What are the factors that affect bone marrow transplantation

summary

My little cousin suffered from leukemia. It took a lot of effort to successfully complete the bone marrow transplantation. There are many factors that affect the success of the operation. Let's take a look at the factors that affect bone marrow transplantation.

What are the factors that affect bone marrow transplantation

First of all, the timing of BMT: the efficacy of BMT in the first remission period is better than that in the second remission period. Brotint et al. (1988) compared the results of first remission and second remission BMT of Al patients, found that the 5-year recurrence rate of patients with first remission BMT was 21% ± 11%, the 5-year disease-free survival rate was 46% ± 9%, and the 5-year recurrence rate and survival rate of patients with second remission BMT were 56% and 22% respectively. Similar results were found in IBM TR and Seattle. Therefore, BMT should be performed in the first complete remission in patients with acute leukemia.

Secondly, the nature of the disease itself: the relationship between BMT efficacy and classification is not clear, it seems that AML efficacy is better than all. For all patients, the following indicators can be considered as high-risk factors: 1) age less than 2 years old or more than 15 years old, peripheral blood white blood cells > 50 × 109 / L at the initial diagnosis; (2) central nervous system leukemia; (3) all with T cell type or special cytogenetic changes; (4) for AML patients, white blood cell count > 75 × 109 / L at the initial diagnosis, or M4, M5 patients, the prognosis is poor.

Finally: the age and general situation of the patients: the older the patients are, the worse the organ function is, and the more likely the complications, especially GVHD, will occur after BMT. Therefore, patients over 45 years old should be cautious about allogeneic bone marrow transplantation. If they are over 50 years old, bone marrow transplantation is generally not recommended.

matters needing attention

It is very important to choose the right patient, the right time, and the right time for surgery. Before that, we must ensure that we meet the requirements of bone marrow transplantation. Only when we fully meet the conditions can we carry out the relevant treatment.