Bone Marrow Transplant

Between people known as bone marrow transplantation but actually, bone marrow, is transplantation of stem cells collected from sources such as cord blood circulating blood. Blood cells are red blood cells (erytron), white blood cells (leukocytes) and blood-platelet (thrombon). Red blood cells (erytron) are carrying oxygen texture vital for body; white blood cells (leukocytes) fight against infections and blood-platelet (thrombon) helps in controlling the bleeding. For a healthy person these three sets of cells need to work regularly. To live healthy life, bone marrow and blood cells are obligatory. Diseases affect bone marrow´s properly functioning.

 

Among following diseases, bone marrow transplantation is recommended:

  • Thalassemia, Leukemia and Lymphomas
  •  Multiple myeloma and in some cases other plasma cell defects  
  •  Myelodysplastic syndrome and  myeloproliferative diseases
  •  Serious aplastic anemia and other conditions of bone marrow deficiency
  •  Serious combined immunodeficiency and other genetic immune system defects
  •  Hemoglobinopathy
  •  Hurler Syndrome and other genetic metabolic defects
  •  Other malignant tumors

 

When there is no other solution or treatment for the blood disease, the best choice can be bone marrow or cordon blood transplantation

 

From whom bone marrow is taken and how is it stored?

 

The person that gives the stem cells to the patient is called vendor (donor). For one person to become donor, it has to have compatible texture group (HLA) with the patient. Compatibility of texture group is often with brothers and sisters, that is why they are examined first. If patient does not have brothers or sisters, mother, father and other close relatives are scanned. If a compatible donor cannot be found among relatives, it is necessary to register to marrow bank. First donors are scanned in home country, then abroad. In Turkey there are two the texture banks: one in Ankara and one in Istanbul. 

 

Can bone marrow (stem cells) have any harmful effects on donor´s health?

 

No, stem cells represent no harm for donors. If a donor is patient´s close relative, there is no any age limit. In case of donation from texture bank, donor has to be in good health and between 18 and 55. For 5 days, donor is exposed to vaccine treatment every morning and night in order to take stem cells from circulating blood. When stem cells come to appropriate level in the blood, they are collected with device similar to the one used in blood donating.

 

What are the forms of bone marrow transplantation?

 

  1. From patient to himself/herself (autologous)
  2. From another person to patient (allogenic) 

 

In case of allogenic bone marrow transplantation, texture compatible donor can be close relative or the one from texture bank.

 

How is transplantation realized?

 

With some cancer types, according to patient´s characteristics high doze of chemotherapy and /or radiotherapy is needed. High dozes of chemotherapy can cause the termination of stem cells. Because of this before harming the stem cells they are collected and hidden in frozen. After a high doze of medicine treatment and/or radiotherapy, frozen stem cells, after melting to body temperature, are again inserted back into the body.

In case of allogenic transplantation, stem cells are taken not from patient itself, but from donor with the compatible texture. Again, after a high doze of medicine and/or radiotherapy treatment, these cells, obtained from the donor, are given to the patient.

What can patients expect after the transplantation?

The most important problem with all transplantations is the repetition of the disease. After autologouos transplantation, patient is not supposed to have any bigger problem. The main problem can actually occur in case of allogenic donor. No matter how compatible are textures between donor and patient, they are still strange bodies to each other. Donor´s strong stem cells in reaction to receiver´s cells can destroy them and in short it can cause disease table called GVHD (graft versus host disease). In this table there can be skin rash, sores in the mouth, dry eyes, diarrhea, and jaundice. During transplantation to prevent these side effects, different kinds or treatment are taken, but still, sometimes, these effects can be seen. We want this GVHD´s table not to show exaggerated levels. These are unwanted side effects of the treatment.