In recent years, due to the development of drugs, considerable progress has been made in controlling bone marrow rejection and implant-versus-host disease. Many bone marrow transplant centers in the world have used unrelated donors with the same human leukocyte antigen, and there are many successful cases with good results. As for bone marrow transplantation, how to do it? The practice of bone marrow transplantation is mainly divided into three stages.
The first stage is conditioning. During this period, patients should first receive a large number of chemical drugs or combined with whole body radiotherapy, the main purpose of which is to completely destroy the original immunity and kill the remaining cancer cells in the body as much as possible.
The second stage is bone marrow extraction and input stage. After the preparation is completed, the bone marrow of about 15 cc per kilogram is extracted from the intestinal bones on both sides of the donor in the operating room, filtered and put into a blood bag, and then the bone marrow can be input into the patient through the patient's central vein to complete the bone marrow transplantation.
The third stage is the post-transplant nursing period, which is also the most important period, because before the new bone marrow grows, patients are most prone to complications such as infection, and the prevention and treatment of this period is the most important link for the success of bone marrow transplantation.
What are the complications of bone marrow transplantation?
The biggest complications of bone marrow transplantation are infection and graft versus host reaction disease (GVHD). Before bone marrow transplantation, patients must receive a lot of chemical drugs or combined with whole body radiotherapy, so patients are almost immune before new bone marrow grows, which may lead to bacterial or viral infection at any time. However, due to the use of sterile room or the application of anti-isolation measures, as well as the invention of new antibiotics and the use of antiviral drug acyclovir, most bacterial or viral infections have been prevented and controlled. However, the treatment of interstitial pneumonia and fungal infection caused by cytomegalovirus (CMV) still needs further research and development. As for graft-versus-host reaction disease, it mainly occurs in allogeneic bone marrow transplantation, while autologous bone marrow transplantation uses its own bone marrow. It can be said that the probability of implant-versus-host reaction disease is very small. At present, cyclosporine, methyl steroid and some immunosuppressants can effectively prevent and control implant-versus-host reaction diseases in allogeneic transplantation. In recent years, the use of some immune antibodies, such as anti-thymocyte globulin, has also had a certain effect on refractory implant-host reactive diseases. Although the development of new drugs has made great progress in controlling infection and implant-host reaction diseases, these two complications are still the biggest reason for the failure of bone marrow transplantation at present and need further study.
In short, bone marrow transplantation has become an indispensable treatment for many hematological diseases and hematological tumors. Although traditional chemotherapy can make many patients achieve remission, most patients are still on the way to relapse. Although bone marrow transplantation is a treatment method of "dying after death", it provides patients with an opportunity to "turn over a new leaf".
When blood donors go to the Red Cross Blood Center or the street blood collection vehicle of the center to participate in voluntary blood donation, if they want to donate bone marrow, they should ask the staff, fill in the registration form, then draw 5 ml more blood and submit it to the HLA matching laboratory for testing. Blood donors in cities under the provincial jurisdiction should register with the local Red Cross by telephone, and the Municipal Red Cross in conjunction with the municipal blood bank or other medical units will arrange time to inform blood donors to fill in the registration form and collect blood samples, and then send them to the provincial HLA matching laboratory for testing. The laboratory staff input the data obtained by testing the blood of blood donors into the bone marrow database. When a donor's bone marrow match matches the patient who needs bone marrow transplantation, the medical staff will inform the donor for further testing, and then extract hematopoietic stem cells for transplantation.