A bone marrow transplant is a procedure performed to replace damaged or destroyed bone marrow stem cells with healthy bone marrow stem cells. The procedure involves extracting the healthy stem cells, filtering those cells, and giving them back, either to the donor himself, or to another person(the recipient). The goal of BMT is to transfuse healthy stem cells into a person, after his or her own unhealthy bone marrow has been treated to kill the abnormal cells.
Types of BMT
There are different types of bone marrow transplants depending on who the donor is. The different types of BMT include the following:
Autologous bone marrow transplant: It is defined as “taken from an individual’s own cells”, where the patient has donated stem cells to be used for their own transplant.
Allogeneic bone marrow transplant: The donor has been selected based on their HLA type (genetic match) and that of the patient. Stem cells are then taken from an HLA matched donor.
Siblings (Matched related donor/ MRD) - Brothers/sisters are the best choice as donors, provided that their HLA type matches with that of the recipient.
Parent/Children (Haploidentical stem cell transplant): A haploid-identical match is when the donor is a parent and the genetic match is at least half identical to the recipient's.
Unrelated bone marrow transplants (UBMT) or matched unrelated donor (MUD): The HLA matched marrow or stem cells are from an unrelated donor, who has been found through bone marrow registries.
Umbilical cord blood transplant: Stem cells are taken from an umbilical cord immediately after delivery of an infant. The stem cells are tested, typed, counted, and frozen until they are needed for a transplant.
Diseases that can be treated are :
Malignant disease :
Relapsed Hodgkins Disease
Relapsed Non Hodgkins Lymphoma (NHL)
Relapsed Ewings Sarcoma
Metastatic Ewings Sarcoma
Metastatic Germ cell tumors
Medulloblastoma, other brain tumors
Other solid malignancy
High Risk ALL
Relapsed or Refractory AML/ALL
Myeloproliferative Neoplasms (MPN)
Non-Malignant disease :
Severe Autoimmune Diseases
Severe Immunodeficiency disorders
Inherited Metabolic disorders
Best Hospitals and Doctors for BMT in India
Dr Dharma Chaudhary and Dr Rahul Bhargava are two of the most eminent doctors in India for treating all kinds of Blood Cancers and other diseases through Bone Marrow Transplant. The two hospitals which can be considered for Bone Marrow Transplant in India are Nanavati Hospital at Mumbai and Fortis Hospital at Gurgaon. Both the hospitals are easily accessible from International Airports at Mumbai and New Delhi.
Bone Marrow Transplant Donors :
For an Allogeneic Transplant, a suitable (HLA matched) donor is a must requirement.
What is HLA typing?
Human leukocyte antigen (HLA) typing is used to match a suitable donor for bone marrow transplant. The best transplant outcome is obtained when a patient’s HLA and the donor’s HLA closely match.
Who can be the ideal donor?
The best possible chance to get the HLA typing match is from siblings. In about 30% of the cases the patient will get a good match from their sisters / brothers. If the patient is not getting suitable HLA match with their siblings then the next possibility is the half matched HLA from their parents or children. Half of the HLA markers come from the mother and half from father. It is unlikely that other family members HLA will match the patient.
How to find donor outside the family member?
If the patient does not have suitable match in the family, then transplant team may look for an unrelated donor. In this case stem cell has to be procured from domestic/ international registry.
Is there any cost involved in preliminary Donor search from the registry?
No, there is no charge involved for a preliminary donor search. If a suitable donor is found, only then the patient has to borne the cost for Stem cell procurement which has to be paid to the donor registry.
What are the kind of preparation required for the donor?
Once the potential donor is identified then he or she will undergo several tests. Tests related to his or her health will be done to determine the extent of the match.
Once a match for a patient needing a bone marrow transplant is found, then stem cells will be collected either by a bone marrow harvest or peripheral blood stem cell collection. Of the two, peripheral blood stem cell donations are now more common 95%, which is painless.
Donor has to take growth factor injection 2-5 days before his stem cell donation. Donor has to admitted and hospitalised for 1 -3 days.
What is the Cost of BMT in India?
The cost of Bone Marrow Transplant (BMT) procedure in India is in the range of USD 45000 - 60000. Since there are many variables in the procedure it is difficult to predict an accurate cost for BMT procedure. This is the reason why we give a range for the treatment.
Cancer treatment requires high quality equipments and care. Hence in India cancer hospitals are majorly tertiary care setups. Some of the best cancer hospitals in India with best in class facilities are located in Delhi/NCR and Mumbai. In Delhi/NCR we have hospitals like Fortis Memorial Research Institute, Gurgaon, India whcih is considered as one of the most advanced hospitals for cancer treatment. Apart from Fortis we have Paras Hospital Gurgaon, India which is a great setup for cancer surgeries. Similarly in Munbai we have Nanavati hospital which offers great cancer treatment facilities all the way from cancer surgery, chemotherapy, liver transplant, bone marrow transplant and even heart and lung transplants.
Our Hospitals have the latest MRI, CT Scan, Digital X-Ray, Mammography, Ultrasound, Colour Doppler, PET CT Scan, Gamma Camera (Nuclear Medicine Scans), Image Guided Radiation Therapy, Gamma Knife, Cyber Knife, Thoracosopy, Sleep Study, Lung Ultrasound Bronchoscopy EBUS etc which gives us the diagnostic and theraputic confidence for providing the right treatment.
Modular fully equipped Operation Theatres with hepa-filters for zero infection rate and C-Arm backed by a state of art ICU helps us in providing world class treatment to our patients. Similarly in cases of transplant our well equipped isolation rooms ensure a zero infection rate which is very important for transplant patients as they have compromised immunity after the surgery.
Our team of doctors include some of the best names from the Indian Medical Fraternity. Dr Ankur Garg - Liver Transplant, Hepato Biliary and Pancreatic Cancer Surgeon, Dr Kaushal Yadav, Dr Abhishek Mitra, Dr Niranjan Naik, Dr Rama Joshi, Dr Sumita Singh, Dr Priyanjana Sharma, Dr Shilpi Sharma Dr Rajiv Yadav, Dr Vikram Singh- All Cancer Surgeons, Dr Pradeep Bansal and Dr Dipanshu Gupta - Urologist and Kidney Transplant Surgeons, Dr Rahul Bhargava and Dr Dharma Choudhary - Bone Marrow Transplant Specialists, Dr Vinod Raina, Dr Suresh Advani - Medical Oncologists, Dr Hemant Pathare - Heart & Lung Transplant Surgeons, Dr J S Virk- Orthopaedic Cancer Surgeon, Dr Amal Roay Chaudhoory and Dr Subodh Pande Radiation Oncologists.
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