Bone marrow transplantation is an experimental procedure which has had some success in enabling people with type 1 diabetes to come off insulin injections.
However, bone marrow transplantation is a relatively untried and risky procedure.
How could bone marrow transplants treat type 1 diabetes?
Type 1 diabetes results from the body’s immune system targeting and killing its own beta cells, which produce insulin, in the pancreas.
Even if people receive islet cell transplants, their immune system will still try to kill off the transplanted cells so transplant recipients need to take immunosuppressive drugs to prevent or delay their transplanted cells being destroyed.
Bone marrow transplantation is an attempt to reset the body’s immune system to no longer attack the pancreas’s insulin producing cells.
How is a bone marrow transplant carried out?
The process detailed follows that used by Dr Julio Voltarelli.
The first stage was to remove a sample of stem cells from the patient’s existing bone marrow.
The next stage involved the patients receiving a high dosage of immunosuppressive drugs to destroy the immune system in the body.
With no immune system to defend the body, patients were kept in isolation away from sources of infection.
The bone marrow stem cells were then transplanted back within the bone marrow.
Was bone marrow transplantation successful in treating type 1 diabetes?
Dr Voltarelli treated 23 patients that had been newly diagnosed with type 1 diabetes and followed the patients up at intervals.
A follow up carried out in 2009 showed that 12 patients had been able to stay free of insulin injections for over 3 years and another 8 received only intermittent injections through a five year period.
One patient did not respond to the transplant and needed to go back onto insulin straight away. 2 other patients needed to go back onto insulin after 1 month and 5 months. 1 patient contracted pneumonia and 2 other patients developed late endocrine dysfunction.
Is bone marrow transplantation for diabetes available on the NHS?
Bone marrow transplantation for type 1 diabetes is still in an experimental treatment and is not available on the NHS.
There are significant risks of contracting infections involved in shutting down the immune system prior to the transplant as well as risks of complications developing after the procedure.
