Bone Marrow Transplant Center;
It successfully treats lymphoma, multiple myeloma, acute leukemias (to a lesser extent chronic leukemias), aplastic anemia and other bone marrow failures, hemoglobinopathies, myelodysplastic and chronic myeloproliferative diseases with stem cell transplantation.
What is Stem Cell?
Stem cells are non-specialized or differentiated cells that have not acquired certain functions, and have the ability to divide and renew themselves unlimitedly. They are the main cells that make up all the tissues and organs in our body. Hematopoietic stem cells are cells that produce red blood cells (red blood cells), white blood cells (white blood cells) and platelets and release them into the bloodstream. It is abundant in the bone marrow and umbilical cord and to a lesser extent in the peripheral blood.
It is an extremely challenging and stressful process for stem cell transplant patients, their relatives and doctors. However, it has been a beacon of hope by offering a new life to many patients such as blood cancer, recurrent lymph node cancer, bone marrow cancer, which had no cure until a very short time ago, and could even be fatal.
Within the scope of Bone Marrow Transplantation, which is applied in the bone marrow transplantation center unit, autologous (self-transplantation), allogeneic (fully compatible) transplantation from other donors or families, and haploidentical (semi-matched) donors are carried out. Bone marrow transplant centers of our hospitals serve both pediatric and adult patients. The collection of stem cells and bone marrow, the sorting and processing of the collected cells by various processes are carried out in the laboratories of our hospitals' bone marrow transplantation centers. Transactions and health analyzes of both donors and recipients are performed at the bone marrow transplant center.
1- Stem Cell
Bone marrow transplant is also known as stem cell transplant. It is the operation of transplanting healthy stem cells taken from the patient himself or another compatible donor, that is, the donor, in order to reassemble the damaged bone marrow stem cells.
Before the bone marrow transplant, drug therapy and chemotherapy are applied for the treatment of damaged stem cells. After these treatments, healthy stem cells are taken from the patient's donor or himself. Cells are transferred through a catheter inserted into a vein in the neck, similar to a blood transfusion. Patients are generally well at the time of transplantation. In the first month after the stem cell transplant, patients who have had a bone marrow transplant experience many side effects. These side effects are followed by a specialist physician and drugs that are good for reducing these side effects are given. Stem cells begin to produce new blood cells in the bone marrow and rebuild the patient's immune system immediately after transplantation.
2- Bone Marrow Diseases
Bone marrow or stem cell transplantation is a procedure applied for the treatment of cancer and many diseases that cause differences in the lymph and blood system.
a) Myeloblastic Acute Leukemia Disease
Monocytes and granulocytes, which form leukocytes that fight against bone marrow-type diseases, form blasts, that is, young cells in the bone marrow. These young cells grow over time and play an important role in the immune system. Findings in acute myeloblastic leukemia disease, as a result of the abnormality seen in the maturation period of blast cells, the cells that cannot maintain their normal levels are unable to fulfill their duties in the immune system together with the collection of cells in the bone marrow and blood. Bone marrow transplant center calls these findings acute myeloblastic leukemia disease. Symptoms include shortness of breath, weakness, fatigue, fever, bone pain, bruises on the skin, bleeding gums and nosebleeds. The diagnosis is made by bone marrow aspiration, bone marrow biopsy, genetic tests and peripheral smear. Treatment is bone marrow transplant and chemotherapy.
b) Primary Amyloidosis Disease
It is a disease caused by the irregular accumulation of proteins produced by the bone marrow in the organs. Symptoms include shortness of breath, fatigue, skin problems, diarrhea, heart rhythm disorders, weight loss, tongue enlargement, and stomach and intestinal problems. The diagnosis is made in our bone marrow transplant center unit by ECG, biopsy, urine and blood tests depending on the area. Treatment is bone marrow transplant and chemotherapy.
c) Aplastic Anemia Disease
It is a disease that occurs when enough blood is not produced due to the very small number of immature young stem cells called hematopoietic in the bone marrow. Causes such as birth, toxic intake, exposure to excessive radiation, tissue disorders, pregnancy, infections cause aplastic anemia. Symptoms include fatigue, weakness, shortness of breath, fever and infection. The diagnosis is made as a result of genetic tests, bone marrow aspiration, biopsy, blood count, serological tests and biochemical tests. In our bone marrow transplantation center unit, treatment is carried out with bone marrow transplantation and immunosuppressive drugs.
d) Paroxysmal Nocturnal Hemoglobinuria
It is a disease caused by the disintegration of red blood cells called erythrocytes, as well as the removal of hemoglobin, which gives our blood its red color and carries both oxygen and carbon dioxide, from the body of the person through the urine, and causes vascular occlusion as a result of coagulation in the veins. Symptoms are heart palpitations, fever, vascular occlusion, fatigue, chest, waist, head and stomach aches. Diagnosis is made by urinalysis, biochemical tests and flow cytometry in our bone marrow transplant center unit. Its treatment is carried out with erythrocyte suspension, bone marrow transplantation, monoclonal antibody therapy and drugs containing iron.
e) Hodgkin Lymphoma
It is a cancer that occurs in the lymphatic systems of the body, which is fighting against many diseases and infections. Many diseases such as AIDS, human herpes virus, and measles cause Hodgkin lymphoma. Symptoms of this disease are night sweats, itching, weight loss, loss of appetite, swelling in the armpits, neck or groin, enlargement of the liver or spleen. Diagnosis is made by computed tomography, ultrasonography, PET-CT, biopsy, biochemical and hematological blood tests. In the course of the disease, bone marrow biopsy is performed. The treatment is radiotherapy, chemotherapy and bone marrow, that is, stem cell transplantation, in our bone marrow transplantation center unit.
