What is Bone Marrow Transplant?

The presence of a healthy bone marrow and blood cells is essential for life. Some diseases can affect the bone marrow and prevent it from functioning. In such cases, bone marrow, peripheral blood or cord blood transplantation may be the right treatment option. Stem cell transplants derived bone marrow and peripheral blood are generally described as “hematopoietic stem cell transplantation”. The only treatment option for some diseases is hematopoietic stem cell transplantation. With hematopoietic transplantation, unhealthy blood-forming cells are replaced with healthy ones. These transplanted cells also begin to produce healthy erythrocytes, leukocytes and platelets.

Apheresis Unit of Yeditepe University Koşuyolu Hospital also operates as the Istanbul Apheresis Center of TÜRKÖK Unit which operates under the Ministry of Health. It provides the accession of transplant candidate patients and volunteer donors throughout Turkey to the related transplant centers by performing the examination, workup and collection of stem cells.

At the Bone Marrow Transplant Clinic team; There are physician supervisor, assistant physician supervisor, triage physician, internist, nurses who are experienced in transplantation, biologists working in apheresis and stem cell laboratory, apheresis nurse and biologist who serves as case coordinator

What is Hematopoietic Stem Cell?

Hematopoietic stem cells are cells that are found in bone marrow, peripheral blood and umbilical cord blood and are capable of life-long self-renewal and transforming into different cells. These cells are blood cells that can turn into red blood cells (erythrocytes), white blood cells (leukocytes) and platelets. 

• Red blood cells (erythrocytes) carry oxygen to the organs. 
• White blood cells (leukocyte) are involved in fighting against infection. 
• Platelets are involved in the control of bleeding.

What is Bone Marrow?

The bone marrow is a soft, spongy tissue that provides the formation of blood cells and is hidden inside the bones.

What are Bone Marrow Transplant Types?

• What is Autologous Transplant?

The patient's own stem cells are used for transplantation. It is a common used treatment option for patients diagnosed with lymphoma and multiple myeloma. At which stage of the treatment stem cells be collected from the patient is an important point. The most important advantage is that the transplant-related mortality (loss of life) rate is low (< 3%). Since there is a possibility of diseased stem cells being mixed among the stem cells collected from the patient itself, the disease may recur after transplantation. In order to reduce the risk of graft versus tumor, stabilizing and/or maintenance treatments can be applied to patients after transplantation.

• What Is Allogenic Transplant?

It is typically used to treat patients with bone marrow disorders such as leukemia, aplastic anemia, and myelodysplastic syndromes. In this process; First of all, the diseased bone marrow is eliminated primarily with chemotherapy and/or radiotherapy called preparation regimen. It is then replaced with stem cells collected from a healthy donor's bone marrow, peripheral blood, or umbilical cord blood.

• What Is Haploidenttic Transplant?

Partial HLA (human leukocyte antigen) mismatch transplantation between the recipient and the donor and made from a 1st degree relative (sibling, child or parent) is called a “haploidentic transplant” or “partial HLA mismatch” transplant. At least 50 percent match is sufficient to be a donor candidate. With this type of transplant, almost every transplant candidate patient can have a potential donor.

• What Is A Syngeneic Transplant?

 It is similar to allogeneic transplant. The difference here is that the donor is the identical (single egg) twin of the patient. Since identical twins have the same genes, they have the same HLA sequences. It is a rare type of transplant. There is no “graft versus host” and “graft versus tumor” effect. It is preferred in the treatment of benign diseases rather than malignant diseases.

Which Diseases Can Be Treated With Bone Marrow 
Transplant?

Autologous Transplant Diseases

• Multiple Myeloma 
• Plasma Cell Leukemia 
• Non-Hodgkin's Lymphoma 
• Hodgkin Lymphoma 
• Acute Myeloid Leukemia 
• Neuroblastoma 
• Germ-Cell Tumors 
• Ovarian Cancer

Other Diseases

• Autoimmune Diseases
• Primary Amyloidosis

Allogeneic Transplant Diseases

• Acute Myeloid Leukemia
• Acute Lymphoblastic Leukemia
• Chronic Myeloid Leukemia
• Myeloproliferative Diseases
• Non-Hodgkin Lymphoma
• Hodgkin Lymphoma
• Multiple Myeloma
• Plasma Cell Leukemia
• Chronic Lymphocytic Leukemia

Other Diseases

• Aplastic Anemia
• Thalassemia Major 
• Sickle Cell Anemia 
• Paroxysmal Nocturnal Hemoglobinuria 
• Fanconi Anemia 
• Serious Combined Immunodeficiency

How is Bone Marrow Transplant Performed

Some drugs (such as growth factors) are given to patients in autologous transplant, and to donors in allogeneic transplant. In this way, stem cells found in the bone marrow are directed to the peripheral blood. Subsequently, the stem cells that have passed into the peripheral blood are collected through a special device. This process is called “stem cell apheresis” or “harvest”. Collected hematopoietic stem cells are frozen and stored under appropriate conditions mostly after undergoing certain processing. It is melted at the day of transplant and transplanted to the patient. In allogeneic transplant, the collected stem cells are sometimes transplanted to the patient without being processed and frozen. Stem cells are transplanted from peripheral blood (via the vein) to the patient in both conditions. With hematopoietic stem cell transplantation, unhealthy blood-forming cells are replaced with healthy ones. These trans planted cells also begin to produce healthy erythro cytes, leukocytes and platelets.

What Spould A Patient Pay Attention For After Bone Marrow Transplantation?

Transplant patient undergo a series of trainings during their discharge. Although the details vary according to the type of transplant performed, during these trainings; patients are informed about diet, protection from infections and some complications that may develop. Patients are told about the drugs they will continue to use at home.