Bone marrow transplantation (BMT) is quiet new procedure in medicine, and it was used for the first time only in 70s of the past century. During this period it became a part of everyday medical practice, allowing to save tens of thousands of lives.
Indications for bone marrow transplantation
Bone marrow is a soft, spongy tissue inside the bones, the main function of which is the hematosis. Here from special cells, which are called stem cells, blood cells are formed: platelets, leukocytes and erythrocytes, important for life processes.
Platelets take part in blood coagulation, leukocytes in protecting the body from infections, and red blood cells transport oxygen to all tissues of the body. These cells are formed in bone marrow continuously, so it’s important that it would be healthy. However, sometimes there are breakdowns in the bone marrow work – there’s a number of diseases violating the process of hematopoiesis. Among them:
In many cases, marrow transplantation is the only chance to save the patient’s life, that’s why active researches are hold actively in this area, that help to improve the procedure and minimize risks.
Types of bone marrow transplantation
There are two main types of transplantation:
While using autologous method the selected cells undergo cryopreservation and are kept frozen until the procedure. For allogeneic method a donor is needed. Often patient’s close relative (brothers, sisters, parents) become a donor. If relatives cannot become donors for any reason, than donor is searched in the international databases.
In the Israeli Hadassah Medical Center, the official representative of which is IMTA group, both types are widely practiced, as the Bone Marrow Transplantation Department has all the necessary equipment, knowledge and specialists . Here are:
In each case, the method of transplantation is determined individually for each patient only after complete evaluation and data collection.
The main stages of procedure
The bone marrow transplant operation consists of several phases of different length.
Diagnostics. At this point, the patient and his donor are carefully examined (at allogeneic method). BMT is a serious operation that requires a certain level of the patient’s health.
The presence of other diseases can lead to complications during or after surgery.
Donor’s bone marrow sampling. This is a fairly simple procedure, practically it doesn’t bring to a risk. It is performed under General anesthesia for children and under regional (epidural) anesthesia for adults. For bone marrow sampling, punctures are made from two sides over the buttocks. As a rule, the donor stays in the clinic only two full days and on the third he is discharged. Among unpleasant sensations – the weak pain in places of sampling and there is some weakness, which disappear in a few days.
Bone marrow transplantation to a patient. Prepared in a special way stem cells are inserted by means of intravenous catheter. This is similar to a blood transfusion and is not a surgical procedure. The condition of the patient is carefully monitored, using the modern equipment.
Therapy. As prior to the BMT, intensified chemotherapy and irradiation are appointed, which weaken the immune system, subsequently medications that help to fight infection in case of getting the body must be taken.
Special danger at the last stage has always been an opportunity for the development of graft-versus-host reaction, GVHR – a life-threatening patient’s condition. However, the latest developments of the researchers of the Hadassah University clinic have allowed to significantly improve its prevention, reducing the risk of strike to a minimum.
These innovations are:
During the therapy a blood transfusions are also done and analyses are taken on regular basis to assess bone marrow transplantation. As soon as the patient begins to produce enough cells, medication and blood transfusion are cancelled, and the patient is discharged.
Fully-being of the patient is stabilized after about six months and he can live a normal life.
