For most people the word “transplant” evokes images of operating theatres and surgical instruments. In reality for the patient the procedure is carried out in two distinct phases:
-Pretransplant chemotherapy and/or radiotherapy, aimed at destroying all bone marrow cells of the patient, in first instance the malignant ones, of course
-Infusion of the bone marrow obtained from the donor.
The hematopoietic stem cells contained in the donated bone marrow are able to find their way by themselves arriving in the correct place where they can “start working”.
There is also a new transplant protocol is which HSC from the donor (often obtained from cordonal blood, which is scarce) are placed directly in their normal anatomic site, meaning that they are injected directly in the bone. Within a week or two from the time of transplant, the first results are visible in the form of circulating white blood cells with cell surface specificity of the donor. Soon afterwards, also the other blood cells appear (red blood cells and platelets).