Head of Department, Elena V. Skorobogatova, M.D., is telling:

Only three hospitals in Russia deal with problems of marrow transplantation to children. One of them is the Russian Children's Clinical Hospital, where the transplantation department works under the patronage of the Research Institute of Pediatric Hematology.

The Department of Marrow Transplantation has been functioning at the RCCH since 1993, when the first transplantation was made. During the first years of our work, we performed only 5 to 7 transplantations each year. And this is quite logical, because opening of the Marrow Transplantation Department meant not only a new and very promising stage of our development but also the birth of a whole direction in medicine. So, we had to elaborate the necessary techniques and to train our staff.

Presently our department performs more than 40 transplantations each year. It is a very good result in itself.

There is a fairly long list of diseases for which marrow transplantation is sometimes the only possible way of successful cure. It includes aplastic anemia, various types of leukemia, immunodeficiencies, tumors, congenital hereditary disorders, enzymopathies, etc. In addition, remember that we perform transplantations only in cases where any other therapy is inefficient.

Depending on the source of hematopoietic cells, there are several types of transplantations:

* Autotransplantations, where hematopoietic stem cells taken for the transplantation are the patient's own cells. This kind of therapy is used only for some diseases and not always preferable.

* Allogenic transplantations, where the graft consists of hematopoietic stem cells taken from a healthy donor. Often the donors are close relatives of the patients (in the case of their histocompatibility), usually brothers or sisters.

If there is no matching donor in the family, it becomes necessary to search for an unrelated donor. The first transplantation from an unrelated donor in Russia took place at our hospital in 1997. Presently we perform 11-12 unrelated transplantations each year and plan to keep to the same level in future. Unfortunately, Russia is not an official member of international marrow donor registries. Therefore, almost all work associated with search and acquisition of an unrelated marrow graft is performed thanks to the enthusiasm of a few people and to private sponsorship.

Generally, marrow transplantation is an advanced and expensive therapeutic technique. The approximate cost of one transplantation is about $60,000–80,000, including the cost of medications and consumables, search and activation of an unrelated donor, laboratory tests, etc. For a number of objective reasons, it is impossible to ensure complete treatment of our patients at the expense of the state budget. Therefore, we presently receive about 15-20% money for off-budget sources: private sponsorship, humanitarian aid, support from regional authorities.