What is bone marrow and bone marrow transplantation?

Bone marrow is found in long bones (such as the humerus, femur) and flat bone marrow cavity (such as the iliac crest, ribs, sternum, spine, etc.) in the cancellous bone between the mesh of a sponge-like tissue, bone marrow produces blood cells slightly red, as red bone marrow. Some of the bone marrow cavity of adult bone marrow contains a lot of fat cells, yellow, and can not produce blood cells, known as the yellow bone marrow. At birth, the body cavity filled with red bone marrow, with age, increased bone marrow fat cells, a considerable part of the red bone marrow is replaced by yellow and finally almost alone in the flat bone spongy bone with red bone marrow. Such changes may not need all the marrow cavity of adult blood, some of the bone marrow cavity blood to replenish blood cells is adequate. When the body during severe ischemia, part yellow marrow can be transformed into red bone marrow and restore the ability of blood.

Bone marrow transplantation: an organ transplant, will be by the intravenous infusion of normal bone marrow in vivo in patients to replace bone marrow in the treatment of disease. For the treatment of hematopoietic function abnormalities, immune dysfunction, hematological malignancies and other malignancies. With this therapy can improve efficacy, improve outcomes, have long survival and even cure.

Bone marrow transplantation in two categories: one for allogeneic bone marrow transplantation (clinical applications since the 1970s, has achieved great success.) It is with the patient the need for human leukocyte antigen (HLA) matching brothers, sisters and a handful of unrelated marrow for allogeneic bone marrow who have entered, or family members such as parents and their children's bone marrow transplantation; and with patients HLA does not quite match unrelated donor bone marrow. Although non-compatriots, brothers and sisters HLA match, but susceptible to varying severity of graft versus host disease (GVHD), especially in the latter case is more serious. Another bone marrow transplantation for the same gene, that is a very small number of monozygotic twins among twin brother or sister of bone marrow transplantation. Another type of autologous bone marrow transplantation (ABMT). To carry out such a late bone marrow transplantation, 80 clinical application. With their own bone marrow, for marrow without those, this method is simple, easy to spread, can be used for only one child, and no incidence of GVHD. For leukemia, lymphoma and various solid tumor treatment.

Human leukocyte antigen (HLA) loci exist on chromosome 6 in both the short arm, each with and by the closely linked loci of complex composition. Each locus by several or dozens of alleles in a composition. The cell membrane, there are currently 200 species found around the antigen. Currently available in the laboratory to the HLA antigen detected only HLA-A-BC, -D/DR these categories. Laboratory measured these types of antigen match between the two does not mean they are not all antigens inconsistencies. In the brothers, and sisters all received from the parents of each gene on a chromosome one, so is the haploid genetic. Brothers and sisters with exactly the same way between the rate of gene accounted for only 25% of the total between parents and offspring chromosomes have a single type of HLA-A, B and other sites with different, so in addition monozygotic twin brother or sister, the Family members and unrelated donor HLA match between the probability is minimal.

HLA started as a human major histocompatibility complex (MHC) was found, the expression of the gene encoding the antigen, involved in controlling cell subsets in immune recognition and interaction, it does not match the HLA on graft and recipient organizations mutually exclusive influence. Clinically, on the one hand can not produce graft engraftment, on the other hand can produce varying severity of acute and chronic graft-versus-host disease, manifested as skin, liver and gastrointestinal diseases, severe cases can lead to death. Therefore, HLA matching on the organization's choice for the marrow and bone marrow transplant success, is one important part.

About 60% of adult acute leukemia patients after allogeneic bone marrow transplantation or with up to 3 years of long survival, some have reached 5 to 6 years. Chronic myeloid leukemia in chronic phase, about 80% of patients can survive for 3 years, some have survived more than 5 to 6 years can be described as radical. Was compared with conventional combined chemotherapy only, do not do bone marrow transplantation in acute leukemia, only 10 to 15% of people survived to 3 years, the average survival is only about a year. Chronic myeloid leukemia survival period was 3 to 4 years, although the slow course of the disease, but no cure with chemotherapy is currently possible. Therefore, the efficacy of bone marrow transplantation achieved better than conventional chemotherapy. Of lymphoma and other solid tumors with autologous bone marrow transplantation can achieve radical purposes.