Bone marrow transplantation

Bone marrow transplantation is one of the main phases in treatment of malignant neoplasms of the hematologic system, malignant solid masses, as well as a number of non-malignant neoplasms, such as autoimmune diseases of the nervous system and immunodeficiencies.

The transplant is the hematopoietic stem cells. They are the foregoers of all types of blood cells and that’s why they have a feature to completely restore hematologic system and immune system.

At a number of diseases bone marrow transplantation help reach durable and stable remissions where regular treatment methods are effectless. In essence, it is very similar to a blood transfusion.

Types of transplantation and indications for their implementation

There exist two main types of transplantation: autologous and allogeneic transplantation.

Most often autologous transplantation is used in treatment of Hodgkin’s lymphoma and non-Hodgkin’s lymphomas (in inefficiency of regular therapies); multiple myeloma (a disease in which excessive overgrowth of plasma cells and increase of the level of specific immunoglobulins takes place;) malignant solid tumors (Ewing’s sarcomas, germinogenic testicular tumors and medulloblastomas, tumors of the central nervous system); a number of non-malignant diseases, such as autoimmune diseases, in particular multiple sclerosis.

In allogeneic transplantation the donor is another person. He can be both related and unrelated (in this case the donor is selected from special database). Allogeneic transplantation can be used for a very wide range of diseases, mostly in treatment of acute leukemia; chronic myeloid leukemia and chronic lymphocytic leukemia, aplastic anemia; Hodgkin’s lymphoma and non-Hodgkin’s lymphomas (in progression after undergo of autologous transplantation).

How does the procedure of bone marrow transplantation work?

High dose chemotherapy

Before the BMT procedure the patient receives high dose chemotherapy, which help destroy tumor cells or aggressor cells (for autoimmune diseases), as well as create conditions for the engraftment of transplanted cells.

BMT

The procedure is carried out in one-two days after the completion of high dose chemotherapy in the patient’s ward. Before beginning BMT the patient is given drugs designed to prevent unpleasantness during the procedure. During the transplantation process, cells are transfused into the patient’s vein over a period of 40–120 minutes.

Surveillance and monitoring

After TMC, the patient is under round o’ clock surveillance until hematopoietic parameters are completely restored. During this period, careful monitoring of all body functions and laboratory parameters goes on. If necessary, various drugs are prescribed to prevent and treat abnormalities if they arise. 2-3 weeks after BMT, the patient is discharged home.

IMPORTANT: In cases where a patient is scheduled for bone marrow cells transplantation from another person (donor), the materials are taken immediately before the procedure or in advance, undergo processing and freezing for subsequent BMT

Hematopoietic stem cell transplant procedure

From 1,000,000 (including preoperative investigations) in uncomplicated cases

Bone marrow cells collection

At the first stage of treatment the patient is administrated a chemotherapeutic agent, which mobilizes (in other words starts) the process of release of stem cells (HSCs). For enhancement of release of HSCs from the bone marrow into the blood, the patient is given a special stimulating drug, mostly subcutaneously.

Blood sampling to determine the concentration of HSC

On a certain day of treatment, blood is sampled to determine the concentration of HSC. If it is optimal a special venous catheter is installed in the patient.

Cells separation

The patient is connected to a special unit (cell separator), into which his blood flows to filter (select) bone marrow cells. The received material is conveyed to biologists, cryologists and immunologists for further processing and freezing.

Patient discharge

After the procedure for collecting HSCs, the patient is discharged from the hospital and after a short period of time is hospitalized for the BMT procedure.