Other diseases that benefit from bone marrow transplantation

Bone marrow transplantation is not just for leukemia. There are several other diseases which are treated with bone marrow transplant.

Multiple myeloma
Multiple myeloma is a rare form of cancer characterized by excessive production and improper function of plasma cells found in the bone marrow. Plasma cells, which are a type of white blood cell, are produced in the bone marrow and eventually enter the bloodstream. Excessive plasma cells may eventually mass together to form a tumor or tumors in various sites of the body, especially the bone marrow. Multiple myeloma is diagnosed when more than one tumor is present.

Plasma cells are a key component of the immune system and secrete a type of antibody known as myeloma proteins (M-proteins). Antibodies are special proteins that the body produces to combat invading microorganisms, toxins or other foreign substances. Overproduction of plasma cells in affected individuals results in abnormally high levels of these proteins within the body.

Symptoms of multiple myeloma
Major symptoms of multiple myeloma may include:

• Bone pain, especially in the back and the ribs
• Low levels of circulating red blood cells (anemia) resulting in weakness, fatigue and lack of color (pallor)
• Kidney (renal) abnormalities

In most cases, patients with multiple myeloma are more susceptible to bacterial infections such as pneumonia. The exact cause of multiple myeloma is unknown.

Lymphoma
Lymphoma is a general term for a group of cancers that originate in the lymphatic system. The lymphomas are divided into two major categories: Hodgkin’s lymphoma and all other lymphomas, called non-Hodgkin’s lymphomas. Hodgkin’s lymphoma represents less than 15 percent of all lymphomas diagnosed. More than 60,000 Americans are diagnosed with lymphoma each year.

Lymphomas, including Hodgkin’s lymphoma, result from an acquired injury to the DNA of a lymphocyte. A lymphocyte is a type of white blood cell. The change or mutation of DNA in one lymphocyte produces a malignant transformation. This mutation results in the uncontrolled and excessive growth of the lymphocyte, in which identical mutated cells are produced. The accumulation of these dividing cells results in tumors in the lymph nodes and parts of the body.

Lymphomas generally start in the lymph nodes or collections of lymphatic tissue in organs like the stomach or intestines. In some cases, lymphomas may involve the bone marrow and blood. It is common for cancer to spread from the original lymphoma site. Lymphocytic leukemias originate and are most prominent in the bone marrow and spill over into the blood. They occasionally spread to the lymph nodes.

Causes of lymphoma
The number of cases of lymphoma reported each year has nearly doubled over the last 35 years, though no one is certain why. It is known that people infected with the human immunodeficiency virus (HIV) have a much higher risk of developing lymphoma. Scientists also know that the prescence of bacterium Helicobacter pylori is associated with the development of lymphoma in the stomach wall. However, these risk factors explain only a small percentage of the cases of lymphoma diagnosed each year.

The incidence of lymphoma is also higher in farming communities. Studies point to specific ingredients in herbicides and pesticides as being associated with the occurrence of lymphoma occurrence, though exactly how much these chemicals contribute to the development of the disease has not been defined.  

The cause of Hodgkin’s lymphoma is also uncertain. However, the Epstein-Barr virus has been associated with about one-third of the cases of the disease. As with non-Hodgkin’s lymphoma, people infected with HIV have a higher risk of developing Hodgkin’s lymphoma.

Symptoms of lymphoma
The first symptom of lymphoma is often painless enlarged lymph nodes. However, enlarged lymph nodes most often do not indicate lymphoma. Other symptoms may vary widely, depending on the location and size of the lymphoma. They may include unexplained and persistent anemia, appetite loss, fatigue, fever symptoms, night sweats and weight loss. Only a biopsy and other lab work can accurately confirm the diagnosis of lymphoma.

Myelodysplastic Syndromes (MDS)

Myelodysplastic syndromes (MDS) are a group of diseases that originate in an early blood-forming cell in the bone marrow. In patients with MDS, the marrow does not produce enough red blood cells, white blood cells and often platelets. In MDS, the maturing blood cells often die in the marrow before they reach full maturity and enter the blood, accounting for low blood cell levels. There may also be an accumulation of very immature marrow cells, called leukemic blast cells.

MDS can be chronic and non-progressing or it can be rapidly advancing. If the MDS interferes only with red and white blood cell production, the disease may be primarily characterized by mild anemia. If there are severe decreases in red and white blood cells and platelets, the symptoms of the disease may include shortness of breath, frequent infections and a tendency to bruise and bleed easily. Patients who have severe decreases in blood cells and who also have leukemic blast cells in the bone marrow are at risk for having the leukemic blast cells take over the bone marrow and evolve into acute myelogenous leukemia.

