Hematopoietic Stem Cell Transplant Center
Definition and importance of stem cell bone marrow transplant
Treatment of bone marrow transplantation and stem cells began in 1985 and preliminary results were obtained for successful results.
Pure bones were transplanted to patients with malignant tumors, non-cancerous or non-malignant blood diseases as well as malignant blood diseases, genetic disorders, and immune diseases.
Bone marrow and stem cell transplantation of infected patients is treated in cases where the bone marrow does not work adequately or so-called bone marrow failure that produces stem cells.
Bone marrow transplantation and Hematopoietic stem cell transplantation are successfully treated in many malignant or benign blood diseases.
Hematopoietic stem cell transplantation also dates to the 1970s by Donal Thomas.
What is a stem cell bone marrow transplant
Bone marrow and stem cells consist in all blood cells in your body if the cells are mature or immatureFrom the blood-forming stem cells of the bone marrow as they are the main cells that guarantee stem cells to form, reproduce or repair each tissue in the human body.
The composition of all blood cell components and stem cells in the body is a pluripotent cell to form immune system cells.
Blood-forming stem cells are cells that are filtered or what we call directly isolated from the blood or the blood filtering has been isolated from the bone marrow, as well as stem cells are self-renewed themselves and whole blood tissue can be formed by differentiating blood cells in different ways.
Bone marrow and stem cells are the component of blood in cells in the bone marrow or filtering of blood or umbilical cord blood in the mother.
They are cells that have the potential to regenerate self-cells and permanently regenerate stem cells into different cells throughout life.
Stem cells and blood composition
Stem cells are the main cells of the body, which have the ability to divide and renew themselves infinitely.
They can transform into cell types as needed, as the human body produces millions of stem cells every day.
There are two main types of stem cells which are tissue-specific cells called embryonic stem cells which are found in the early stages of fetal development and adult stem cells found in certain tissues in the body after development.
The most important advantage of embryonic stem cells is that they are pluripotent, that is, they can turn into more than 200 types of cells in the body.
The differentiation of stem cells into different types of cells is limited by their original tissue, that is, they can self-renew as they only have the ability to transform into a specialized cell type of tissue and organ whose genes they carry.
The main task of adult stem cells is tissue repair in order to ensure the integrity and continuity of the tissues located in them.
As an example, blood cells taken from adult stem cells in the bone marrow can turn into red blood cells, but not into other cells, such as nerve cells or liver cells.
Is there a difference between bone marrow transplantation and stem cell transplantation
The main goal of the treatment is to collect hematopoietic stem cells and give them to the patient.
During the treatment it is possible to apply stem cell extraction from the bone marrow, which is very rich in hematopoietic stem cells, and stem cells taken from the blood (peripheral blood or umbilical cord blood) can also be used.
Means bone marrow is a stem cell product of the body. As well as during the extraction of stem cell taking application there are differences in the methods used in stem cell collection Mama causes some side effects and complications.
Where to get hematopoietic stem cells
In terms of blood production, the most common place for stem cells (hematopoietic stem cells) is the bone marrow where stem cells are found in human blood, which we call peripheral blood cells and also there are stem cells in umbilical cord blood.
Stem cells can be obtained from embryonic tissues, umbilical cord blood and hematopoietic stem cells;
- Bone Marrow transplant or stem cell transplant: (located inside the bone marrow) Stem
- Cell Transplantation: blood stem cells collected from the bone marrow are used.
- Peripheral Blood Stem Cell (PBSC) transplantation: blood stem cells that are collected from the blood in the body.
- Umbilical cord blood transplants: blood stem cells collected from the placenta of a newborn baby and the umbilical cord.
Stem cells from bone marrow are collected under general anesthesia in sterile operating room conditions.
The function of bone marrow is to produce blood cells as follows:
- 175 billion red blood pellets/day
- 70 Billion Leukemia Cells/Day (Neutrophils, Acids, Basal Cells) Neutrophils, Eosinophils, Basophils
- It can increase production capacity 10 times if necessary
Hematopoietic System
- These cells are blood cells that can turn into red blood cells (red blood cells) and white blood cells (leukocytes and platelets.
Specific function of many mature blood cells (more than 10) that make up the system:
- Transfer oxygen to tissue, to carry red blood cells (red blood cells) oxygen to the organs.
