Top Bone Marrow Transplant Package in Istanbul, Turkey

What is Bone Marrow and Hematopoietic Stem Cell?

Bone marrow is a soft; sponge like tissue located inside the bone. It contains c
ells termed hematopoietic or blood making stem cells.
Hematopoietic stem cells may divide to generate more blood making stem cells or
develop to create red blood cells-erythrocytes , white blood cells-leukocytes and
mbocytes that join blood circulation. Most of hematopoietic stem cells are found
in bone marrow however there are also traces of them in the umbilical cord and b
lood.
Cells obtained from any of these locations may be used for transplant.

What is Bone Marrow Transplant?

Bone marrow transplant and peripheric blood stem cell transplant is the healing
of damaged stem cells using high doses of chemotherapy and/or radiation therapy.
There are three types of transplant:
Autologous transplant: Transplant from patients own stem cells.
Syngeneic transplant: Transplant by acquiring stem cells from identical twins.
Allogeneic transplant: Transplant by acquiring stem cells from siblings or paren
ts. A non-related donor may also be used if suitable.

How is Bone Marrow Transplant Performed?

Transplant from own body fundamentally requires the treatment of illness. For th
is reason, Patient will be treated in accordance with a method specified by phys
icians. In the next stage, stem cells are collected and frozen with the help of
certain medication.
The dose of medication must be increased in these types of patients. On average
patient is given high doses of medication for a week following the collection of
healthy stem cells. Healthy hidden stem cells are given back to the patient fol
lowing high dose of medication treatment. This approach allows the self-repair o
f stem cells damaged during treatment.

How is Bone Marrow Obtained for Transplant?

Stem cells used in bone marrow transplant are obtained from a liquid centre call
ed marrow. On general terms the procedure of obtaining bone marrow, usually call
ed harvesting , is similar in al three types of bone marrow transplant (autologous,
allogeneic, syngeneic). During the procedure the donor is either given a sedati
ve general anaesthesia or local anaesthesia resulting in numbness below the wais
t.

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Needles are inserted into the bone marrow of the pelvic bone for extraction. Mar
row harvesting takes about one hour.
Harvested bone marrow is processed to remove traces of bone and blood. A preserv
ative may be added to the harvested bone marrow and later frozen to keep the ste
m cells ready until needed. This method is known as cryopreservation. Stem cells
may be kept for long years using the cryopreservation method.

Diseases Treatable with Bone Marrow Transplant

Acute Myeloblastic Leukaemia
Acute Lymphoblastic Leukaemia
Non-Hodgkin s Lymphoma
Hodgkin s Lymphoma
Multiple Myeloma
Myelodysplastic Syndrome
Chronic Myelocytic Leukaemia
Chronic Lymphocytic Leukaemia
Aplastic Anaemia
Paroxysmal Nocturnal Haemoglobinuria
Primary Amyloidosis
Solid Cancers: Testicle Cancer, Ovarian Cancer / Ewing Sarcoma
Hereditary Diseases: Haemoglobinopathies
Autoimmun disease (Scleroderma, Lupus, Rhomateid arthrite)
Top Bone Marrow Transplant Package in Turkey
Initial Assessment at Anadolu
Initial assessment begins with transplant physician meeting at the bone marrow t
ransplant outpatient clinic. This meeting will involve:
Transplant coordinator nurse giving the patient an orientation tour of the bone
marrow transplant department.
The following steps will commence once the form is signed:
1. Forward Planning
Selecting caretaker: A relative or close friend is chosen to help the patient in
every sense. The transplant coordinating nurse will train this person on his/he
r responsibilities.
Living in Istanbul or Kocaeli: Patient will be briefed on the need to live somew
here near to the hospital up to 1- 4 months following the transplant. Transplant
team will help to make necessary arrangements.
2. Preparing for Transplant
Choosing donor: Allogeneic Transplantation: The first step for allogeneic transp
lant is locating a HLA matching sibling or relative.
Examination: Outpatient tests will be performed for 1-2 weeks to determine overa
ll medical condition; additional examinations like bone marrow aspiration, lung
x-ray ,
Bone marrow mobilisation procedure will span a 7 to 20 day period depending on t
he regime.

3. Preparation Regime
Treatment regime duration and components is different for each type of illness a
nd on average continued for 2 to 8 days.
4. Stem Cell Transplant
1 or 2 days after the preparation regime is completed arfempheil stem cell will
be infused quite similar to blood transfusion.
Whether autologus or allogeneic all frozen bone marrow or perigherl stem cell co
llected from the donor will be thawed beside the patient following necessary pre
parations and administered intravenously through the central catheter.
Bone marrow or perigherl stem cell can be collected transplant dry from donor an
d given to the pztrent unfrozen. Donor will begin mobilisation regime prior to t
he transplantation. Bone marrow will be collected on the day of transplantation
and administered intravenously without getting frozen.
5. Waiting for Engraftment
Engraftment is the successful incorporation of grafted bone marrow into the body
of the host resulting in generation of blood elements. This process takes betwe
en 10 to 35 days. Following engraftment patient s discharge condition and date wil
l be specified depending on factors like infection, intravenous medication and a
dequate oral nutrition intake.
6. Post-Engraftment Healing
First signs of healing after engraftment will take about 3 months. This period i
s spent near the hospital in Istanbul or Kocaeli. Patient will be asked to come
to the hospital for regular blood tests (weekly or shorter) during this period.
Patient s caretaker should be prepared to assist the patient during this period. P
atient and caretaker are trained accordingly. Physician or nurse may be contacte
d by phone at any time during this period whether a query or a complication. Che
ck-up intervals will become less frequent as the patient starts to recover.
7. Post-Healing Long Term Monitoring
Once engraftment is complete and the healing process begins patient and caretake
r will be informed on long-term transplant monitoring. Patient will receive in-d
epth evaluation and be given a report for the referring physician to monitor. Th
e farewell meeting appointment to take place with the participation of the physi
cian and nurse will provide comprehensive information to the patient and caretak
er on to do s, instances demanding notification, monitoring parameters, lifestyle,
diet and exercises. Referring physician nonetheless performs long-term monitori
ng; the patient is generally called up for the first assessment in approximately
3 months. Long-term monitoring plan is developed specifically for the patient d
epending on medication, degree of immune system recovery, graft versus host dise
ase and other complications that may develop.
Patients are also called to participate a vaccination programme at 12 and 24 mon
ths after engraftment.

Why Anadolu?
At Anadolu Medical Center s modern and tranquil atmosphere our internationally ren
owned and experienced team prepares personalized treatments for our patients, wh
ich makes a difference to them and their families.
Bone Marrow (Stem Cell) Inpatient clinic features 22 beds on two levels. There i
s a special divide section at the entrance of each patient room creating a speci
al section between the room and corridor. All staff of the BMU and (enter) pass

to the patient rooms through this special zone, which purifies the individual fr
om potential imported infections. This system significantly minimises risk of pa
tient contact with such infections
Our spacious rooms feature special hepafilters and are designed to provide the p
atient psychological and mental comfort during their stay. Hepafilters are also
installed in wards giving the patient the freedom to walk outside his or her roo
m. Besides a personal music system, cable TV and wireless internet each patient
room includes a specially designed orthopaedic bed.
At first application transplant candidate patients are requested to provide all
past medical records, laboratory results, screening and pathology reports. In th
e next stage patients will be asked to provide a detailed background story, whic
h is followed by an in-depth physical examination. The decision for transplant i
s given only after specialists evaluate benefits of treatment that will offer to
the patient.
Our department employs state-of-the art diagnostic and treatment technology to s
urgically treat cardiovascular and lung diseases. Its patients range from newbor
ns to adults.
To improve the quality of life, offering world-class health service,
Is an Institution pioneering in the field of strategic business partnerships and
is affiliated with Johns Hopkins Medicine,
Offering expert staff, a patient-centered approach and successful medical practi
ces,
Raises the bar in Turkey using cutting edge technology,
Health services provided by qualified medical personnel approved by internationa
l authorities,
Is a senior in the field of Oncology with its Bone Marrow Transplant Center,
Treating patients from around the world,
Offering patient's families comfortable accomodation with its on campur hotel,
Improving an organization Constantly improving itself and involved with corporat
e social responsibility projects.