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Bone and Marrow Transplantation at Apollo Hospitals, India
The blood and bone marrow transplantation center at Apollo Hospitals, India has performed over 150 transplantations with an excellent success rate. Apollo Hospitals, India is also a trusted name in BMT for international patients, as the hospital has not just a highly qualified BMT team, but also very stringent infection control norms which are critical for BMT patients.
What is Bone Marrow Transplantation?
Bone Marrow Transplantation is a form of intensive treatment used to treat certain cancers like leukaemias, lymphomas and some non-cancerous diseases like thalassaemia.
Bone marrow is found inside our bones, and is the ‘factory’ that makes blood. It is responsible for producing white blood cells (to protect against infection), red blood cells (to carry oxygen around the body) and platelets (to prevent bleeding). Stem cells are blood cells at their earliest stage of development in the bone marrow, before they have become committed to developing into white cells, red cells or platelets. It is these ‘mother’ cells which are the key factors in transplantation.
What are the different types of bone marrow or stem cell transplantation?
There are two main types of transplants – Autologous and Allogenic.
Autologous Transplants: This means that the bone marrow or stem cells used for the transplant are one’s own. A little bit of the patient’s bone marrow or stem cells is taken and stored before high dose treatment. When the treatment is over, the bone marrow or stem cells are given back through a vein.
Allogeneic Transplants: In this type of transplant, bone marrow donated by someone else is used. It is essential that the donor’s tissue matches. The most suitable donor is usually a close relative, most commonly a brother or sister. It is possible to get a good match from an unrelated donor, but this facility does not exist in India.
What is the basic process?
There are three main steps in the transplantation process -
The first step is the collection of the bone marrow or stem cells (the harvest) from the donor. We now know that the umbilical cord blood is also a rich source of stem cells.
The second step is to completely destroy the existing bone marrow and thereby help the patient receive the new stem cells.
The third step is to infuse the bone marrow or the stem cells through the intravenous route, like a blood transfusion. There may be no signs of a new bone marrow growing for two to three weeks, and occasionally it may be a few months before the new bone marrow produces all the components of the blood adequately.
How does one prepare for transplantation?
Having a transplant can be very demanding, physically and emotionally, and the family and friends too, may find this very stressful. It may help if patients can talk about their fears and concerns.
It is important to understand why one is having the transplant and what the actual processes will be, so that the patient can make practical arrangements and also prepare himself or herself mentally. It is a good idea to discuss the entire process with the doctors and nurses involved, before the patient goes into hospital.
Here are some questions one may like to ask:
• What are the benefits of the treatment?
• What are the risks of the treatment?
• How will the transplant affect the way I live?
• Will I be able to have children after a transplant?
• How long will it be before I can start leading a normal life again?
• What are the other treatments available to me?
• Can one predict how the disease will progress?
• Who can visit me?
• Will my treatment make me feel too unwell to see people?
• Is there a television in the room?
• Is there a telephone link in the room?
• Can I bring in my own clothes?
• What do you suggest that I bring to the hospital to make my stay more comfortable?
• Where can the attenders stay?
Many people find it very helpful to discuss the procedure with someone who has already had a transplantation. The doctor should be able to arrange for this.
Being fully informed and prepared will help to make the transplant process easier for the patient and the family.
Who can be a donor for an Allogenic transplant?
Matching bone marrow is done by blood tests alone. It is not necessary to test the donors bone marrow at this stage.
It is usual to start by testing the brothers and sisters, as they are likely to provide the best match; parents are not usually good matches.
The donor should be in good health. He or she will be given a thorough medical checkup to make sure that there will be no risk to his or her own health from the procedure.
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