Causes of Myelodysplastic Syndrome
In most cases, there is no external cause for myelodysplastic syndrome. However, the use of certain drugs that are designed to damage DNA and are used to treat lymphoma, myeloma or other cancers such as breast or ovarian cancer increase the risk of developing myelodysplastic syndrome, or even acute myelodysplastic leukemia. Therapeutic radiation for lymphoma may also increase the risk of developing MDS.

Symptoms of Myelodysplastic Syndrome
In chronic MDS, the diagnosis may first be hinted at from a finding of anemia during a medical evaluation. If the anemia is moderate or severe, exaggerated fatigue, shortness of breath on exertion (such as during climbing stairs), pale skin or weakness may be present. In this form of the disease, abnormalities in white cells or platelets are usually not severe enough to cause symptoms.

In the more advanced and progressive form of the disease, which is called low blast cell count myelogenous leukemia, the patient often seeks medical attention because of loss of sense of well being, fatigue, weakness or loss of appetite.

Diagnosis of Myelodysplastic Syndrome

• Complete blood count
• Bone marrow examination
• Chromosomal examination (cytogenics)

A diagnosis can only be made by measuring the blood cell counts and examining the appearance of blood cells through the microscope. A microscopic examination of bone marrow cells is often performed as well. Evaluation of the patient’s chromosome structure can be performed on blood and bone marrow samples. This cytogenetic evaluation can be helpful in reaching a conclusive diagnosis.

Myeloproliferative disorders
Myeloproliferative disorders are a group of blood diseases characterized by chronic increases in some or all of the blood cells.

All blood cells start out as blood-forming, or hemopoietic, stem cells with the potential to become red cells, white cells or platelets. Myeloproliferative disorders begin with a change to the DNA of a single stem cell in the bone marrow where blood cells are made.

This group of relatively rare blood disorders includes: 

• Polycythemia vera
• Essential (or primary) thrombocythemia
• Idiopathic myelofibrosis

Sarcomas
Sarcomas are cancers that form in the cells that hold the body together. This includes cells of the muscles, nerves, bones, fat, tendons, cartilage and other forms of connective tissue. There are hundreds of different kinds of sarcomas, which come from different kinds of cells.

Sarcomas are classified into two categories: soft tissue sarcomas and non-soft tissue, or bone, sarcomas.

Soft tissue sarcomas begin in the tissues that connect, support or surround other structures and organs of the body. These tumors may form in muscles, tendons, fibrous tissues, fat, blood vessels, nerves and synovial tissues that surround the joints.

Bone sarcomas can grow in any bone of the body, but most often occur in the arms and legs.

It is common for sarcoma cells to invade surrounding tissue and can spread, or metastasize, to other organs of the body, forming secondary tumors. The cells of secondary tumors are similar to those of the original cancer. Secondary tumors are referred to as "metastatic sarcoma" because they are part of the same cancer and are not a new disease.

Autoimmune Disorders
Autoimmune disorders are a group of diseases in which the body’s immune system mistakes the body’s own cells and organs as foreign, causing it to form antibodies and attack the body itself. There are over 80 types of autoimmune diseases, including lupus, rheumatoid arthritis and aplastic anemia.

Physicians are beginning to treat some severe autoimmune diseases, including aplastic anemia, with bone marrow or stem-cell transplants.

Aplastic Anemia
Aplastic anemia occurs when the bone marrow stops making enough blood cells. The bone marrow is almost empty of blood-forming cells and is described as “hypoplastic” or “aplastic,” Greek for low- or no-growth. The anemia results from reduced red cell production. Complications of aplastic anemia include infections, which are a result of reduced white cell production, and bleeding, resulting from reduced platelet production.

There are approximately 1,000 new cases of aplastic anemia in the United States each year.

Symptoms of Aplastic Anemia
Symptoms of aplastic anemia may occur suddenly or develop slowly over several weeks or months. Symptoms include:

• Fatigue
• Shortness of breath during exercise or exertion
• Rapid heartbeat
• Pale skin
• Frequent infections that may not heal easily
• Unexplained bleeding, including frequent nosebleeds
• Easy bruising
• Skin rash

Aplastic anemia can be chronic and, if left untreated, can be fatal.