Treatment of Pancytopenia in Germany
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Pancytopenia is a condition characterized by a decrease in the levels of red blood cells, white blood cells, and platelets. The causes of this phenomenon may be quite varied. Patients with some diseases can expect that the production of their own cells will be restored in the future. However, in other cases, doctors have to resort to a bone marrow transplant. You can undergo your diagnostics and treatment of pancytopenia in Germany to get the best results. German doctors are striving to find the cause of the decreased blood cell production and eliminate it to restore the patient's own hematopoietic system.
Content
- Causes
- Diagnostics
- Elimination of the cause of pancytopenia
- Maintenance therapy
- Stem cell transplantation
Doctors find and eliminate the cause of pancytopenia whenever possible. They treat the underlying disease that has caused a decreased number of blood cells. Most patients require maintenance and symptomatic therapy. In severe cases, doctors perform a stem cell transplant.
You can undergo your treatment at the University Hospital Mannheim, University Hospital Ulm, or University Hospital Freiburg.
You are welcome to leave your request on the Booking Health website and we will take care of the organization of your trip. You will receive information about specialized clinics and modern treatment methods. Our employees will make a quick treatment appointment, bypassing a long waiting list. Our specialists will also help you to get a visa, book airline tickets, and get to the hospital. We will book an apartment for you or an accompanying person, if required. You will visit the clinic accompanied by an interpreter, and Booking Health will also take care of the translation of your medical records. A personal coordinator will always be in touch with you until your successful return home.
Causes
Pancytopenia is not a separate disease, but a hematological syndrome. The condition can develop as a result of many diseases. Some possible causes are:
- autoimmune diseases (systemic lupus erythematosus and rheumatoid arthritis);
- viral infections, such as parvovirus, HIV, Epstein-Barr virus, hepatitis, or COVID-19;
- bacterial infections, with tuberculosis being the most common;
- protozoan infections, with malaria being the most common;
- taking drugs that are toxic to the bone marrow (for example, cytostatics, immunosuppressants, antibiotics);
- alcoholic cirrhosis;
- nutrient malabsorption in the small intestine;
- tumors: lymphoma, leukemia, or myeloma;
- bone metastasis due to cancer;
- hypersplenism is characterized by an increased destruction of blood cells in an enlarged spleen;
- hyperparathyroidism, which is characterized by increased activity of the parathyroid glands.
Diagnostics
Accurate diagnostics of pancytopenia is as important as the treatment of this condition. Since there are many causes that lead to the development of this disease, it is necessary to find out what exactly caused a decrease in the number of cells in the blood. Many causes can be eliminated once and for all, while other diseases can be controlled for a long time.
Diagnostics include the following:
- blood tests, such as a complete blood count and a blood biochemistry test;
- determination of vitamin B12 and folic acid levels;
- examinations for infections, primarily for HIV, malaria, and tuberculosis;
- abdominal ultrasound.
If a patient has been examined and the cause of pancytopenia remains unknown, a bone marrow aspiration will be performed. This procedure is carried out under anesthesia. Bone marrow is harvested from the pelvic bone. In 75 % of cases, a bone marrow aspiration helps doctors to determine the cause of pancytopenia. Doctors can also detect malignant processes.
Elimination of the cause of pancytopenia
The cause of pancytopenia should be eliminated whenever possible. In this case, one can count on the restoration of bone marrow function and an increased production of blood cells.
The following options can eliminate the cause of pancytopenia:
- in the case of taking drugs that suppress the bone marrow, these can be canceled and replaced with drugs with a similar therapeutic effect;
- treatment of infections, such as HIV and tuberculosis;
- treatment of autoimmune inflammation with anti-inflammatory drugs, glucocorticoids, or immunosuppressants;
- restoration of normal nutrition, detection and elimination of the causes of poor nutrient absorption in the small intestine (for example, use of enzyme drugs for pancreatic insufficiency).
Surgical treatment may sometimes be required as well. For example, an enlarged spleen may cause decreased levels of platelets and erythrocytes in the blood, and, to a lesser extent, the number of leukocytes. In this case, doctors remove the spleen, and gradually the number of cells in the blood returns to normal. In Germany, this operation is performed using a minimally invasive laparoscopic technique.
Rarely, pancytopenia can be associated with hyperparathyroidism. The treatment involves surgical removal of the enlarged parathyroid gland.
Maintenance therapy
Symptomatic and maintenance treatment is required for all patients. In some cases, this can be the only treatment needed. For example, if pancytopenia is related to parvovirus, it will go away on its own over time. However, during this period, patients need maintenance therapy to avoid complications.
Treatment options include:
- red blood cell transfusions;
- platelet transfusions;
- antibiotics for bacterial infections or low neutrophil levels in the blood;
- antivirals.
Stem cell transplantation
Patients with aplastic anemia require a stem cell transplant, since it is impossible to restore their own bone marrow. German doctors perform an allogeneic bone marrow transplantation from a donor. This procedure helps to cure the disease or achieve long-term remission.
An allogeneic stem cell transplant is most effective in patients under the age of 40, and especially in people under 20 years of age. It is at this age that such a procedure is usually carried out. After 40 years, the results are worse, so bone marrow transplants are often rejected due to more stringent selection criteria for candidates for the procedure.
You are welcome to use the Booking Health service to undergo your diagnostics, treatment, and rehabilitation abroad. On our website, you can find the cost of services, compare prices in different hospitals, and make your treatment appointment at the best price. Our website presents the best German hematology centers. Please leave your request on the Booking Health website so that our specialists can help you to find clinics in Germany and arrange your trip abroad.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Vadim Zhiliuk and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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