Ten questions about bone marrow transplantation

What is “blood stem cell”?

Ten questions about bone marrow transplantation Blood cells in normal human bodies, including red blood cells, white blood cells, and platelets, are continuously produced and differentiated by hematopoietic stem cells in the bone marrow. The so-called “blood stem cells” refer to these hematopoietic mother cells that have the ability to reproduce and differentiate. Hematopoietic stem cells usually account for about 1 to 4% of the nucleated cells in the bone marrow, but they are very rare in peripheral blood, less than 0.1%.

Ten questions about bone marrow transplantation

These blood stem cells can be clinically determined and quantified using cell culture methods (such as CFU-GM) or special marker staining (such as CD34); in addition to blood stem cells found in bone marrow and peripheral blood, umbilical cord blood at birth It is also rich in many blood stem cells; these blood stem cells can be used as bone marrow transplantation or peripheral blood stem cell transplantation to restore the patient’s blood immune system.

What is a bone marrow transplant?

Bone marrow transplantation is simply to transplant the bone marrow of a normal person into the patient’s bone marrow which is abnormal or loses hematopoietic function, and restores the patient’s hematopoietic function. Bone marrow transplantation is divided into allogeneic bone marrow transplantation and autologous bone marrow transplantation according to the source of bone marrow. Allogeneic bone marrow transplantation can be divided into parental and non-parental bone marrow transplantation. Parental bone marrow transplantation is performed by the patient’s sibling or other close relatives. Non-parent bone marrow transplant donors are the general public who donate bone marrow; while autologous bone marrow transplants, the donor is the patient itself. When the patient achieves remission by chemotherapy, the patient’s bone marrow is extracted and processed and frozen. ,Ten questions about bone marrow transplantation And then bone marrow transplantation at an appropriate time.

How to take bone marrow to a patient? How much do you need to smoke? Does it drain the bone marrow? What are the sequelae of bone marrow donation?

When the donor is ready to donate the bone marrow, the doctor will let him enter the operating room, receive general anesthesia, and then use special needles to extract the bone marrow from the intestinal bone on both sides of the donor. The bone marrow is like blood. The amount of blood drawn is usually determined by the weight of the patient ’s bone marrow. Generally, bone marrow is extracted from the bone marrow of about 10 to 15 pounds per kilogram of the patient’s body weight, and then filtered into a blood bag, which can be input through the patient’s central vein Bone marrow infusion is performed in the patient Ten questions about bone marrow transplantation.

As for any complications or sequelae after bone marrow extraction? This is also the most important concern of bone marrow donors. Bone marrow donation is different from other organ donations. Because bone marrow has a very strong regeneration capacity, it produces about 70㏄ of new blood every day. Therefore, it usually takes about 1 to 2 weeks after bone marrow donation. Fully recoverable; therefore, bone marrow pumping will not drain.

Ten questions about bone marrow transplantation

As to whether there are any complications or sequelae, according to research reports, the chance of occurrence is extremely small. Generally, there will be some soreness and occasional fever after pumping, and it can fully recover after treatment Ten questions about bone marrow transplantation.

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What is “peripheral blood stem cell transplantation”?

Many studies in the 1970s used hematopoietic stem cell culture tests and found that after cancer patients received high-dose chemotherapy, when their bone marrow was inhibited and recovered, many hematopoietic stem cells ran out of the bone marrow and circulated in the peripheral blood; in recent years, It has also been found that leukocyte-forming hormones such as G-CSF and GM-CSF can be used to drive blood stem cells in the bone marrow to the surrounding blood. Using these leukocyte-forming hormones alone or in combination with chemicals can increase the number of peripheral blood stem cells by several tens to several digits. A hundred times, these peripheral blood stem cells can be collected to replace the bone marrow to restore blood immune function; therefore, the so-called “peripheral blood stem cell transplantation” is to use some chemicals or white blood cells to generate hormones to stimulate the hematopoietic stem cells in the bone marrow to run to the peripheral blood, and then use The blood cell separator collects these hematopoietic stem cells, refrigerates them in ultra-low temperature liquid nitrogen, and then allows the patient to receive a large amount of chemotherapy or systemic electrotherapy at the appropriate time Ten questions about bone marrow transplantation. The frozen peripheral blood stem cells are thawed and returned to the body.

