Pay attention to these 15 rules after bone marrow transplantation in children

By Memorial Editorial Board Jun 09, 2022

Among the diseases observed in childhood, those with a genetic transition occupy an important place. Especially in our country, excess kin marriage causes more hematological diseases, immune system deficiencies and metabolic disorders to develop more. Significant part of many diseases, from acute leukemia retaining different systems and organs, Mediterranean anemia, from neuroblastoma to multiple sclerosis, can be treated with a Bone Marrow Transplantation procedure performed in childhood. Rules that will be followed after bone marrow transplantation increase the chance of success of the treatment. Prof.Dr. Bülent Barış Kuşkonmaz from Memorial Ankara Hospital, Department of Pediatric Hematology and Bone Marrow Transplantation Center gave information about bone marrow transplantation and the rules that should be followed in further process.

Stem cells can be differentiated according to their source.

Stem cell, that is present bone marrow and forms blood cells also called shaped elements of the blood, is named hematopoietic (blood-forming) stem cell; transplanting hematopoietic (blood-forming) stem cell to the patient is named hematopoietic stem cell transplantation. If bone marrow is used as a source of stem cell, it is called bone marrow transplantation; if peripheral blood (blood circulating in our veins) is used, it is called peripheral stem cell transplantation; if cord blood is used, it is called cord blood. Bone marrow transplantation is performed for various cancers and non-cancerous diseases that cannot be treated with other methods of treatment or have a low chance of treatment.

Kin marriages increases the risk of disease

Since kin marriages is common in our country, hematological diseases with genetic transition, immune system deficiencies and metabolic diseases are more common. Bone marrow transplantation should be performed to treat some of these diseases. Bone marrow transplantation treatment can be performed in hematological cancers such as acute leukemias, in benign hematological cancers such as Mediterranean anemia and inherited bone marrow failure, in inherited immune system failure such as severe combined immunodeficiency, in solid tumors such as neuroblastoma and Hodgkin's lymphoma, in inherited metabolic diseases such as Hurler syndrome, and in autoimmune diseases such as multiple sclerosis.

Bone marrow transplantation is not a surgical operation.

Before bone marrow transplantation, a treatment that is called preparatory regimen, and that generally takes 7-10 day, and that contains chemotherapy and sometimes radiotherapy, is applied to the pediatric patients. Main two objectives of this are to make room for stem cells of healthy donor by eliminating patient's stem cells in bone marrow, and to prevent rejection of healthy stem cells by suppressing patient's immune system. Bone marrow transplantation is not a surgical procedure or operation. Collected stem cells are given to the patient intravenously. In order to minimize the risk of infection during the transplantation process, patients stay in special rooms.

Bone marrow transplantation does not cause health problems in stem cell donors.

In our country, volunteers who apply to Bone Marrow Bank, Turkey Stem Cell Coordination Center are primarily checked for diseases such as contagious diseases, immunity, or infectious diseases. In donors selected from healthy people, mild pains such as temporary pain taking a few days and bone pain resulted from the drugs may be felt in the region where stem cell has been collected. Apart from these complaints, no serious health problem has been reported in the donors. It should be noted that the lives of many patients can be saved by stem cell donation for which any serious side effect has not shown.

Depending on the disease and disease condition in which the transplantation was performed in children, the success rates of the transplantation and chances of obtaining a long-life span vary. In some diseases (for example, aplastic anemia, beta-thalassemia), success rate of transplantation may be above 80-90% while this rate is about 70-80% in leukemia.

Nutritional measures should be strictly followed after transplantation.

Because immune system of the transplanted children will be weak for a certain period of time, nutritional measures followed in the hospital should be continued against infections that can be transmitted from food. Well-cooked meats and vegetables, pasteurized milk, milk products and fruit juices, and thick-shelled fruits like orange and banana, composte, packaged products, and salt and spices added during cooking, and water of reliable brand or boiled water are among the foods allowed. Raw and uncooked foods, non-pasteurized products, thin-shelled fruits like grape and strawberry, nuts, pickle, and non-packaged products are among the forbidden foods.

What should be done after transplantation

After bone marrow transplantation, the patients are closely monitored more often in the first months. While it takes time for immune system to return to normal after transplantation, particular attention should be paid to the risk of infection. In this context, the points that patients with bone marrow transplantation should pay attention to are as follows:

They should be paid attention to personal hygiene (hand washing, bathing at least twice a week)
The house where they will live after discharge should be cleaned properly.
The patient should stay in a separate room, the walls should be stained with erasable paint.
Visitors should not be accepted as much as possible; if they must be accepted, there should be a small number of visitors.
Sun cream should be applied before going out into the sun.
The patient should not go sea or swimming during 1 year after transplantation.
Until the immune system regains its normal function after transplantation, modification in the house should be avoided.
Until the immune system regains its normal function after transplantation, modification in the house should be avoided.
After the transplantation, the child should be sent to school for at least 6 months and continue his/her education at home.
Pets should not be fed at home and contact with animals should be prevented.
Close contact should not be made with people who have got live vaccination.
Cotton clothes should be preferred instead of woolen, nylon clothes; newly bought clothes should be washed before being worn.
Children who going outside of home should wear mask.
Contact with people with infection should be avoided.
Crowded places and environments with a high risk of infection should be avoided.
In pediatric patients with bone marrow transplantation, recommended vaccination scheme must be strictly followed.

Prepared by the Medical Editorial Board. Our health library contents have been prepared for informational purposes only and with the scientific content on the registration date. For all your questions, concerns, diagnosis or treatment about your health, please consult your doctor or health institution.

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