home after the procedure.