How is peripheral blood stem cell transplantation different from autologous bone marrow transplantation?
 The similarities and differences between peripheral blood stem cell transplantation and autologous bone marrow transplantation are as follows:

Peripheral blood stem cell transplantationAutologous bone marrow transplantation
Blood stem cell sourcePeripheral bloodmarrow
Do you need to pump bone marrowNo, donate blood as usualYes, like allogeneic bone marrow transplant
Need to drive blood stem cellsYes, patients need to receive drive chemotherapy and / or injection of leukocyte growth hormoneNo need
Patient blood cell recovery timeFasterSlower
Use drugs such as antibioticslessmany
Average length of hospital stayShorterLonger
Ten questions about bone marrow transplantation

Peripheral blood stem cell transplantation does not require bone marrow extraction, and blood cells recover rapidly in clinical practice. Therefore, autologous bone marrow transplantation has gradually been replaced Ten questions about bone marrow transplantation.

Who needs an allogeneic bone marrow transplant?
 Allogeneic bone marrow transplantation is mainly used to treat (1) severe aplastic anemia (2) chronic myelogenous leukemia (3) acute leukemia (including acute myeloid and acute lymphocytic leukemia) (4) malignant lymphoma (including He Jie King’s lymphoma and non-Hodgkin’s lymphoma) (5) congenital diseases (such as severe thalassemia) or immunodeficiency (6) other solid tumors; the first three of which are currently covered by health insurance, and Others require prior approval before implementation.

Who needs a peripheral blood stem cell transplant?
 Peripheral blood stem cell transplantation, like autologous bone marrow transplantation, is currently mainly used to treat solid tumors that are sensitive to high-dose chemotherapy or electrotherapy, such as malignant lymphoma, breast cancer, neuroblastoma, germ cell cancer, lung cancer, etc … Its long-term effects are yet to be evaluated, so it is currently necessary to apply for advance health care benefits before implementation.

What is a bone marrow bank? Why build a bone marrow bank?
 Bone marrow transplantation has been a life-saving treatment method for various blood diseases, tumors and some congenital diseases. Bone marrow transplantation requires the donor to cooperate with the patient’s human white blood cell antigen. Therefore, relatives of siblings are the most suitable source of bone marrow. About 1/4 to 1/3; most patients who need bone marrow transplantation still can’t find suitable siblings as marrow donors. The so-called “bone marrow bank” is a human leukocyte antigen database established by gathering patients who are willing to donate their own bone marrow to suitable and need bone marrow transplants to save lives. When a patient who needs bone marrow transplantation cannot find a suitable relative donor, he can enter his human leukocyte antigen data into the bone marrow bank to find a matching non-parent donor Ten questions about bone marrow transplantation.

How to become a happy donor
 When you register as a voluntary marrow donor, about 10 抽取 of blood will be drawn from your arm vein to test your human leukocyte antigen-A, -B, and -DR types, also known as HLA. The HLA results are entered into a computer database. When a patient who needs bone marrow transplantation cannot find a suitable bone marrow donor among his siblings, he can enter the patient’s HLA type data into the computer and find a suitable volunteer bone marrow donor in the bone marrow bank. If you are the bone marrow donor who is compatible with the patient’s HLA, when the patient begins to receive bone marrow transplantation, the patient will be hospitalized to collect the bone marrow on the scheduled day of bone marrow transplantation. Therefore, the establishment of the bone marrow bank does not require the bone marrow to be removed and stored To get up, just check the type of HLA first, and wait for the patients who need bone marrow transplantation and the HLA cooperation is the same before the need for bone marrow extraction. This is also a common misunderstanding of ordinary people and I become a happy donor Ten questions about bone marrow transplantation.

Ten questions about bone marrow transplantation

Are there any conditions for a donor?


 Generally speaking, as long as you are in good health and have no history of important organ failure, infectious diseases (such as AIDS) and malignant tumors, men and women aged 18 to 55 can be of any blood type Ten questions about bone marrow transplantation.

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