What is bone marrow transplantation? You need to be well prepared

With the increasing prevalence of blood diseases such as leukemia and anemia, bone marrow transplantation has become common. In fact, the conditions for bone marrow transplantation are very harsh. First, the HLA (human leukocyte antigen) matching must be completely consistent. Second, one must have a good mentality and physical strength, otherwise one will not be able to cope with the subsequent radiotherapy and chemotherapy, pathogenic microorganism infection and the body's rejection reaction.

Bone marrow transplantation, also known as hematopoietic stem cell transplantation, is a treatment method that treats a series of diseases by intravenously infusing hematopoietic stem and progenitor cells to rebuild the patient's normal hematopoietic and immune systems. Hematopoietic stem cell transplantation has basically replaced the term "bone marrow transplantation" because hematopoietic stem cells come not only from the bone marrow, but also from peripheral blood that can be mobilized by hematopoietic factors, and can also come from umbilical cord blood. These hematopoietic stem cells can be used to rebuild the hematopoietic and immune systems.

Pretreatment and return:

Before transplantation, patients should undergo a series of blood and bone marrow tests to confirm the disease diagnosis, type and disease status in order to determine the appropriate conditioning regimen, post-transplant primary disease monitoring and appropriate intervention strategies. At the same time, it is advisable to choose a donor with an HLA matching that is as identical as possible, between the ages of 8 and 60, in good health, without serious heart, lung, liver, kidney, brain or mental illness, and with normal hematopoietic and immune system functions.

Use of conditioning regimens can create space, immunosuppression, and clearance of disease. The intensity of the conditioning regimen is designed to both prevent transplant rejection to the greatest extent possible and achieve patient tolerance of its side effects, so there are a variety of conditioning regimens to choose from. One of the key characteristics of the conditioning regimen for non-myeloablative hematopoietic stem cell transplantation is that its radiotherapy (chemotherapy) intensity is significantly lower than that of traditional regimens. There are three main sources of hematopoietic stem cells used for transplantation: bone marrow, peripheral blood hematopoietic stem cell collection and umbilical cord blood. After appropriate processing, it can be returned to the pretreated patient.

With the improvement of transplantation technology, its therapeutic effect has gradually stabilized. Currently, the difficulty in selecting transplant donors has become a major obstacle to transplantation. The application of HLA-incompletely matched relative donors, HLA haploidentical related donors and unrelated donors and the improvement of related technologies have become hot topics in clinical research, and non-myeloablative technology has also brought about a conceptual revolution. The scope of application of hematopoietic stem cells continues to expand, and technology continues to improve, which can benefit more patients.