The wards of General Haematology

Alexei A. Maschan, Ph.D. (Med.), deputy director of Research Institute of Pediatric Haematology.
Galina A. Nvichkova, M.D., supervisor of General Haematology ward of Russian Pediatric Clinical Hospital.

  The wards of general haematology and bone marrow transplantation are the clinical base of the Research Institute of Pediatric Haematology; they specialize in treatment of the most grave blood conditions in children: aplastic anaemias, acute mieloblastic leucosis, inborn immune deficiencies and other serious defects of immune and haemotalogical systems.
  Aplastic anaemia is found in 2 to 6 cases in 1 million children per year. It is an immune defect of marrow, when it loses its ability to produce mature blood cells — erytrocytes, trombocytes and leucocytes. Each of these cells has its narrow specialization — erytrocytes transport oxygen from the lungs to the tissues, trombocytes are responsible for cessation of haemorrages, leucocytes - for struggle with infections. If these cells are deficient, children begin to suffer from haemorrages and severe infections, each of which may be lethal. Unless specifically treated, 90% of children die within 6 months. The best cure of aplastic anaemia is the transplantation of bone marrow from a compatible brother or sister, but only 25% of patients have such donors. Those who do not have a compatible donor may opt for another very efficient cure — so-called immunosuppressive therapy. If these methods are applied at an early stage, their combined effect provides for the reconvalescence of 80 to 85% of patients; however, as time ticks away, the results of the cure deteriorate abruptly. The cost of medicine for any of the therapy variants amounts to 25,000 through 35,000 USD.
  Acute mieloblastic leucoses are found in 6 to 10 children in 1 million per year; they are the most malignant form of children's leucoses. When not treated, 100% of patiens die within two months since the beginning of the disease. Leuceumic cells at this form of disease are highly resilient to chemotherapy, so only the most aggressive therapy, usually accompanied by bone marrow transplantation, provides reconvalescence. The treatment of patients goes on for 5 to 6 months; it is based on very intensive chemotherapy, which leads to critical decline of the number of trombocytes and leucocytes and requires frequent blood transfusions and long-term application of antybiotics and mycocidal medication. The cost of the treatment of one child with acute mieloblastic leucosis is 20,000 USD; if accompanied by bone marrow transplantation — 40,000 - 50,000 USD. The cost of transplantation from a non-related donor is much higher, since the costs of the search of bone marrow in world data bank and its subsequent transportation to Russia amounts to 25,000 - 30,000 USD.
  The medical and nurse staff our our wards is composed of young but experienced specialists with brilliant education, trained in leading clinics of France, Austria and USA. In a year, we cure 20 patients with aplastic anaemias, 10 patients with acute mieloid leucoses, conduct 15 bone marrow transplantations. Apart from treating children, we train young doctors from all over Russia, which gives us hope that our vast positive experience would spread beyond the limits of our clinic. Unfortunately, shortage of funds allows us to help only one third of the children we could treat, should the clinic be optimally loaded: general haematology ward could take 120 - 150 patients per year, bone marrow transplantation ward — 45 - 50.
  During the last years, thanks to sponsors' help both from companies and individuals, we significantly imporved treatment results both of aplastic anaemias and leucoses.
  We can claim that our results are on the par with good Western clinincs. We are very grateful to all our wonderful helpers, many of whom we do not even know personally; we invite us to visit our wards, meet our doctors, our patients and their parents and to feel the atmosphere of hope and joy given to us by our friends.