The program is a bone marrow transplant in Israel from Assuta Hospital aims to develop advanced strategies for autologous and allogeneic stem cell transplantation for a wide range of hematological malignancies , solid tumors and other life-threatening disorders.
Patients of private clinics are a comprehensive assessment to determine whether they are suitable for health for transplantation. If so, then the hospital doctors prepare them for this procedure. Clinic services include:
- Evaluation of patients (diagnostic screening).
- Collection of blood stem cells.
- Treatment of cells and cryopreservation (cold storage).
- Preparation, treatment of patients.
- Infusion, transplantation of stem cells.
- Prevention and treatment of complications.
Learn more about stem cells
For a successful transplant requires hematopoietic cells. At the moment, the stem cells are taken from bone marrow, umbilical cord and peripheral blood. They can take from a few donors. When the fence is derived from the patient - this is an autologous material. If samples are taken from other people - allogeneic. When the donor is an identical twin, donation called singenicheskim. Related allogeneic donors to look for among the patient's family members and unrelated to them shall be identified through the registry or the blood bank.
Indications for bone marrow transplant in Israel
Performed a bone marrow transplant in Israel for serious diseases, including:
- Leukodystrophy, osteopetrosis, Hurler syndrome, and others.
- Immunodeficiency, HIV, Wiskott-Aldrich syndrome.
- Pure red cell aplasia, sickle cell disease, beta-thalassemia.
- System and multiple sclerosis, systemic lupus erythematosus, juvenile rheumatoid arthritis, Crohn's disease.
Among precancerous diseases transplantation appointed:
- Lymphocytic and myelomonocytic leukemia.
- Myelogenous leukemia.
- Myelodysplastic syndromes.
- Disorders of plasma cells.
- Hodgkin's and Non-Hodgkin's lymphoma.
The donor search for kinship lines and from the bank register
Once the disease is identified, and transplantation is considered as a possible therapy, it is required to find a donor. The more matches with the patient it will be observed, the greater the likelihood of success of the procedure and the absence of complications.
For donor organizes a special study to test antigens from members of his family. The resulting test information helps the doctor to determine the risks. Are taken into account age indicators, gender-specific, weight parameters and other data. Thus, it is believed that a younger donor rather elderly, female stem cells for men are less favorable, in the absence of blood tsitamegalovirusa gives the best results during the procedure, etc.
If a blood donor can not be found, sought an unrelated supplier of biomaterials. For this study cord blood banks and donor lists, which are represented in the databases of the 43 countries, and umbilical cord blood - from 21 countries.
The process of finding unrelated donors begins with DNA matching. This is followed by a preliminary search, which investigated the registry database. At the request of the potential donor to the patient will have to pay, as it passes laboratory tests, screening for viruses, the physical examination. With the consent of the donor is determined date. Bone marrow is collected on the day of the alleged transplantation with the intention to carry out the transplant procedure within days.
Stages of a bone marrow transplant in Israel
Process transplantation typically divided into the following five phases:
- The infusion of stem cells.
- Neutropenic phase.
- Rehabilitation period.
Air conditioning lasts 7-10 days. His goal is to make up for the results of chemical, radiation or both technologies to remove a malignant tumor, prevent rejection of new stem cells and make room for a fresh batch. The most common conditioning circuits include a full body irradiation and the use of chemotherapeutic agents in different combinations. To prevent graft rejection can be added anti-T-cell agents. Patients usually tolerate this stage. The only adverse reaction that can occur here - it's nausea and vomiting reflex. However, this discomfort quickly eliminated by antiemetic therapy.
Processing and stem cell infusion
Infusion of stem cells is carried out for an hour, but this period varies depending on the infusion volume. Stem cells can be treated prior to infusion infusion. Before the procedure, the patient is given medication profile to prevent backlash. The cells were then introduce via a central venous catheter. In fact, the session is similar to the standard blood transfusion. Among the potential complications: anaphylaxis, volume overload. In addition, stem cells products that were cryopreserved comprise dimethylsulfoxide. Not only is the preservative has a very distinctive taste and smell of it could potentially cause kidney failure.
Period lasts 2-4 weeks. During this period the patient is essentially no effective immune system. Healing is not yet running at full capacity, and the patient is very susceptible to all sorts of infection and inflammatory reactions. Supportive treatment and empiric antibiotic therapy are the basis of successful completion of this phase.
In the early phase of herpes simplex virus is an important potential pathogen. This can occur by reactivation of a previous infection. In addition, during this period, the body susceptible to endogenous flora and the development of skin and harmful intestinal microorganisms. The most dangerous nosocomial infections, because most of them are resistant to standard regimens using antibiotics.
In addition to the risk of infection there is another problem - the food. As a rule, most of the patients mouth strikes a heavy mucositis. Therefore, a special mode is selected, do not have a negative impact on the patient's condition.
At this stage, bone marrow transplant goes to completion. Gradually tightened symptoms of mucositis, neutralized other skin damages and mucous. Waning fever, tormented by the patient for several days. The body includes a protective barrier and slowly released from infections. However, there is a very different reaction. The fact that the immune system can attack the entire body in the transplantation of hematopoietic stem cells. This is what happens in some cases, causing serious complications. This "attack" exposed skin, gastrointestinal tract and liver. Visible reaction may become blisters and rashes, diarrhea, hyperbilirubinemia. Reaction eliminated the appointment of a competent treatment.
The period lasts from several months to several years. Gradually, all the negative reaction to stabilize. Most patients who survived a bone marrow transplant in Israel, appointed reimmunizatsiya. It comes about a year after the procedure. The use of immunization depends on the age. In addition, inactivated poliovirus vaccine can be given. Oral vaccine against polio can not appoint. Vaccination against influenza should be administered every year in all patients. If the protective titer is derived from tetanus vaccine, you can proceed to vaccination against Hib, pneumococcus and hepatitis B. After 2 years, immunization can be continued vaccine against measles, mumps and rubella only if the patient has successfully immunized with the above composition, it is disconnected from the immunosuppressants for more than 6 months ago.
Bone marrow transplantation has a beneficial effect on improving survival and quality of life for patients with severe disease (listed above). Those patients who are directed to the transplant in remission or with stable disease showed better results when compared with patients who were transplanted stem cells in relapsed disease. Better indicators give young patients. Accent current research is aimed at reducing the toxicity of the drugs using the materials unrelated donors.
How much is a bone marrow transplant in Israel
The clinic Assuta transplant is performed using the latest equipment, which is difficult to find in the leading clinics of the world. The cost of the transplant:
- When a related donor - $ 142,000.
- When an unrelated donor - $ 196,000.
Doctors Hospital are recognized experts in their fields, as evidenced by numerous patient testimonials:
Igor Leonidovich, 49 years old
"When I wanted to know how much change Israel, which was needed after my nephew complicated chemotherapy amounts voiced everywhere essentially the same, with small differences. Assuta because I think by far the most advanced in this regard, the hospital of Israel, chose her. Donor was unrelated. If used cell related donor, all would have cost a lot of budget. We did everything neatly. We monitor the condition sensitively and carefully. Gave bunch of recommendations before discharge. Overall, I was satisfied. "