some of 100% gooood news New bone marrow transplant method eases risk

Mixed chimerism is after a BMT or cord blood transplant. It is the combination of the DNA of both the host and the donor.

I was told today exactly the same at the heart of our Dutch stem cell transplant centre.
I have heard no radiation is needed for us kind of sct' patients. Do you got more questions?

Hi baloch

I get the feeling that you are somehow confused about the techniques or protocols concerning transplants in general.

Generally speaking in transplants, you need to inject the patient with normal and matched stem cells. The sources of these stem cells vary.They can be taken from the bone marow of the donor and eventually this is called Bone marrow transplant. Or you can have them from the umblical cord of a baby (these kind of cells are characterised by not being so resistant to the host(patient) and therefore lowering GVHD, but the disadvantage is that they are quiet few in quantity as the cord blood does not have a lot of stem cells compared to other sources.)  In this case the transplant is called cord blood transpalnt. The other source of stem cells could be directly coming from the donor blood stream through injecting the donor by certain drugs that increase the quantity of stem cells in the blood stream so they can be collected. In this case the transplant is called Stem cell transplant.

So the above explains all the possible sources in obtaining stem cells. But these stem cells have to match with the patients HLA type. So if the stem cells of the donor and the patient (host) match exactly, we call this 100% HLA matched. But still some transplants succeed without having 100% match . So there is a range for this match, but the closest the match the more sucesseful is the transplant because you reduce the risk that GVHS occurs ( this means when the stem cells start to attack the patient instead of curing)

How these stem cells are injected, which drugs used before and after transplant, kind and quantity of chemotherapy before transpalnt...... all these are called protocol and this is what differniate a center from another and this what makes the variation of success rate from one center to another. Every center or hospital has a certain technique or protocol to follow.

The article you posted was highlightening a certain techique or a different protocol which is the usage of certain drugs that lowers the immune system only instead of using chemotherapy. The advantage of this is that the side effects are gentler than those of the chemotharapy. Dr Krishnmaurti  is the pioneer in using this technique. At the same time more transpalnts were done using chemotherapy than this technique and the advantage of this is that you have a big number of operations done in the world  by this way and this allows you to have statistics in order to weigh your pros and cons

Results of ANY transplant:

1-Success..the marrow of the patient is 100% made from the donor cells which is called 100% engrafment (the patient is cured and can have some side effect that lie in a range)

2- Mixed chimerism (this happenes when the marrow of the patient and the donor co-exist peacefully togather but the part of the donor is able to produce ''good'' blood allowing the patient to be independant of transfusions. Thsi mixed chimerism is supposed to continue through all the life of the patient in order to consider him/her cured

3- Rejection (the patient rejects the donor cells and he/she is back to thal)

4- Failure (it is the same as rejection but could be accompanied with severe GVHD that could be fatal in some patients.)

The bad thing about transplant in general is that you don't choose or know which result you are going to end. Of courese the doctor will tell the percentage of sucess or failure according to each case, but there is no a concrete gurantee

There are a lot of variable that play a role in increasing the success rate
1- Patient's health from all aspects ( ferritin, hepatits, antibodies, liver, heart, kidney functions.....)
2- HLA match ( the more the match the better the results and less side effects)
3- Expierence of the transplant center
4- When all the above points are present, the age would be a minor variable. But if the above points are not well taken of and the patient is some how ''old'' , then at this point, age matters

Manal

baloch

You said in another post that your brother will do a BMT in 2 months, where are you going to do it??
Did the doctor suggested keeping his sperms in a bank (since he is an adult) in order to be used later on when he decides to have children

manal

By using chemotherapy, the patient bone marrow is completly dead, so that the donor cells will be replaced instead of it.

In the second technique, no chemotherapy is given but only drugs that reduce the immunity of the patient. Since no chemotherapy is used therefore the patient bone marrow is still there and not destroyed and therefore whn the new marrow cells of the donor start to produce blood, they co-exist togather with the old marrow. that is two say mixed chimerism which means that in the body of the patients there are two marrows: the donor marrow and the patient marrow

This is not 100% guanteed to happen because at some time the old marrow overlaps the donor marrow and the transplant is rejected.

manal

I really do not understand all the question

But to the part that i understood, in Egypt and to my knowledge we follow the protocol of using chemotherapy before the transplant in order to completly get rid of the muted or the ''bad'' marrow of the patient.

Mixed chimerism is the result of the transplant and NOT a procedure done

my bro did  not have other poblem  ferritin, hepatits, antibodies, liver, heart, kidney functions all is negtiv bm mateced 100% and  doctor suggested  me to donet my marrow for  my bro to do bmt  in jordan or egypt or indai that alll . wht u will say wher sould i will don it .... wht u will say wait for gene therpy or do bmt

Having a 100% matched BM with a good patient's health increases the sucess rate of the transplant.

About whether to choose gene therapy or BMT, ....gene therapy is a procedure that is under trails and it is not availabel right now for public and it will take years to be there. Patients who are going through gene therapy this year (as mentioned in other posts) are voulnteers that are willing to try this cure on their ownselves. So everything concerning gene therapy is trails.

BMT is a cure that is available right now world wide and it has been done with known percentages and results

The decision of doing a BMT or not has to be taken y the patient after weight the benefit and the risk resulting from this transplant. To understand the risk, the patient should sit and talk with the doctor to evaluate the patient's case in particular with regards to all the variables we discussed above.

As for where to do it, there are a lot of expierenced centers worldwide, the most well known are in Italy... Of course there are other countries like USA, France, Saudi Arabia, India ......, but Italy has the highest success rate of BMT in thalassemia

Concerning the countries you mentioned, you have to directly corresponds with centers specialised in BMT in order to discuss such procedures.

As for Egypt, we do BMT but the majority is for cancer patients compared to thal. Best doctors here for tansplant are Dr. Hossam Kamel and Dr. Alaa el Hadad

manal