I’ve received lots of questions about the bone marrow transplant received last week by Good Morning America co-anchor Robin Roberts, who revealed three months ago that she had MDS, or Myelodysplastic Syndrome, a disorder in which the bone marrow doesn’t produce enough functioning blood cells. This occurred five years after she was diagnosed with and treated for breast cancer. The questions ranged from: “Was this her cancer coming back?” and “Why did she need a transplant?” to “Is this common?”
Although I don’t know details of Ms. Roberts’s medical history, let me try to shed light on the situation based on the news and information released so far.
Bone marrow is the tissue inside the pelvis and so-called long bones (leg bone, or femur, and arm bone, or humerus) that produces blood cells. We have three types of blood cells, each of which play different roles. Red blood cells carry oxygen, white blood cells fight infection and viruses, and platelets cause the blood to clot. Without functioning bone marrow, people can become extremely tired because of lack of oxygen to the brain and tissues, develop deadly infections, or suffer consequences because of bleeding.
According to the media, Roberts underwent chemotherapy as part of her treatment for her breast cancer. In rare cases, chemotherapy cures the cancer but causes changes in the bone marrow that result in the development of MDS – and the necessity of bone marrow transplantation to cure the patient.
In order to have a bone marrow transplant, one must find a donor who is a match, by testing relatives or searching databases of large screening banks. If the transplanted cells aren’t a match, the body will reject it and the transplant won’t take. Fortunately, Roberts’s sister proved to be a match. The donor’s bone marrow is removed from the donor’s long bones or pelvis, then carefully tested and prepared for transplant.
Another kind of chemotherapy is administered to the patient to essentially wipe out the poorly functioning bone marrow (and the MDS cells) and start again, fresh.
The patient is given the new bone marrow cells through an IV and then the magic happens. Bone marrow cells seem to have their own homing mechanism, like a natural GPS that takes them through the bloodstream directly to the bone marrow, where they settle in and begin to produce healthy bone marrow.
During recovery, patients are confined to a sterile environment to reduce the risk of infection since natural defenses are low. The patients wear a mask for protection and have few visitors or outside contact. Fortunately, in most cases, the bone marrow is functioning at full capacity within a few months, and the patient is cured.
Our thoughts are with you, Robin – get well soon!