Bone Marrow Transplant in India

Bone marrow transplant (BMT) is considered one of the best curative methods for several types of cancers and blood disorders like sickle cell disease, aplastic anemia, leukemia, and thalassemia. Bone marrow transplant (BMT) is effective for multiple sclerosis as well and many others. India provides highly effective low-cost bone marrow transplant (BMT) options available in several hospitals based in India.

What does a Bone Marrow consist of?

Bone Marrow as its name suggests has a link with the bones. Since it forms the centermost part of the bones and performs a very important task of synthesizing new blood cells of the body.

Bone marrow is mainly a soft sponge-like material which is present inside the bone cavity. It helps in forming new blood cells or hematopoiesis, like producing red blood cells, white blood cells, platelets. Bone marrow of bones like sternum, ribs, vertebral column, and pelvic bones are involved in hematopoiesis process. Bone marrow is affected by several hereditary or other diseases and drugs.

Several types of bone marrow found in the human body are:

RED MARROW: It mainly helps in the production of the blood cells in the body.

YELLOW MARROW: It comprises the fatty tissue of the body.

Both red and yellow marrows contain many capillaries and blood vessels.

The anatomical structure of the bone includes: A bone mainly has three parts compact bone, spongy bone, and the bone marrow. Out of these, a bone marrow forms the basic core structure of the bone. The ends of the bone are spongy and constitute red marrow with a compact outer layer. Sufficient amount of blood supply is equipped to the bone marrow.

 

What is the importance of bone marrow stem cells?

In humans, mesenchymal and hematopoietic stem cells are the main components of the bone marrow.

Redbone marrow is equipped with too many blood vessels. It effectively synthesizes red blood cells (RBC), white blood cells (WBC), and platelets. Yellow bone marrow is made up of mesenchymal stem cells which mainly produces fat, cartilage, and new bone.

Stem cells are such cells which have the ability to differentiate and get specialized in other cells. Some stem cells lead to the formation of monocytes, neutrophils, macrophages, basophils, erythrocytes, eosinophils, dendritic cells, platelets, T cells, B cells, and natural killer cells etc. Maturation of these cells occurs by a process of hematopoiesis. Some of these are myeloid lineages and others are lymphoid lineages with having different potency and capacity to regenerate.

During a bone marrow transplant (BMT) done in India or any other country, these stem cells with regenerative properties are transplanted into the patient during treatment which rapidly multiplies and makes millions more of their own kind. The blood cells formed by the bone marrow has a limited life of nearly 120 days but their replacement occurs with the new cells and this cycle goes on. So in case, there occurs a decrease in blood count than it signifies malfunctioning or some disease presence.

The functioning of the main blood cells are as follows:

Red blood cells or erythrocytes: These cells help in transporting oxygen in the entire body.

White blood cells or leukocytes: These cells help in fighting infections and against diseases.

Platelets or thrombocytes: These cells help in clotting or stopping bleeding from injury.

These blood cells get into the circulatory system from the bone marrow and perform their specific tasks.

 

What does the entire process of bone marrow transplant (BMT) involve?

Bone marrow transplant (BMT) is a procedure which reboots the immune system of the body. Several conditions like aplastic anemia, leukemia, sickle cell anemia can be cured with the help of bone marrow transplant (BMT). The process involves mainly a replacement of the defective or diseased bone marrow with a new healthy marrow. Prior transplantation (BMT) procedure, chemotherapy is also given to the patients to kill the carcinogenic cells in the body.

For certain cancers like blood cancers, this procedure of BMT serves a good treatment method. Bone marrow transplant (BMT) enables the body to reach original blood cell numbers by effectively producing new blood cells. Even several cancerous or non-cancerous lesions are treated with BMT.

 

What are the main types of bone marrow transplant (BMT)?

There are different types of bone marrow transplant (BMT) available for different types of diseases. Every patient is not suitable for every available type of BMT. Each BMT has its own parameters which if fits as per the condition get successful results otherwise can even lead to complications.

Following are a few different types of bone marrow transplant (BMT):

Autologous transplant: In this type of transplant, the patient’s healthy stem cells are extracted by apheresis and preserved before starting with Chemotherapy. After this high-dose chemo or radiation therapy is given to the patient to kill all cancer cells. Which is further followed by bone marrow transplant (BMT) using the patient’s healthy cells. This replaces the defective marrow cells with the healthy ones and the functioning gets resumed. It might take a few weeks initially to reboot the entire mechanism and show successful results. In this type of transplant chances of infections and rejection are very low which makes it a safer choice amongst all. However, every patient does not have healthy cells which can be extracted safely before starting with treatment making it a limitation.