f) Non-Hodgkin Lymphoma
It is a type of cancer that occurs in the lymphatic systems, which are in charge of strengthening immunity in the body. Situations such as exposure to pesticides, viral diseases, some drugs, exposure to toxic gases cause this disease. Symptoms include weight loss, fever, night sweats, weakness, sores on the skin, and palpable swellings in the armpits, neck, or groin. Diagnosis and treatment methods are similar to Hodgkin lymphoma cancer.
g) Myelodysplastic Syndromes
With the abnormality of the time it takes to produce new blood cells in the bone marrow, the maturation of cells in the bone marrow becomes more difficult. This disease, which generally occurs in older ages, causes anemia in the body by causing platelet and leukocyte deficiency. As the disease progresses, it can turn into leukemia. Symptoms include night sweats, weakness, abnormal weight loss, bruising on the skin, and fever due to infections. The diagnosis is determined by genetic tests, blood count and bone marrow aspiration or biopsy in our bone marrow transplant center unit. Its treatment is done with drugs, erythrocyte suspension and stem cell transplantation.
h) Multiple Myeloma Disease
It is a cancer caused by excessive and uncontrolled proliferation of plasma cells in the immune system. This disease, which generally occurs in later ages, causes broken bones, weakening of the immune system and kidney failure. Symptoms include fever, malaise, loss of appetite, weight loss, low back pain, bone pain, and kidney failure. The diagnosis is made in our bone marrow transplantation center unit by bone scanning, bone marrow aspiration, urinalysis, biochemical and hematological tests, protein electrophoresis and immunofixation electrophoresis. The treatment is radiotherapy, chemotherapy and stem cell transplantation.
i) Chronic Myelocytic Leukemia
It is the presence of leukocytes that make up the immune system, too matured cells in the blood. In this type of cancer, where genetic problems are very effective, the number of red blood, white blood cells and platelets is quite high. Symptoms include pain, fatigue and sweating. Diagnosis is by peripheral smear, blood count, some genetic tests and bone marrow aspiration. Its treatment is carried out in our bone marrow transplantation center unit with drugs and bone marrow transplantation in resistant patients.
j) Chronic Lymphocytic Leukemia Disease
It is a cancer disease that occurs when the normal structure of lymphocytes in the immune system is disrupted and accumulates too much in the patient's body. Lymphocytes, whose structure is deteriorated, do not help the immune system, and it also prevents the production of red blood cells and platelets. Its symptoms are weight loss, weakness, fatigue, fever, enlarged spleen and liver, swelling in the groin, armpit and neck. Diagnosis is made by blood count, flow cytometry, peripheral smear, genetic tests and bone marrow aspiration. The treatment is immunotherapy, chemotherapy, radiotherapy and stem cell transplantation in our bone marrow transplant center unit.
k) Hemoglabinopathies
It is a genetically caused disease caused by the disruption of the globin chains that make up the hemoglobin in the blood.
l) Mediterranean Anemia, namely Thalassemia
It is an anemia disease that is passed on to the next generations with genetic problems that are more common in the Mediterranean region. Its symptoms are iron excess, heart failure, bone deformity, spleen enlargement, and hormonal disruption. Diagnosis is by peripheral smear, complete blood counts and hemoglobin electrophoresis in our bone marrow transplant center unit. Its treatment is bone marrow transplant, erythrocyte suspension transplant and certain drugs.
m) Sickle Cell Anemia Disease
It is a genetic disorder caused by the deterioration of the structures of hemoglobin, which is responsible for carrying oxygen to the blood, and the inability to perform its functions and the decrease in red blood cells in the blood. Symptoms include chest pain, stroke, infections, bone pain, gallstone formation, and crises. The diagnosis was made in our bone marrow transplant center unit. peripheral smear, complete blood counts, and hemoglobin electrophoresis. The treatment is certain drugs, preventive measures, erythrocyte suspension transplantation and stem cell transplantation.
What is Stem Cell Transplantation?
It is the process of giving healthy hematopoietic stem cells to the person himself (autologous transplant) or from another compatible donor (allogeneic transplant) in order to regenerate bone marrow stem cells that have been damaged / lost their function due to some benign or malignant diseases. Since the bone marrow is rich in stem cells, it was the first source used in stem cell transplants. However, nowadays, environmentally-derived stem cells are preferred because they are safe, fast and less irritating for both the recipient and the donor. In recent years, stem cells obtained from the umbilical cord have been used in transplants.
Before the stem cell transplant, chemotherapy and/or drugs are administered to the patient and the bone marrow is drained, and then stem cells taken from the patient himself or from a healthy tissue compatible donor are given. After this process, stem cells settle in the recipient's marrow, multiply and begin to produce hematopoietic cells, producing new blood cells and restructuring the immune system. The patient's blood values begin to improve within 2-4 weeks. Meanwhile, the patient is followed closely by his doctor. Especially on days when blood values are low (sometimes every day), blood support and in case of infection, antibiotics are needed. Full recovery of the immune system, on the other hand, requires much more time, and it may take up to 1-2 years, especially in allogeneic and umbilical cord transplants.