Bone Marrow Transplantation

Bone Marrow Transplants

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Why Manipal?

Manipal Hospital is the best Bone marrow transplant hospital in Dwarka, Delhi which was inaugurated recently in 2020 to cater to the needs of patients with all kinds of blood-related problems both malignancies and non-malignant problems. The centre provides bone marrow transplant services for all malignant and benign haematological disorders. Manipal hospital is the top bone marrow transplant hospital in Dwarka, Delhi where specialists in bone marrow transplant have extensive experience helping people with all types of diseases, including very rare ones.

Bone Marrow Transplant Department


The Bone Marrow Transplant (BMT) procedure involves the replacement of the damaged bone marrow with healthy bone marrow. The procedure requires a lot of specialized training and experience, and advanced equipment for a successful outcome.


The BMT procedure started in early 1983 and has undergone a steady growth since then in India. BMT has been associated with 50% higher chances of disease-free survival in acute myeloid leukaemia and aplastic anaemia and about 80% survival in thalassemia major with matched sibling donor BMT at the appropriate age.
 

Why Manipal?
 

  • The centre is equipped with advanced transplant procedures and highly experienced medical staff.

  • It is fully assisted by world-class infrastructure, sophisticated laboratories, blood transfusion services, and radiation oncology unit. 

  • The BMT centre is equipped with a 5-bed unit with HEPA filter and positive pressure ventilation. 

  • Best Bone marrow transplant surgeon in Dwarka, Delhi who are experts and highly experienced in transplant procedures.

  • Facilities are also available for cryopreservation and apheresis stem cell products.

  • Irradiation of the blood products (to prevent Transfusion Associated Graft-Versus-Host Disease) is also done at our centre.


Why is a Bone Marrow Transplant Done?


Bone marrow is a spongy tissue, present in the bone. It is responsible for the production of various blood cells. The bone marrow transplant procedure is done when the bone marrow is not able to function properly, and all the other methods to control the disease have been exhausted. The bone marrow may be damaged or not functioning either due to cancer, or other reasons. Bone marrow transplant is required when the bone marrow stops making new blood cells as in the case of aplastic anaemia or producing an increased number of cells as in the case of cancer. In the case of Haemoglobinopathies, genetically defective stem cells are replaced by normal functioning cells of the donor. 


Diseases and Conditions


Following are some of the diseases that require bone marrow transplantation:
 

  • Acute Myeloid Leukemia/ Acute Lymphoblastic Leukemia

  • Hodgkin’s lymphoma

  • Non-Hodgkin’s lymphoma

  • Multiple myeloma

  • Myelodysplastic syndrome

  • Non-cancerous conditions

  • