Bone marrow harvesting for transplantation; autologous
CPT4 code
Name of the Procedure:
Bone Marrow Harvesting for Transplantation; Autologous
Summary
Bone marrow harvesting for autologous transplantation involves collecting a patient's own bone marrow stem cells, which are then used for future transplantation to treat certain medical conditions. This procedure is often performed under anesthesia to ensure patient comfort.
Purpose
This procedure is commonly used to treat conditions like leukemia, lymphoma, and multiple myeloma. The goal is to collect healthy bone marrow stem cells that can be transplanted back into the patient after intensive treatment, such as chemotherapy, which destroys the diseased marrow.
Indications
- Blood cancers like leukemia, lymphoma, and multiple myeloma
- Some solid tumors treated with high doses of chemotherapy
- Patients whose bone marrow is otherwise healthy and can safely undergo the collection process
Preparation
- Fasting for at least 8 hours before the procedure
- Possible medication adjustments, as advised by the physician
- Blood tests and imaging studies to assess the bone marrow
Procedure Description
- The patient is placed under general or regional anesthesia.
- A large needle is inserted into the back of the pelvis bone (iliac crest).
- Bone marrow is aspirated (suctioned out) through the needle.
- Multiple punctures may be needed to collect a sufficient amount of marrow.
- The collected marrow is then filtered, processed, and stored for future use.
Duration
The procedure typically takes about 1-2 hours.
Setting
Bone marrow harvesting is usually performed in a hospital or a specialized surgical center.
Personnel
- Hematologist or oncologist
- Anesthesiologist
- Surgical nurse
- Laboratory technicians
Risks and Complications
- Risks: Bleeding, infection, pain at the collection site, allergic reactions to anesthesia
- Rare complications: Damage to nearby organs, prolonged bleeding
- Management: Infection can be treated with antibiotics; pain can be managed with medications.
Benefits
- Provides a means to restore healthy bone marrow after high-dose chemotherapy.
- Uses the patient's own cells, reducing the risk of rejection or graft-versus-host disease.
- Improved survival rates for several types of cancer.
Recovery
- Most patients can go home the same day or the following day.
- Instructions include resting, avoiding strenuous activities, and monitoring for signs of infection.
- Full recovery may take a few days to a week.
- Follow-up appointments are necessary to monitor health and recovery.
Alternatives
- Allogeneic bone marrow transplantation (using donor cells)
- Pros: May be the only option if patient's marrow is unsuitable.
- Cons: Higher risk of graft-versus-host disease, possible need for immunosuppressive therapy.
- Peripheral blood stem cell transplantation
- Pros: Less invasive collection process.
- Cons: Requires mobilization of stem cells from bone marrow to bloodstream.
Patient Experience
- During the procedure, the patient will be under anesthesia and should not feel pain.
- Post-procedure discomfort or soreness at the collection site is common but usually manageable with pain medications.
- Most patients experience fatigue and mild restrictions on physical activity during recovery.