Syngeneic Transplant: In this type, an identical twin is a mandatory requirement. Since the identical twin is the one who provides the stem cells being a donor. It is preferred in cases the patient and the identical twin share a similar DNA pattern which is an advantage during bone marrow transplant (BMT) to avoid any rejection cases.

Allogeneic Transplant: In this type, a donor can either be some matching relative or matching non-relative. A mandatory requirement here is compatibility of the donor which comes with a matching HLA.

Umbilical Cord Blood: It is a kind of allogeneic transplant but in this stem cells obtained from newly born baby’s umbilical cord are used during bone marrow transplant (BMT). These umbilical cord cells are immature cells which require less complete matching. But these take a while in regenerating and getting the blood numbers to normal.

 

Is there any importance of tissue as well in Bone marrow transplant (BMT)?

Bone marrow transplant (BMT) requires matching of the issue as well because the tissue has an outlined structure in form of HLA which requires complete matching between a donor and a recipient. HLA outline mainly acts as a marker to help identify if the cell belongs to the patient’s body or not. Several types of surface proteins of the cells are examined by the doctors prior to BMT to ensure HLA matching. Just like the DNA this particular tissue type is also hereditary and is passed from parents to their offsprings. So there are chances that a sibling or a parent might possess a somewhat similar tissue type which can help in getting an easy marrow donor.

Treatment of several diseases is done these days with the help of bone marrow transplant (BMT). India has also revolutionized in the medical field and several economic treatments are available. Currently, India is offering one of the best BMT but the only thing essential is finding a matching donor. These days even blood cord banks and other bone marrow registry sources also help in getting the desired matching donor for the transplant.

 

What does pre-transplant test include before a bone marrow transplant (BMT) is done?

Some of the tests which help in finding the compatibility amongst donor and a patent before the BMT are as follows:

  • CT scans or CAT scans
  • Tissue typing typing
  • Complete blood count analysis
  • Chest X-ray
  • Bone marrow biopsy and aspiration
  • Skeletal survey
  • EEG and ECG
  • Dental check-ups to irradiate any possible infection risks

 

What does the harvesting of bone marrow require?

During the bone marrow examination, both bone marrow biopsy, as well as aspiration, is done for a complete detailed analysis of the condition. Since both, the tests give an added deeper analysis when done together instead of doing only one of them.

The extraction of bone marrow is done from the hip bones or ilium. A needle is inserted to extract the marrow tissue from the bone which is then stored under proper conditions before a BMT is done. Also, the extraction of marrow is done under the effect of local or general anesthesia. But amongst children instead of hip bone, upper tibia or shin bone is used for the marrow extraction.

Further, there is guideline which is supposed to be followed by every country globally let it be a BMT treatment in India or in any other country. The body named National Marrow Donor Program guidelines to help and assist with details like the amount of marrow which can be removed from a donor corresponds to 15 mL/Kg of the donor. The weight of the patient receiving the bone marrow lets the doctor decide the actual requirement generally. Also, a single dose of X 103 and a couple of doses of X 108 bone marrow cells per unit square weight is the standard requirement in autologous and allogeneic transplants respectively.

At times, few unwanted complications also require attention as they pop up on ad hoc basis during or post transplant . Some of the main complications comprise of a variety of infections, injuries of bone, and even anesthesia allergies etc. These are taken care of during BMT treatment in India by every hospital.

Extraction of stem cells is even done from the peripheral blood in some of the cases. This method is getting popular and is really less complicated in reality. Since the donor is only given with few drugs and then a blood sample is collected which is later processed to obtain the stem cells. Finally, those cells can be used during bone marrow transplant (BMT). This method is less painful from the donor’s perspective and requires no buffer healing period since it only involves extracting blood sample instead of marrow from the bone which needs some healing time.

 

What are the main diseases for which bone marrow transplant (BMT) is recommended?

Several diseases require treatment with a bone marrow transplant (BMT). In India, Several hospitals are equipped with proper examination set up for cancers and other diseases affecting bone marrow and their treatment options. Although, every patient is not suitable for a BMT. Especially, last stage cancer patients or the ones with complex disorders might not get a successful transplant and in some rare cases finding the best suitable donor becomes a hurdle.