- The functioning of the immune system, white blood cells (leukocytes) are involved in infection control.
- Bleeding control, platelets are involved in bleeding control.
- Most blood cells have a very short lifespan and must complete continuous production, the average human needs hundreds of billions of blood-forming cells per day, and blood composition is a highly sophisticated production that controls the blood-forming balance.
- Blood-forming stem cells are the first and best-specifically detected and unique cells that have been successfully used for years.
What should become the bone marrow and stem cell transplant center units in children and adults:
- Unit Bone Marrow Center
- Special Floor Section for Bone Marrow Patients
- Human Leukocyte Antigen Tissue Matching Laboratory (HLA)
- Blood Stem Cell Filter Laboratory
- Cryopreservation and Stem Cell Treatment Plant
- Cellular Flow and Molecular Hematology Plant
Human Leukocyte Antigen (HLA)
In the laboratory, which is designed and operated according to the rules of EFI (immunology of the European Union), the service is provided to patients undergoing bone marrow and stem cell transplant treatment.
The results of human Leukocyte Antigen (HLA) tissue matching are evaluated and read from patients and donors and considering this, a treatment decision is made for the patient.
Transplantation of bone marrow and stem cells from insured identical donors is performed.
If there is no match in the tissues from the donor, the solution is a half-matched donation called “haplo” in addition to a donor from non-relatives or research from the blood and stem cell center in Turkey or Europe.
Bone marrow transplantation and stem cell transplantation – what diseases can be treated
Many malignant and non-malignant diseases in children can be cured by bone marrow and stem cell transplantation in children and adults.
Bone marrow transplantation and stem cells have two types:
- Implantation of bone marrow self-stem cells
- Bone marrow transplant stem cells from donor
- Bone marrow transplant stem cells from research at Central Blood Bank or from Europe
Patients are treated by transplantation of bone marrow and stem cells from the donor or self-stem cell transplant means from the bone marrow of the patient himself. It is done in cases of malignant or benign non-cancerous cancers.
The treatment decision for bone marrow and stem cell transplantation is taken from the donor for malignant cancerous diseases such as leukemia of bone marrow or myeloid dysplasia syndrome etc.
The treatment decision for the transplantation of the bone marrow self-stem cells is mainly taken in solid tumors and some types of recurrent lymphoma and others.
The following diseases are the most beneficial of bone marrow and stem cell transplants in children and adults:
- Leukemia
- Aplastic Anemia
- Lymphoma
- Multiple Myeloma
- Immunodeficiency Disorders
- Solid Tumor Cancers
Patients suffer from diseases differently and bone marrow transplants may not be suitable for everyone suffering from these diseases.
Malignant blood diseases
Acute Lymphoblastic Leukemia
- Acute Myeloblastic Leukemia
- Chronic Myeloid Leukemia
- Juvenile Myelomonocytic Leukemia
- Myelodysplastic Syndrome
- Non-Hodgkin Lymphoma
- Hodgkin Lymphoma
Primary immunodeficiency (hereditary immunodeficiency)
- Severe Combined Immunodeficiency (SCID)
- Adenosine Deaminase Deficiency
- Lack of Zap-70
- Omenn Syndrome
- Chediak Higashi Syndrome
- Wiscott Aldrich Syndrome
- Di George Syndrome
- IPEX IPEX Syndrome
- (ALPS) Autoimmune Lymphoproliferative Disease (ALPS)
- Chronic Granulomatous Disease
Other hereditary diseases
- Thalassemia Major
- Sickle Cell Anemia
- Fanconi Aplastic Anemia
- Diamond Blackfan Anemia
- Primary Hemophagocytic Lymphohistiocytosis
- Congenital Dyserythropoietic Anemia
- Kostmann’s Disease
one marrow failure (defect of blood-forming stem cells)
- Acquired Aplastic Anemia
- Structural Aplastic Anemia
- Dyskeratosis Congenita
- Shwachman Diamond Syndrome
- A megakaryocytic Thrombocytopenia
- Paroxysmal Nocturnal Hemoglobinuria
Autoimmune diseases (patients who do not respond to standard treatment) – stem cell transplantation in the treatment of autoimmune diseases
- Crohn’s Disease
- Systemic Lupus Erythematosus (SLE)
- Rheumatoid Arthritis
- Evans Syndrome
- Autoimmune Hemolytic Anemia
Metabolic diseases
- Wolman’s Disease
- Mannocytosis
- Mucopolysaccharidosis
- Leukodystrophies
- Adrenoleukodystrophy (ALD)
- Metachromatic Leukodystrophy (MLD)
- Globoid Cell Leukodystrophy (Krabbe)
- Osteopetrosis (Metabolic Bone Disease)
