The Stem Cells Transplantation Department of Medical Centre named after Rabin is one of the best in Israel.
The bone marrow hematopoietic stem cells transplantation (HSCT) and peripheric stem cells transplantation is one of the main malignant tumors treatment methods. The hematopoietic stem cells transplantation is the procedure of hematopoietic stem cells (HSC) suspension introduction to a patient with further assignment of mieloablative irradiation doses and maximally endured doses of cytostatic (antitumoral) preparations.
Subject to the source of transplanted cells production, HSCT is divided into the following kinds:
The allogenic bone marrow transplantation(allo-BMT), at which the source of hematopoietic stem cells suspension is the bone marrow of a healthy person (a related or unrelated donor), fully or partially compatible according to HLA-system.
The allogenic transplantationof peripheric blood cells (allo-TPSBC) when as the source of HSC, peripheric blood stem cells of a healthy person (a related or unrelated donor), fully or partially compatible according to HLA-system, received after the bone marrow stimulation by recombinant growth factors (granulocytic (G-CSF) and granulocytic macrophage colony-stimulating factor (GM-CSF)) is used.
The autologous bone marrow transplantation (auto- BMT), when the source of hematopoietic stem cells suspension is the bone marrow of a patient which stays in a full remission condition.
The autologous transplantation of peripheric blood stem cells (auto-TPSBC), at which HSC have been received after the bone marrow stimulation G-CSF and GM-CSF.
The syngenic BMT or TPSBC, at which the donor is a monogerminal twin, fully compatible with the recipient.
The allogenic transplantationof funic blood HSC.
The peripheric stem cells intake
Until recent time, the main source of HSC at transplantation was the bone marrow (allogenic and autologous). Yet BMT has some drawbacks: the necessity of narcosis, pain syndrome in the place of bone marrow intake, a high probability of contamination (pollution) by tumor cells. Moreover, the bone marrow intake is often impossible with patients after radiation and intensive chemotherapy. That’s why, TPSBC has been suggested, the physiological base of which is the data about stem cells going from the bone marrow into blood.
TPSBC has some advantages in comparison with BMT:
when receiving PSBC, there is no necessity of general anaesthesia, consequently, there exists the possibility of the PSBC intake in the outpatient setting, restoration after the conditioning regime of granulocytic, thrombocyte and erythroid shoots occurs quicker in the case of TPSBC, when using auto-PSBC, the possibility of malignant tumors impurity in the transplant (at disease remission) is less in comparison with autologos bone marrow, the absence of the component therapy usage necessity.
The mobilization of PSBC can be carried out with the help of cytostatics (cyclophosphan, iphosphamide and others). The main source for children mobilization of PSBC is recombinant type-high (neogene, granocit, leukomax). The PSBC intake is carried out on the 4th, 5th, 6th day since beginning of colony-stimulating factor introduction. At that time, there observed significant increase in peripheric blood leukocytes quantity (4-10 times more) and HSC. The PSBC cryopreservation is carried out by the method analogous to bone marrow freezing.