Bone Marrow Transplantation

It is a process that can restore damaged blood formation in a patient's body. It consists in intravenous application of hematopoietic cells either of the patient himself/herself (autologous transplant) or donor cells (allogeneic transplant). However, before the actual application, the patient has to undergo an exacting preparation when high doses of cytostatics are used.

The most frequent indications for transplantation of hematopoietic cells are: acute myeloid leukemia, acute lymphatic leukemia, non-Hodgkin lymphomas, malignant lymphogranulomas, myelodysplastic syndromes, myelofibrosis, chronic lymphatic leukemia, chronic myeloid leukemia, serious aplastic anemia, myelomas, and congenital disorders of hematopoiesis, metabolism and immunity.

We indicate transplantation only in those patients whose disease is not curable in another, less risky way because transplants, especially allogeneic, are connected with a not negligible risk of post-transplant complications that can lead to the transplanted person’s serious harm or death. The patient’s organs can be damaged during preparative regimen, the graft can react against the host in an acute or chronic form, a severe (bacterial, fungal, viral) infection can develop, organs can be damaged under the influence of medications, and a whole number of other complications can occur.

It is difficult to speak in general terms. Every diagnosis is different and every patient comes in a different condition. However, in 2012 an analysis was made for transplants performed in 1986–2010 and the results are as follows:

Acute myeloid leukemia: The five-year survival rate is approximately 50 percent; about 40 percent of patients survive more than ten years.

Chronic myeloid leukemia: The long-term survival is around 70 percent. Patients transplanted after the year 2000 have an 85–90 percent probability of ten-year survival, while the survival of patients transplanted earlier is around 60 percent.

Myelodysplastic syndrome: Patients transplanted at a less advanced stage of disease have approximately 70 percent probability of ten-year survival, while patients transplanted at an advanced stage have around 30 percent probability.

Acute lymphoblastic leukemia: Transplanted patients have a 50 percent probability of long-term survival.

Some 15 thousand bone marrow transplants are performed annually in the world, which is approximately thousand times more than 30 years ago. It is one of the reasons why bone marrow donors have been ever more important. We in the IHBT perform around 60 allogeneic transplants a year.

Patients’ rooms have their own sanitary facilities, LCD TVs with DVD players, radios and fixed phone lines. Patients can freely use their personal cell phones, and can utilize an internet connection through a WIFI network.

A basic condition of successful treatment is the guaranteed cleanness of the premises, especially of patients’ rooms. A high level of air purity is reached thank to an air-conditioning unit with three-level filtration and final HEPA filters. A positive overpressure in patients’ rooms prevents the entry of infectious agents from outside.

The rooms are equipped with central distribution system of oxygen and compressed air.

When being admitted to a transplant unit, bring basic personal toiletries with you (a new soft toothbrush, toothpaste, non-irritant soap, shaving accessories and washable slippers). The other things (a pyjama, towels and washcloths) will be given to you clean and sterile on a daily basis to guarantee a germ-free environment. Upon agreement with nursing personnel, it is possible to bring enough cotton socks or cotton pyjamas which, however, we will have to sterilize and will not be held responsible for any possible damage. It is also possible to bring books and magazines, a radio cassette player, a cell phone, a laptop and videocassettes (we will wash them with a disinfectant solution). As to food and beverages, it is possible to bring a small amount of fruit that can be peeled (oranges, tangerines, bananas), 100 percent instant coffee – only coarsely granulated Nescafe, mini jugs with coffee milk, tea bags, canned non-alcoholic beverages (cans of 0.33 l), biscuits without filling, purchased canned fruit in small containers, and individually wrapped sweets and chewing gum.