Bone Marrow Transplant
Bone marrow transplantation is currently the most effective method of treating hematological, oncological and autoimmune diseases, when the patient, after therapy aimed at suppressing his own immunity, is injected with pre-prepared bone marrow. We say bone marrow, but we mean transplantation of stem cells, the source of which is either bone marrow or blood.
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In what cases is a bone marrow transplant required
Often, a bone marrow transplant is the final stage of treatment for some diseases, which is preceded by a fairly long period of preparation.
This procedure is in most cases indicated for the following diseases:
- Blood diseases, leukemia, acute lymphoblastic leukemia, acute myeloid leukemia and chronic myeloid leukemia aplastic anemia;
- neuroblastoma (read more),
- Hodgkin’s disease (read more)
- other oncological diseases
The need for a bone marrow transplant is justified by the fact that some lymphomas and forms of cancer require fairly aggressive chemotherapy, which destroys not only infected cells, but also healthy cells.
It is the transplant that in the future gives doctors the opportunity to use high radiation and chemotherapy to fight cancer cells. Then the damaged bone marrow is replaced with healthy one.
In many cases, this procedure is the only possible option for treatment and recovery. The speed of decision-making about transplantation is also very important, since the preparatory stage is sometimes long, and patients have little time.
Types of bone marrow transplantation
- There are two types of bone marrow transplantation:
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- autologous transplantation and
- allogeneic transplantation
The type of transplantation is determined by doctors depending on the patient’s indications.
Autologous transplantation
Autologous transplantation is the transplantation of one’s own cells. Before high-dose chemotherapy, one’s own stem cells are collected, frozen, and then injected into the patient. This allows one to restore one’s own immune system and hematopoietic system in a short time.
Bone marrow is extracted under general anesthesia with several punctures from the iliac or femoral bone. T-lymphocytes are extracted from the obtained material and frozen for subsequent transplantation. In the future, these cells enter the blood already processed and free of cancer cells.
Visually, this procedure looks like a blood transfusion.
This method is indicated when the disease does not affect the bone marrow: ovarian cancer, breast cancer, lymphogranulomatosis, non-Hodgkin’s lymphomas, and brain tumors. It can be performed when the disease is in remission. Also, the patient should not have kidney, liver, heart, or lung diseases. For this, a special examination and treatment are carried out as soon as possible, if possible. The presence of infectious diseases also makes this type of transplant impossible. Otherwise, the risks of complications increase.
Allogeneic transplant
The first thing you should do is stop panicking, pull yourself together and start fighting for your life.
Treatment must be started as quickly as possible. There is no time to think. The longer the patient thinks, the larger the tumor grows, and it is more difficult and expensive to remove.
First of all, it is necessary to undergo all additional tests and conduct diagnostics. And immediately contact an oncologist who will develop a treatment plan, select the most effective treatment methods for your case and begin treatment.
What are the risks?
With a high compatibility variant, the necessary graft-versus-tumor (GvT) reaction occurs, when donor cells perceive tumor cells as foreign and begin the process of their destruction.
But the lower the percentage of tissue compatibility, the higher the likelihood of graft-versus-host disease (GvHD), that is, rejection of transplanted tissues.
To prevent such a reaction, lymphocytes are removed from the donor blood and after the transplant, immunosuppression is performed. That is, a transplant with a low percentage of compatibility, although from a related donor, is associated with the maximum number of complications.
Statistically, there is a 25-30% chance that the patient will have a related donor (brother or sister) whose material is suitable for transplantation. If it is impossible to find a related donor, then the clinic resorts to searching for a donor in the international registry of bone marrow donors. And here we are talking about the following type of transplantation
Transplantation of bone marrow from a compatible unrelated donor – there is an international registry of bone marrow donors, this is a database of voluntary donors, of which there are up to 6 million people in the world.
The probability of finding a genetically suitable person is quite high. It is about 40%.
Typically, finding a suitable person takes no more than half an hour, but the process from the moment contact is established with the donor and his consent is received until the transplant itself can take several weeks to several months.
Preparing for Bone Marrow Transplant in Turkey
It sounds quite paradoxical, but in order to perform a bone marrow transplant, the patient must be “healthy” enough.
