BONE MARROW TRANSPLANT UNIT
For the first time in Eastern India, Apollo Gleneagles Cancer Hospital has launched a dedicated comprehensive Bone Marrow Transplantation Service.
Bone Marrow – the wonder tissue
Bone marrow is a special, spongy, fatty tissue that houses blood stem cells. These stem cells are located inside a few large bones and transform themselves into white and red blood cells and platelets. The bone marrow thus has the vital responsibility of producing blood cells in our body.
What is Bone Marrow Transplant?
When the bone marrow is sick, unable to produce the normal healthy blood cells, and is not responsive to conservative management with medicines, a patient is considered for a bone marrow transplant where the diseased marrow is replaced with healthy marrow.
What are the different types of Bone Marrow Transplantation?
- ALLOGENEIC BMT: The blood stem cells are obtained from the peripheral blood or bone marrow of a donor who is suitably matched to the patient.
- AUTOLOGOUS BMT: The bone marrow or peripheral blood stem cells are taken from the patient and re infused after treating the patient with high dose radiation or chemotherapy. Although called BMT, blood stem cells can be obtained from peripheral blood and umbilical cord / placenta as well.
Who needs BMT?
BMT is done at Apollo Gleneagles Cancer Hospital for following conditions:
- Paediatric tumours
- Multple sclerosis
- Auto-immune diseases not responding to medical treatment
- Thalassemia and sickle cell disease
- Aplastic Anemia
- Acute leukemia
- Chronic leukemia
- Childhood genetic diseases
- Auto-immune diseases not responding to medical treatment
- Solid tumours (renal, breast, colon, ovary etc)
Who can be a donor for BMT?
Donor for BMT has to be matched with the patient in their 'tissue type'. This is confirmed by typing their HLA antigens. Family members (first or second degree relatives), unrelated volunteers can be donors of bone marrow. Umbilical cord blood can also be used.
Does the donor face any health problem due to donating bone marrow or peripheral blood?
100 ml to a litre of bone marrow (depending on the age of the patient and the donor) is withdrawn under general anesthesia. Except for slight local pain at the site of withdrawal for a few days, the donor is unlikely to face health problem due to the donation. For Peripheral Blood Stem Cells, no anesthesia is needed and the procedure is done on a machine Cell Separator over 2-3 hours.
How is BMT done?
Stage 1: Preparation the patient for BMT (CONDITIONING) (usually 2-10 days)
High dose of chemotherapy or radiotherapy is given to destroy the diseased marrow or destroy the cancer elsewhere and also to suppress the patient’s own immune system (in case of allogeneic transplant), so that the blood stem cells are not rejected.
Stage 2: Pre-engraftment (before the transplanted blood stem cells start working) (Usually 2-3 weeks)
After high dose chemo-radiotherapy, the blood stem cells are destroyed and normal blood cells are not produced. The patients need to be kept in a clean room within the BMT unit in strict isolation during this time. They also need a lot of blood and platelet transfusion.
Stage 3: Post-engraftment (after the transplanted blood stem cells start working)
Once the donated stem cells start functioning, the patients can come out of critical isolation. As the counts of blood cells steadily increase and the patient improves clinically, he/she can be discharged. However regular checkup and follow-ups are essential to detect any health problem or graft versus host reactions, which is a possibility.
What are the complications of BMT?
Like all transplants, sometimes patients may face some complications. It can range from diarrhea, vomiting, irritation of mucous membranes, infections, bleeding etc. On some occasions the host may reject the transplanted marrow or the donor stem cell can react against the host. But with regular follow up and treatment, the chances of these reactions can be reduced significantly.
Can the patient lead a normal life after BMT?
Yes, with few steps like reducing the chance of infections, maintaining good hygiene, taking a balanced, nutritious diet, opting for a healthy lifestyle with light workouts, avoidance of excess stress, taking medications regularly and maintaining regular follow-ups, Bone Marrow Transplant recipients can lead a normal life and can pursue education, professional and family life, after the first 6 months of BMT.
Bone Marrow Transplantation at Apollo Gleneagles Cancer Hospital:
For the first time in Eastern India, Apollo Gleneagles Cancer Hospital has launched a dedicated comprehensive Bone Marrow Transplantation Service. Key features of AGCH BMT Services:
- Internationally renowned BMT Physicians
- Dedicated Nursing Service
- 6-bedded state-of-the -art BMT unit
- Pre and post-BMT counselling and support-service
- HLA-Typing laboratory and flow cytometry stem cell counting
- Harvesting and storage of blood stem cells for BMT at a later date
- Unrelated Cord Blood Transplantation for suitable candidates in collaboration with Public Cord Blood Bank of STEMCYTE, USA
- Real-Time PCR for diagnosing post-BMT infections
- Multi-disciplinary support services of a 425-bedded JCI accredited multi specialty hospital
- Patient and family education and support
BMT - a Team approach
Enduring the journey of a Bone Marrow Transplant is not very easy. But it is a journey worth taking for majority of blood cancer patients to maximize their chances of cure.
At Apollo Gleneagles Cancer Hospital, we are committed to offer the patients the best possible services with a heartfelt care. A team of experienced Hemato - Oncologists, Bone Marrow Transplant Physicians, specially trained Nurses work round the clock to ensure that patients receive nothing but the best. We consider the family members, an integral part of the treatment and involve them in all decisions. Working as a compassionate and competent team, we help our patients fight and win over blood cancer and other serious blood diseases.
Bone Marrow Transplant Consultant
Dr. Suparno Chakraborty
MD (Med), MD (BMT, Univ of Birmingham, UK), FRC Path (UK)