Hematology: Aplastic anemia — Allogeneic bone marrow transplantation. Treatment
Aplastic anemia is one of the most severe forms of anemia. It is characterized by a pronounced inhibition of red blood cell, white blood cell and platelet production, and therefore the patient reports severe weakness, trophic disorders, increased bleeding and decreased immune defense. The standard treatment for aplastic anemia is bone marrow transplantation, which allows achieving favorable results in 85-90% cases.
After the first visit to the clinic and case history collection, the physician prescribes a set of tests, including:
- general clinical examination, i.e. a complete blood count, urinalysis, and blood chemistry;
- bone marrow puncture subject to microscopic examination of the obtained material;
- ultrasound, CT, and MRI, according to indications, to identify the comorbidities and perform a differential diagnostics.
Allogeneic Bone Marrow Transplantation
Upon severe disease course, the treatment must be initiated as soon as possible. At the stage of selecting a compatible donor, the patient receives a transfusion therapy, immunomodulators, and hormones.
There are two possibilities of stem cell taking from a donor:
- Bone marrow puncture.
- Taking the peripheral blood and its subsequent processing.
In the second case, the procedure takes place with minimal morbidity (venipuncture). Under the action of special drugs, the bone marrow stem cells enter the bloodstream, where they are extracted using apheresis technology, and the remaining red blood cells are returned to the donor's blood stream.
A suspension of donor stem cells is administered into the patient’s vein, and then they rush into the bone marrow and populate the same. After surgery, the patients require special conditions in a separate ward and skilled nursing services. The cost of required drugs must be discussed with the attending physician. The bone marrow transplantation usually involves stay in a clinic full time for up to 57 days. The patient is discharged after receipt of further advice on lifestyle, observation and outpatient treatment.Hide
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