The stage of the disease, general physical condition, age – these factors are important when deciding whether a patient can undergo a transplant.
For example, a transplant can be performed on a patient who is young and currently feels generally well. Autologous transplantation is possible if the patient is over 65; allogeneic – up to 50 years. Stem cell transplantation has a lower risk, so it can be performed on fairly old patients.
The procedure for collecting bone marrow from a donor or from the patient takes place in the operating room under general anesthesia. A special needle is inserted into the pelvic bone, where the main reservoir of bone marrow is located. Then the container with stem cells is delivered to the laboratory. The stem cells are selected on an apheresis machine. If the number of living cells is sufficient, then preparation for the transplant begins. By the way, the amount of bone marrow in a donor is restored in about 2 weeks.
What kind of preparation does the patient undergo?
The patient is hospitalized, then for a week, usually 7-8 days, undergoes radiation or chemotherapy, which destroys cancer cells and his own bone marrow. The exact dose and composition of the drugs depend on the disease and are prescribed to the patient according to world treatment protocols.
How a bone marrow transplant works.
Once the doctor has determined that the patient is ready for the transplant and is healthy enough to undergo the procedure, the bone marrow transplant is performed. Similar to a blood transfusion, bone marrow is administered intravenously. A special catheter is inserted into a large vein, usually under the neck, and then under the skin of the chest to the heart. This sends the stem cells directly into the bloodstream. The bone marrow cells are distributed throughout the patient’s bone marrow.
Postoperative period
The first 2 weeks are the most critical, as it is possible to determine whether the transplanted cells are reproducing or not. Since chemotherapy kills the patient’s own cells and immunity, it is especially important to keep the patient in a virtually sterile environment during the period after bone marrow transplantation. 30-40 days, when the number of cells increases, leukocytes, erythrocytes, and platelets are produced, the patient is completely protected from the outside world. He has no direct contact with other patients. And only after this period, when no infections are detected and the cells have begun to reproduce themselves, the patient is transferred from a special box to a regular department. These safety measures are critically important during this period. Subsequently, the patient remains in the department for about 40-60 days under constant supervision of doctors and only after that can he be discharged.
After discharge from the hospital, the patient continues the recovery process at home. If he lives in another city, he rents a place near the hospital, since he needs to visit his doctor several times a week to be monitored, receive medications, and have a blood transfusion if necessary.
Usually, within 6 months after the transplant, the patient is not yet ready to return to his usual life, since he feels weak, wants to sleep and rest. Visiting public places is contraindicated. Cinemas, supermarkets are places where people gather, and therefore viruses. Therefore, if the patient risks going to such places, he must strictly limit the time of visits and use a mask.
Usually, it takes about 1 year for the transplanted bone marrow to begin to function as one’s own. At the same time, it is necessary to constantly be in contact with the treating team of specialists.
Bone marrow transplant price
Below are very average prices for bone marrow transplant in Turkey:
- Allogeneic transplant from 40,000 US dollars
- Autologous transplant (from a relative) from 80,000 US dollars
- Autologous transplant from an unrelated donor from 100,000 US dollars
It should also be noted that Turkey is among the top three leaders in the number and effectiveness of bone marrow transplants. For comparison, the price of a similar transplant in Israel is from 100 to 160 thousand dollars, in Germany from 150,000 dollars.
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Why Do Patients Choose Turkey for Treatment?
Today, more and more patients from Europe, Asia and the former CIS countries are traveling to Turkey for treatment. In recent years, Turkey has been among the TOP 3 leading countries in international tourism in many destinations.
Modern technologies
Modern equipment and advanced diagnostic methods allow us to detect diseases at early stages with maximum accuracy and provide the most effective treatment.
Competent professors
All the professors we work with have passed international accreditation. Doctors have experience working in the largest medical centers in the world.
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Turkey is actively competing with Israel and Germany for leadership in international tourism. Here you can get high quality treatment at lower prices without hidden fees.
Comfort is very important
Individual approach and quality of service – this is what distinguishes Turkey from other countries. The main task of the clinics is to create the best conditions for physical and emotional treatment.
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