Some of the diseases are mentioned below which require a bone marrow transplant (BMT) after proper and confirm diagnosis:

  1. If a biopsy blood smear reveals leukemia or abrupt neutrophil, and white blood cell counts it might indicate diseases like
  • Gaucher disease
  • Multiple Myeloma
  • Rare cases of Anemia
  • Other Hematological diseases due to a blood disorder

 

  1. Hodgkin lymphoma, Non-Hodgkin lymphoma, and myelomas all need Hematopoietic Stem Cell Transplant. In such cases, the likelihood of a patient’s survival increases after transplantation (BMT) than without it. Several autologous transplantations are done every year globally to help such patients survive.

 

  1. Several autoimmune disorders like amyloidosis, systemic lupus erythematosus, and systemic sclerosis also require an autologous bone marrow transplant (BMT) to treat such conditions.

 

  1. In some of the following cases allogeneic transplants are required to treat the conditions:

 

  1. Testicular cancer, genetic immunologic disorders, and hematopoietic disorders etc require a bone marrow transplant (BMT) to deal with the condition and increase patient’s survival chances.

What are the complications involved in most of the bone marrow transplant (BMT) cases?

Bone marrow transplant (BMT) in India is a low cost highly effective treatment offered for several diseases. But there are certain risks or complications involved in any bone marrow transplant (BMT) done in any part of the world. These risks are generalized which means most of the cases have certain risk factors which mainly governs the patient’s condition or history or matching and compatibility issues of the transplanted marrow. These risks are highly minimized taking certain precautionary measures and every hospital in India dealing with a BMT ensures following the guidelines to provide an effective and successful bone marrow transplant (BMT).

Bone marrow transplant (BMT) procedure is a complicated one does not matter in which country it is carried out currently. Because Country like India holds and deals with a big number of transplants every year that too of foreign patients. So India is equipped and enabled in every way to handle complicated and ask prone cases and the efficiency of the doctors is remarkable. But in most of the bone marrow transplant (BMT) cases, autologous transplants and the other bone marrow transplant (BMT) involving related donors has lesser risk chances of rejecting and other complications. Whereas a huge number of other bone marrow transplant (BMT) cases faces graft-versus-host disease (GVHD), rejections, and graft failure.

Some of the symptoms to look for GVHD include itchy rash, dry eyes, feeling sick, diarrhea, flaky skin, skin and eye discoloration with an appearance of yellowish tinge etc. Several infections can also appear after transplantation (BMT). But most of the infections are minimized by Hospitals in India following certain things like:

  • Regular sanitizing and cleaning of the patient’s room
  • Daily bathing habits
  • Ensuring proper dental hygiene to avoid any infections
  • Avoid eating raw eggs and half cooked food
  • At times some vaccines are also given to the patients who undergo a bone marrow transplant (BMT) to prevent infections, viruses, flu, and pneumonia etc. For foreign patients, getting treatment in India measures are taken to ensure a complete dose is given either during vaccination or by prescribing certain medicines to provide a buffer period to heal without infections.

 

What does a bone marrow transplant (BMT) prognosis include?

The prognosis of any type of bone marrow transplant (BMT) involves a certain dependency on success or future of transplant over a few factors, which are as follows:

  • The type of transplant done since the ones involving donors might have certain rejection chances as well
  • The compatibility of matching of HLA of the patient and recipient cells, tissue etc.
  • The type and stage of cancer for which bone marrow transplant (BMT) is done
  • The variety and dose of chemotherapeutic agents given to the patient
  • The patient’s health condition and any complications during BMT treatment

After the bone marrow transplant (BMT), few follow up sessions are mandatory but hospitals in India these days even offer online follow up sessions to their international clients. So worrying about post-treatment care has reduced a lot. Even this allows the patient to be in touch with doctors in India even after treatment and reduces the certain level of complications by following the proper guidelines or instructions of the doctors. Patients can leave for their native countries once the doctor gives them a clearance with no problems and further follow up sessions can be done via online portals with ease.

 

Related FAQs:

1) Q: How many types of cancers exists?

A: There are several types of known and even unknown cancers. This number might account to 100 or even more with new forms of cancers emerging every year. The treatment for almost every cancer type is available in India. Especially, the ones needing a bone marrow transplant (BMT).

 

2) Q: Are there any particular early blood cancer symptoms to look for?

A: Yes, blood cancer can be easily diagnosed in early stages by noting a few symptoms like fatigue, fever, chills, night sweats, appetite loss, and frequent infections etc.

 

3) Q: Why cancer diagnosis is delayed in most of the cases?

A: In maximum cases, the cancer symptoms takes some time to appear. During that span of time cancer cells multiply to form billion of such cells. So health evaluation at regular intervals is a must for early detection of any disease.

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