Self-stem cell bone marrow transplant (stem cells are taken from the patient himself) in children and adults
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Bone marrow transplantation and stem cells from the donor (stem cells are taken from the donor) in children and adults |
· Multiple Myeloma
· Plasma Cell Leukemia · Non-Hodgkin Lymphoma · Hodgkin Lymphoma · Acute Myeloid Leukemia · Neuroblastoma · Germ Cell Tumors · Ovarian Cancer
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· 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 | Other diseases |
· Autoimmune Diseases
· Primary Amyloidosis |
· Aplastic Anemia
· Major Thalassemia · Sickle Cell Anemia · Paroxysmal Nocturnal Hemoglobinuria · Fanconi Anemia · Severe Combined Immunodeficiency |
What are the main indicators for treatment of bone marrow and stem cell transplantation
- Blood-forming cancers (leukemia – lymphoma – myeloma)
- High-dose treatment in non-blood-forming cancers
- Genetic bone marrow diseases or acquired diseases: aplastic anemia, thalassemia, in sickle cell disease
- Increased incidence of autoimmune diseases.
What is the CD34-derived cell in the treatment of bone marrow transplantation and hematopoietic stem cells
Differentiation cluster and surface differentiation antigens (CD) or (Cluster of Differentiation) hematopoietic stem cells from the mother cell (CD34):
The presence of many cell surface molecules has been identified with studies conducted today. One is the particles of the differentiation group (surface differentiation antigens (CD).
The naming of CDs is an acceptable method worldwide, and CD molecules are used to diagnose and treat many diseases.
Cluster differentiation (CD) is productive cells found in bone marrow that can be transformed into whole cells. They are found in very small amounts in circulation.
The differentiation cluster characterizes the surface differentiation antigens of CD34 cells as being directly transformed into tissue cells.
In this way it allows the healing of tissues that usually have no chance of healing such as cartilage cells and neurons.
Examination of donors in bone marrow and stem cell transplantation in children and adults
Pediatric or adult hematology, oncology and immunology specialists who follow patients at the center are responsible for determining the need for donors for bone marrow and stem cell transplantation in children and adults and examining related donors for patients.
The responsibility for the decision to start the examination for the irrelevant will lie with the members of the board of Agriculture.
One of the most important factors limiting the application of stem cell transplantation is that the patient is not an HLA-compatible stem cell donor (compatible with the tissue type) as the tissue set corresponds in identical twins and siblings who have the same genetic inheritance from both parents.
The tissue type of ideal donor is a compatible brother for patients. There are 3 alternative stem cell sources in stem cell implants for patients not conforming to HLA:
- Voluntary and non-relative donors
- Cord blood donors
- HLA- Relative donors partially mismatched.
HLA’s similar relatives donors to patients without a family donor are screened for a donor compatible with the tissue type of donor banks in our country (TÜRKÖK) and volunteer donors registered with the World Bone Marrow Bank where donated cord blood is voluntarily stored.
Types of bone marrow transplants and blood-forming stem cells in children and adults
- Autologous Bone Marrow Transplant
- Allogeneic Bone Marrow transplant
- Haploidentical Bone Marrow Transplant
Stem cell transplants are divided into two bone marrow transplantation sections of the donor and self-bone marrow transplantation so that if the stem cells we use are the stem cells of the patient himself, this is called self-stem cell transplantation.
If it is not possible to use the patient’s own subjective stem cells and if we use another healthy person’s stem cells means the donor it is called a stem cell transplant from the donor.
Autologous Bone Marrow Transplant
Among the standard treatment methods in cases of lymphoma and myeloma where it is used as a treatment for blood tumors.
Stem cells from the bone marrow are collected from the patient, i.e. when the disease is cured or in stable condition from special drugs (chemo) and then previously frozen stem cells are transferred to the patient.
These extracted and pulled stem cells are frozen using dimethylsulfoxide or hydroxethyl starch and stored in mechanical freezer -135 ° C, vapor tanks -156 ° C or nitrogen tanks -196 ° C.
