Childhood Leukemias, Bone Marrow Transplantation and Pandemic

Prof. Dr. Barış Malbora explained the difficulties experienced in child bone marrow transplants during the pandemic period.

The Covid-19 pandemic has affected all segments of the society, regardless of whether they are big or small, and continues to affect it. The number of our childhood cancer patients is not less during the pandemic period than in other years. The most important source of Bone Marrow Transplant treatment is voluntary donors. Due to the decrease in the number of volunteers during the pandemic period, it was difficult to access blood products needed for the treatment of children such as erythrocytes, platelets and plasma.

Prof. Dr. Barış Malbora explained the difficulties experienced in child bone marrow transplants during the pandemic period.

Childhood Leukemias, Bone Marrow Transplantation and Pandemic

Today, childhood leukemias (bone marrow cancer, blood cancer) are diagnosed more easily than in previous years thanks to technical and scientific developments. In our country, these diseases can be diagnosed and treated under the conditions of western countries. As pediatric blood diseases and cancer physicians, we feel lucky. Because our children, who have a higher survival rate compared to adults, respond better to treatment. Approximately 85% of leukemias seen in childhood regain their health with only chemotherapy. The remaining 15-20% require bone marrow transplantation after chemotherapy after recurrence of the disease or for reasons of susceptibility to relapse.

The Covid-2019 pandemic, which was first seen in China at the end of 2020 and then turned into a major health problem in our country in the spring of 19, affected and continues to affect every part of the society, regardless of large or small. On the one hand, while trying to prevent the disease, we, as healthcare professionals, try not to disrupt the treatment of our patients with leukemia and in need of bone marrow transplantation. Diseases unfortunately don't listen to the pandemic. The number of these patients is not less than in other years during the pandemic period.

During the Pandemic Period, The Number of Volunteers Has Decreased.

Looking back, the last year has been very difficult for all of us. One of the difficult points was the difficulties in reaching blood products such as erythrocyte, thrombocyte and plasma that we need very much during the treatment. Unfortunately, and only healthy volunteers are the only source of these blood products. During the pandemic period, there was a significant decrease in the number of our volunteers. Our children with rare blood groups in the society were affected much more by this situation. The biggest reason for our blood donor volunteers to stop being donors is that they do not want to be in the hospital environment due to the pandemic and 'will the virus infect me?' was the fear. In fact, it is possible for us to be a blood donor without worrying by strictly following the mask, distance and hygiene conditions that we all know very well. We, the healthcare professionals at the forefront of this war, continue to provide health services within the framework of the rules. In other words, being in the hospital with the precautions we are all familiar with will not harm our health. I call out to all our volunteers from here: Please do not stop donating blood, especially during this difficult pandemic period. Blood diseases such as leukemia, other cancers and Mediterranean anemia (thalassemia) that require regular blood transfusion for life have not stopped working due to the pandemic. The chance for these patients to survive is hidden in your blood donation.

Covis-19 Threats Patients with Immune System Abortion.

Another problem experienced is the confrontation of our patients or patient relatives with Covid-19 infection during the treatment process. As we all know, it is not easy to predict how the Covid-19 infection will progress in which individual. The risk is higher in known conditions such as advanced age and having a chronic disease. Chemotherapy and immunosuppressive drugs used for cancer or bone marrow transplantation cause Covid-19 infection to be more severe and even our patients to lose their lives. Here, all of us as a society, especially our patients' relatives, have great responsibilities. Please let us meticulously follow the rules of mask, distance and cleanliness both for ourselves and for these children who are fighting serious diseases.

Volunteers Donors are the Most Important Elements of Treatment in Bone Marrow Transplant Treatment.

Another problem we experience is related to our patients who need a bone marrow transplant. Approximately one fourth of stem cell transplants in our country are provided by siblings, parents or relatives. The rest are provided from bone marrow banks, which are made up of a pool of volunteers in the world and in our country. Although it is a very young institution established under the roof of the Red Crescent in our country, TÜRKÖK, which is a hope for the people of both our country and other countries, continues to heal many patients. So far, bone marrow donors have been found for more than 1500 patients through TÜRKÖK. Unfortunately, there are problems in this regard during the pandemic period. One of the main problems is that healthy volunteers who match the patient and tissue group stop being donors. Some of our patients have more than one non-relative donor. These patients were in the lucky group during the pandemic period. Unfortunately, our patients, who had only one volunteer donor all over the world, were not so lucky. There were also our citizens who were the only donors and the transplant process was initiated and during this period, they gave up being donors with the excuse of pandemic. Unfortunately, this is one of the most difficult situations to manage for us. In this case, unfortunately, what we can do for the health of our patient is very limited. Here I want to tell all our citizens: Please be a stem cell donor and don't stop being a donor when you match a patient. Especially in these difficult days, the lives of these children are in your hands.