Bone Marrow Transplantation

 Bone Marrow Transplantation

Operation goal:

The purpose of a bone marrow transplant is to replace the affected bone marrow tissue in the body. These tissues are usually infected and damaged due to cancer (for example, leukemia or what is known as leukemia) or from other diseases affecting the bone marrow cells.

The bone marrow is made up of cells. These cells are responsible for the process of classifying the blood cells of different types (which are known as stem cells). Bone marrow is a tissue that contains fat cells in addition to a specific fluid. It is found in the inner section of most bones in the body.

Bone marrow transplantation is, in most cases, in order to treat problems of blood cell production and classification, as a final treatment - leukemia of all kinds (such as: ALL, AML), aplastic anemia, low platelet count (Thrombocytopenia) caused For many diseases affecting platelets, various genetic diseases such as thalassemia, multiple myeloma and others.

A bone marrow transplant allows the body to rebuild its own blood cell store, produce blood cells properly, and balance cell levels in the blood. In many cases, a bone marrow transplant is the only way to treat these diseases completely. This process is done by transferring stem cells from the patient himself (autologous bone marrow transplantation from healthy cells that have been saved), or from a suitable donor according to the matching of the tissues.

Prepare for the operation:

As mentioned above, the bone marrow transplant requires an appropriate donor in terms of matching the tissues. Tissue congruence is checked with a simple blood test. The people examined are usually relatives of the patient, or registered donors on the Bone Marrow Donor Registry - National / Global.

There are additional tests that must be performed before the transplant, which include: taking a sample from the patient’s bone marrow, blood tests such as a complete blood count, blood chemistry test, and coagulation tests. In addition to liver and kidney function tests, urine test, and tests to ensure that there are no infections in the body - among these tests are: blood and urine culture.

In order to purify the body from the affected stem cells, a preparatory treatment must be performed before transplantation. It is a treatment that takes ten days, during which the patient is given strong preparatory chemotherapy by intravenous injection, in addition to radiotherapy if necessary. The patient is also provided with fluids. These treatments are relatively difficult, and the patient must arrive at the time of the operation while he is in a healthy condition to do so.

process:

If the bone marrow transplant is not from the patient himself, but from a donor, then stem cells are taken from the donor before the transplant. The cells are taken from the bone cavity directly, by means of a special needle (similar to the needle used to examine the bone marrow), or by giving a preparatory injection and taking the cells from the blood.

Bone marrow transplantation is done by introducing new stem cells into the patient’s body through an intravenous catheter. A day or two after the end of the preparatory chemotherapy.

It takes a quarter of an hour to transfer cells into the patient’s blood through an IV line, and there is no need for local or total anesthesia.

  Operation Risks:

Contamination of the site of intravenous catheter insertion - this infection is often superficial and treated topically. However, in rare cases, it may lead to more severe infection of the layers of the skin or blood vessels (phlebitis).

Bleeding - Bleeding occurs mainly in the area where the catheter was inserted, as a result of local tissue damage. It is usually a small hemorrhage under the skin that clears up within a few days.

Rejection of the transplanted marrow of the body (myeloid attack of the host) - here the transplanted cells make a severe immune reaction against the cells of the body. Today, however, many drugs can be given to the patient in order to prevent this phenomenon.

Postoperative treatment:

After the bone marrow transplant, the patient stays in the hospital under observation, until he regains his health and the capacity of his immune system.

In the first days after the operation, the patient often feels very tired, loss of appetite, nausea, and even the need to vomit, in addition to some symptoms caused by the preparatory chemotherapy that preceded the operation, which causes a large number of side effects.

Immediately after the transplant, the patient is given medications to reduce the activity of his immune system, in order to reduce the chances of rejection of the transplanted marrow. These drugs are given to the patient for a long time - in some cases for life - and it is necessary to carefully monitor the patient’s blood tests because of the various side effects that these medicines may cause.

The patient can take pain reliever as needed. Sometimes painkillers can be given intravenously. In the following cases, the patient must go to the doctor directly: a sudden rise in temperature, low blood pressure, persistent pain despite the use of analgesics, shortness of breath, diarrhea, itching, rash, or bleeding.