35 years ago, the first bone marrow transplant was performed in Poland

35 years have passed since the pioneering transplant. A six-year-old girl underwent the first successful bone marrow transplant in Poland. The donor was the girl’s sister. The patient, for whom the transplant was the only chance, lives to this day.

The first transplant in Poland

Today we celebrate the 35th anniversary of the first successful bone marrow transplant in Poland. November 28, 1984 A team of specialists from the Central Teaching Hospital of the Military Medical Academy, the current Military Institute of Medicine, paved the way for Polish doctors.

The first successful allogeneic transplant in Poland was carried out by the then six-year-old Ola Przybylska, suffering from Diamond-Blackfan disease (caused by an inborn lack of red blood cells). The marrow was collected from the girl’s younger sister. This pioneering procedure is described by Justyna Wojteczek in her book “Positivist to the bone marrow”. The protagonist is prof. Wiesław Jędrzejczak – long-term head of the Department of Hematology, Oncology and Internal Diseases at the Medical University of Warsaw and a national consultant in the field of hematology. Prof. Jędrzejczak belonged to the team that carried out the transplant of a six-year-old girl.

How was the breakthrough during martial law?

In the 80s, there was a shortage of basic medical equipment, so it was necessary to develop our own biopsy needles and use juicer filters to filter the blood. Solitary rooms did not exist. The room in which the patients were kept was separated from the vestibule and the toilet only by a sheet hung on nails. Nevertheless, it was possible to ensure sterile conditions and safely carry out the operation. As prof. Jędrzejczak, the team did it on their own, without the support of foreign centers. The method was recreated on the basis of medical publications, access to which – during the martial law – was limited.

The story of Ola Przybylska

Ola Przybylska’s operation went down in the history of medicine as the world’s second bone marrow transplant to be performed in a person with Diamond-Blackfan disease. It was also the first surgery of this type performed without irradiation of the entire body. Patients with this type of anemia were kept alive by regular transfusions. After 60 transfusions, Ola developed liver damage caused by excess iron. The girl weighed only 18 kg. Transplant was the only chance for her. She survived thanks to the courage and determination of doctors. The method that uses the cytostatic busulfan for the first time in the world has been recognized as the best and still the most widely used method of bone marrow transplantation.

– Stem cell transplant procedures, especially allogeneic ones, changed the prognosis of patients with leukemia and other hematological diseases, which were previously only treated with conventional methods, i.e. chemotherapy and radiotherapy. The effectiveness was much lower. Only the possibility of a bone marrow transplant from a donor allows the entire hematopoietic system to be restored, and healthy blood begins to flow in the patient’s veins. Transplant reduces the risk of relapse, says Dr. Tigran Torosian, medical director at the DKMS Foundation.

In 1985, the same team, led by prof. Jędrzejczak, it was the first time that he transplanted the bone marrow using the patient’s own cells. Treatments at the hospital at ul. Szasers in Warsaw were performed until June 1987. Over the course of more than two years, nine allogeneic transplants and one transplant from the patient’s own cells were performed. Allogeneic transplants are the most risky. As a result of complications, 12–13% of them die. patients. Among the recipients operated by prof. Jędrzejczak, three are still alive today.

The future of blood transplantology

First in Poland bone marrow transplant from an unrelated donor conducted in 1997 by prof. Jerzy Hołowiecki from the Department of Hematology and Marrow Transplantation in Katowice. The patient was Urszula Jaworska, who told Onet her story – you can read it here. Since then, the number of transplants has started to increase. Today, 20 centers all over the country deal with bone marrow transplants. In the last year, over 1,8 thousand were carried out. such treatments.

– In the early 80s, stem cells were taken directly from the bone marrow, from the plate of the iliac bone. It was the primary and only option. In 1989, transplantation with cells collected from peripheral blood was performed for the first time in Poland. Today, over 80 percent. stem cells used in transplants come from the peripheral blood. Procedures are changing, new methods of cell therapy are emerging, but they are still in the early, experimental stages, explains Dr. Torosian.

Throughout the Polish bone marrow donor base Over 1,7 million people registeredwhich gives it the fourth place in the world and the second in Europe.

– Poland is in second place not only in terms of registered donors, but also in terms of the annual number of real donors who donate their cells to save others’ lives. Only the Germans are ahead of us – says Dr. Torosian.

Bone marrow collection from peripheral blood takes 4 hoursand from the plate of the iliac bone a maximum of an hour. The donor organism regenerates quickly, even within 3 days.

– In Poland, someone hears the diagnosis of leukemia every hour. Most of these people need a transplant from an unrelated donor. The probability of finding a donor in the family is 25%. Most often, the related donor is a sister or brother. Over 35 million people are registered in all databases around the world. The chance of finding a donor is one in 20 thousand, and if the patient has rare HLA antigens – even one to several million says – Renata Rafa from the DKMS Foundation, who herself registered with the bone marrow donor database and donated her stem cells.

– The registration campaign was organized at my university. Less than two months after enrolling in the database, I received a call that there was a patient who was waiting and needed a transplant of my cells. So I got the donor very quickly. The procedure went smoothly, because before donating the bone marrow, I was thoroughly examined, an EKG was taken, an ultrasound of the entire abdominal cavity, and a morphology. It was checked if I had any infectious disease. In mid-September 2009, I donated stem cells to a teenager from the United States. After 10 years, I know that he is alive and doing well – says Renata Rafa.

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