Bone Marrow Transplant Center And Hematology

Policy
1 - Background:

The first successful allogeneic bone marrow transplants (BMT) in human were carried out in 1968.

Since then, use of allogeneic or autologous hematopoietic stem cell transplantation (HSCT) has increased dramatically, with an estimated 40-50,000 HSCTs worldwide in 2001. The team of the NCI, Cairo University, has pioneered this filed in Egypt and started an allogeneic and autologous BMT program since 1988 with over 1000 transplants performed over the past 18 years. It was the first team in Egypt who started the use of PBSC as a source of stem cells both in allogeneic and autologous settings.

April of 1997 witnessed the opening of Bone Marrow Transplant Center by His Excellency the President of Arab Republic of Egypt: Mohamed Hosny Mubarak
2 - Aim
The aim of establishing the BMT unit in Nasser Institute Hospital was to offer a potentially curable therapy for a varied group of benign and malignant hematological diseases as well as some metabolic and immunodeficiency disorders. This kind of therapy will be delivered according to the well-known international standards in this field.
3 - New technologies
  • Use of peripheral blood stem cells (PBSC) as a source for allogeneic hematopoietic stem cell transplantation leads to faster hematopoietic recovery, less neutropenic fever, and shorter hospital stay as compared to conventional BM harvesting.
  • Estimation of the adequacy of PBSC graft: Fresh PBSC harvest aliquots are immunostained and analyzed for CD34+ cells using the flowcytometer within 1-2 hours.
  • Nonmyeloablative transplantation: in which, the conditioning regimen is designated not to eradicate the malignancy, but rather to produce immunosuppression to achieve engraftment and development of graft-versus-malignancy-effect. Encouraging results are reported in CLL and MDS.
  • Donor lymphocyte infusion (DLI): Infusion of lymphocytes obtained from the original donor represents a new approach for treating patients who have relapsed after an allogeneic transplantation. The purpose of DLI is to use the graft-versus-leukemia effect from the T cells of the donor.
  • Manipulation of stem cell grafts (cell selection):
    • Positive selection (of CD 34+ cells): using CD34 membrane antigen-specific monoclonal antibodies.
    • Negative selection (ex-vivo purging of tumour cells): Immune-mediated and chemotherapy-mediated methods.
    • Negative selection (ex-vivo purging of tumour cells): Immune-mediated and chemotherapy-mediated methods.