Hematopoietic Stem Cell Transplant (Bone Marrow Transplant)
Bone marrow is a procedure performed to replace damaged or diseased bone marrow with healthy blood-forming stem cells. The bone marrow procedure is also referred to as a stem cell transplant.
Basically, bone marrow is a soft, spongy tissue found in your bones. It is responsible for producing stem blood cells which further give rise to blood cells including red blood cells, white blood cells, and platelets.
A person may be required to undergo a bone marrow transplant in India if he/she suffers from any of the health complications mentioned below:
- Bone marrow diseases such as aplastic anaemia.
- Blood cancers including leukaemia or lymphoma.
- Other immune deficiencies and genetic disorders like sickle cell disease.
Types of Bone Marrow Transplant
Depending upon the donor, a bone marrow transplant procedure is categorized into three main types:
- Autologous bone marrow transplant: If the transplant is done using your own stem cells then it is defined as the autologous bone marrow transplant.
- Allogeneic bone marrow transplant: If the transplant is done using the bone cells from a donor based on his/her genetic match then it is defined as an Allogeneic bone marrow transplant.
- Hematopoietic stem cell transplantation: This kind of transplantation involves the intravenous infusion of autologous or allogeneic stem cells for treating hematopoietic function in patients.
Here is the basic procedure followed by the specialists and Doctors at the top bone marrow transplant hospitals in India:
bone marrow transplant (BMT) units at Narayana Health has completed more than 950 Stem cell transplants with most of them being allogeneic stem cell transplants including HLA matched siblings, matched unrelated, cord blood as well as Haplo-Identical transplants.
The stem cells in your healthy bone marrow are responsible for producing blood cells, especially leukocytes or white blood cells (WBCs) that are essential for the immune system. Blood cancers and associated treatment such as chemotherapy and radiation treatments deplete your bone marrow. Stem cell transplants help in regenerating new cells from the old cells to help your body create more cancer-free cells. The stem cells can be collected either from your own bloodstream or from that of a donor.
Here’s how the transplant process looks:
Before the transplant:
- Before the blood is drawn out, you or your donor will be injected with medicines to transfer blood-forming stem cells from your bone marrow to your bloodstream.
- The stem cells from you or your donor’s blood will be collected, separated from the bloodstream, and kept in a frozen state.
- You go through a conditioning treatment which involves high or low dose chemotherapy or radiation to kill the cancer cells and your own stem cells so as to replace them with new stem cells.
During the transplant:
- The infusion procedure begins with you sitting in a chair and the infusion passing through a surgical line attached to your neck.
- You will be monitored for any fall in temperature or blood pressure and developing a fever.
- You may experience some side effects such as headache, nausea, and shortness of breath.
After the transplant:
- After the transplant is complete, your stem cells will start grafting to the bone marrow in a period of two to four weeks. Next, they will also start producing white blood cells, platelets, and red blood cells.
- In case the stem cells are from a donor, you will need to take antibiotics and anti-rejection medicines to help your body accept the transfused cells. You may also need transfused red blood cells, platelets, and nutrition.
- You may need to stay in a hospital for a month until your immune system starts functioning. It’s important to stay in a germ-free environment.
- You will need to visit the outpatient section so that the doctors can check your blood and bone marrow for any complications.
Care and support
After a bone marrow transplant , the doctors and nurses will keep a close eye on how the patients are recovering. Patients may require:
- Blood transfusions to elevate the blood cell counts
- Drugs to lower immunity system and help prevent GVHD
- Meds to help with side effects, if any
- Lab tests
- Medicine to fight infections
You may find that your emotions are all over the place ????. But understand that it is normal and will go away as you recover. Talk to your doctor, friends and family and get support from the people who have recovered from this procedure
Our Bone Marrow Transplant Centres
The BMT unit at Mazumdar Shaw Cancer Center (MSCC), Narayana Health City in Bengaluru has been catering to both national and international patients' bone marrow transplant needs. The BMT hospital’s unit has a cord blood facility to collect cord blood units for public banking and usage for cord blood transplants. The BMT Unit at MSCC is also one of the few transplant centres with facility for Total Body Irradiation (TBI), which is used during conditioning for lymphoid malignancies as well as in the reduced-intensity conditioning transplants. To know more, click here
Dharamshila Narayana Superspeciality Hospital, Delhi has completed over 100 Haploidentical low cost bone marrow transplant in india with an impressive outcome in most difficult cases of refractory leukaemia, lymphoma and severe aplastic anaemia with a disease-free-survival of over 70% in malignant diseases and over 80% in non-malignant diseases. The clinical and basic research carried out by the team at Dharamshila Narayana Superspeciality Hospital has won accolades within the country as well as internationally at the BMT Tandem Meetings in the USA for 4 consecutive years from 2015 onwards. To know more, click here
Our unit in Kolkata (Howrah) is built as per FGI standards (Facility Guidelines Institute, USA) and has the expertise in performing autologous stem cell transplants as a curative option for various blood-related disorders.
SRCC Children’s Hospital, Managed by Narayana Health in Haji Ali Park, Mumbai, is a state-of-the-art Multi-speciality Tertiary Care Hospital dedicated to treating infants, children and adolescents BMT/ HSCT Unit at NH SRCC is a 4 bedded facility with state-of-the-art HEPA filtered rooms, isolation facilities, laminar flow and dedicated BMT trained physicians & nurses. The unit is also supported by a child centric multidisciplinary team of transfusion medicine physician, hemato-oncologists, intensivists, nephrologists, gastroenterologists, surgeons, cardiologists, endocrinologists, hematopathologist, physiotherapist, dietician and physiotherapist. Being a dedicated paediatric hospital, the unit is geared to handle babies as well as young adolescents.
To know more, click here
The faculty teams at our Bone Marrow Transplant Units comprise of highly skilled and experienced Hematologists, medical oncologists, pediatric oncologists and specially trained nursing and paramedical staff manning the units round the clock. This combined experience makes it a major referral centre for stem cell transplants. BMT surgery requires vast and varied experience to deliver a positive outcome, so we have India’s best doctors with us. In addition, the staff is always quick for a patient’s care and support.
Bone Marrow FAQ's
- Anemia- a disorder in which the marrow stops producing new blood cells
- Cancer- any cancer that affects the bone marrow like leukemia, lymphoma, and myeloma
- Neutropenia- A genetic disorder that causes chronic infections
- Sickle cell anemia- a genetic blood disorder that can cause distorted red blood cells
- Thalassemia- This is an inherited blood disorder; here, the body produces an irregular type of hemoglobin.
- Graft versus host disease- this is a condition where the donor’s cells begin attacking your body.
- Graft failure- this is where the cells that are transplanted don’t produce new blood cells, as expected
- Cataracts- this happens when a cloud-like film forms in the eye lens.
- Internal bleeding- will occur in major organs like the brain, lungs, and other parts of the body.
- Constant diarrhea and vomiting
- Damage to vital organs
Short term side effects include-
- Mouth sores
- Reduced platelet count
- Low red blood cell count
- Early menopause
- Probable lung damage
- The risk of developing another type of cancer
- Thyroid issues