Merve Ekinci, who lives in Şanlıurfa, was diagnosed with Mediterranean Anemia (thalassemia), a genetic blood disorder, at the age of 2.5. Merve, who needed a blood transfusion every three weeks, was required to have a bone marrow transplant before the age of 6, but no suitable donor could be found from her family or relatives. Merve, whose development was behind her peers due to the disease, was at risk of developing cirrhosis. The damage to her pancreas also led to her becoming a diabetic.
Merve's long-standing hope turned into reality last summer with a suitable donor found through the National Bone Marrow Bank (TÜRKÖK). Since Merve was 17 years old, the risks were high, and her donor was not a perfect match. There was also a chance that she would not be able to have children due to chemotherapy. Merve, who loves children and wants to be a kindergarten teacher, had her eggs collected and frozen using a closed-method procedure performed at Yeni Yüzyıl University Gaziosmanpaşa Hospital. The bone marrow transplant was performed on October 4, 2019. After a challenging treatment process that lasted for weeks, Merve was discharged. Last year, she was reunited with her cousin Elif Nur in Şanlıurfa, who had also undergone a bone marrow transplant for the same disease at the same hospital.
SHE SUCCEEDED DESPITE ALL ODDS
Prof. Dr. Barış Malbora, a Pediatric Hematology Specialist at the Bone Marrow Transplant Center on the team that treated Merve, said, "A donor was found for Merve years later, but it wasn't a 100% match. A difficult bone marrow transplant process awaited us. This was because she had been receiving blood transfusions every three weeks for many years, her iron levels had become very high, and her internal organs and hormonal glands were negatively affected. Her liver had almost reached the cirrhosis stage. Her pancreas was also affected, and she had become a diabetic. She also had stunted growth. She had problems with her sexual development as well. All of these were caused by thalassemia. There were also risks associated with the donor. The match was not perfect, but a 90% compatible donor had been found. There was also a gender and blood type incompatibility. We took all the risks and performed the bone marrow transplant. As we expected, she went through serious complications, but she fought them all and regained her health."
THE RISK OF BONE MARROW REJECTION INCREASES WITH AGE
Prof. Dr. Malbora explained that it is a very rare situation for a bone marrow transplant for this disease to be performed after the age of 16. "It should be done before the age of 16 if possible, because it gives better results. As the patient gets older, they are exposed to more blood transfusions; this increases the iron accumulation in the body and causes damage to the organs and hormonal glands. It also increases the risk of bone marrow rejection because the patient receives blood products so frequently. In fact, we performed a bone marrow transplant on Merve's cousin, Elif Nur, last year. But Elif Nur was only 3 years old. For that reason, she had a smooth treatment and recovered and returned to Şanlıurfa. Despite all these risks, Merve overcame them all and will now be reunited with her cousin," he said.
THE HEALTHIEST EMBRYO WILL BE CHOSEN
Due to the chemotherapy Merve was going to undergo before the transplant, she would have no chance of becoming a mother in the future. Prof. Dr. M. Gürkan Arıkan, a Gynecological Oncology Specialist, and Assoc. Prof. Dr. Meryem Kürek Eken, an Obstetrics and Gynecology and IVF Specialist at Yeni Yüzyıl University Gaziosmanpaşa Hospital, joined Merve's treatment and managed to obtain mature eggs from the ovaries of the young girl, who had never menstruated due to her illness despite being 17. Her ovaries were removed and frozen using a closed-method procedure. Assoc. Prof. Dr. Meryem Kürek Eken said, "It was a difficult treatment. Since she had never menstruated before, we didn't know if we would be able to get mature eggs. We succeeded in developing mature eggs by stimulating her ovaries and collected her eggs using a closed method. If Merve wants to have a baby in the future, her partner will also be screened for thalassemia. If her partner doesn't have thalassemia, the child will only be a carrier, and this won't be a problem. But if thalassemia is also detected in her partner, the embryos will be screened, and the healthiest ones will be selected and transplanted with the IVF method. This way, she will be able to have a healthy baby."
MUST BE DONE BEFORE THE PATIENT STARTS CHEMOTHERAPY
Prof. Dr. M. Gürkan Arıkan stated that the critical point in such patients is to perform the ovarian freezing procedure before the patient starts treatments like chemotherapy or radiotherapy that will have a toxic effect on the body and ovaries. He provided the following information:
"We need to collect the eggs in a short period of time. This period usually does not exceed 1 month. The tissue or eggs we collect can be stored for up to 5 years. If they need to be stored for a longer period, which is usually the case for child patients, the permission of the Ministry of Health is required. Then, if the patient will live somewhere far from the center where the tissue is stored, the two centers communicate with each other to ensure the transfer to the other center, and the IVF procedure is performed at the center where the patient is located."
'I GREW UP IN HOSPITALS'
Merve Ekinci said she was very happy to be free from hospitals and expressed her feelings with the following words:
"I am in the 10th grade. I was diagnosed with thalassemia when I was 2.5 years old. I had the transplant on October 4th. As long as I can remember, I always spent my time in hospitals. But now I'm free from the disease, so I'm very happy. It's a really great feeling. I'm going to finish school and become a teacher at the first opportunity. I also really want to be a mother in the future. I'll choose to be a kindergarten teacher because I love children very much."
Source: Gazete Vatan