Endogenous stem cell transplantation is used to treat solid tumors (testicle, lung, ovary, breast) that are lymphoma and organ cancers other than bone marrow.
Allogeneic Bone Marrow transplant:
Bone marrow transplantation and stem cells from the donor are offered to patients as a therapeutic option with treatment success rate rates where it uses all technological and molecular advances.
Transplantation of stem cells from the donor is the process of transferring blood-forming stem cells from a healthy donor to the patient after a high rate of chemotherapy.
A stem cell donor can be harmonious (twin), brother, half-brother relative or non-relative volunteer.
After bone marrow transplantation (stem cells), it takes 10 to 15 days for stem cells to start producing blood cells again.
During this period, the patient is supplemented by blood cells from outside, because the bone marrow will need to transfer red blood cells and platelets for the time it takes to produce enough healthy cells on its own.
Haploidentical Bone Marrow Transplant:
If a fully compatible stem cell cannot be found from the person himself, his family or a donor, a single-match transplant is performed using semi-identical stem cells obtained from first-class relatives.
Bone marrow transplant and blood stem cells – Duration of bone marrow transplant
Before transplantation, initial preparations are made by assessing the type and stage of the disease and the performance of the recipient.
The patient is prepared for transport using chemotherapy or radiotherapy protocol called “preparation system.”
These protocols take 8-10 days. Blood-forming stem cell transplantation is not an operation but rather the source of blood-forming stem cells (bone marrow, peripheral blood or umbilical cord blood) that are planned for the patient’s intravenous transplantation after chemotherapy or radiation.
The spread of these cells through the blood, down to the bone marrow and its stability, is called “nesting.”
“Bone marrow patch” occurs when the donor stem cells that settle here begin to produce intact blood cells. Although this process takes an average of two weeks, it may be shorter or longer.
If no complications are observed after bone marrow transplant, the patient is discharged after 4 weeks. In case of complications, hospital stay may be prolonged.
What are the risks of bone marrow stem cell transplantation
Bone marrow transplantation (stem cells) can take a long time for the immune system to be healthy and to produce healthy new blood cells immune recovery after transplantation depends on many variables.
For example, immune recovery can take up to five years depending on the source of the stem cells used, immunosuppressive interventions, various problems that develop, and cell subtypes that can show improvement at different times.
Bone marrow transplant patients are at risk of infection during this time and should take precautions.
Also, a decrease in the number of blood cells which can cause anemia, heavy bleeding, bruising, an increased risk of infection, and some patients may need a blood transfusion for a while.
Possible complications associated with bone marrow transplantation
(Graft-versus-host disease, abbreviated GvHD), a syndrome characterized by inflammation in various organs and graft-versus-host disease is often associated with marrow transplants and stem cell transplants.
It can have serious and life-threatening complications, donor-derived cells may damage the patient’s own cells and graft-versus-host disease (GVHD) may occur (adverse effect. The lower the matching of the tissue group between the donor and the patient, the greater the risk of GVHD.
And to minimize this negative effect, the patient should use drugs that suppress the immune system, which we call immunosuppressants, for a long time.
- Stem cell error
- Infections
- Cataract
- Infertility
- New cancers
Results of bone marrow and stem cell transplantation
The goal of bone marrow and stem cell transplantation is to eliminate the existing disease with so little damage that preparatory treatment means chemotherapy which will be applied in this way and may be the most important cause of premature death as well as the only source of overcoming the disease and even achieving medium- and long-term recovery.
Therefore, familiarity with and mastery of preparatory treatments and having the skills and experience to choose the most appropriate preparatory treatment for the patient is the most important part in the treatment of bone marrow transplant and stem cells of the patient.
Bone marrow transplantation can treat some diseases and soothe others. Bone marrow transplant goals depend on your individual condition but often involve controlling or treating your disease, prolonging your life, and improving your quality of life.
Some people complete bone marrow transplantation with few side effects and complications. Others face many difficult problems in the short and long term.
It can be frustrating if significant difficulties arise during transplantation. It is sometimes useful to remember that there are many survivors who have had a very difficult time in the transplant but have eventually had successful transplants and returned to their normal activities with a good quality of life.
The severity of side effects and the success of the transplant varies from person to person and can sometimes be difficult to predict before the transplant.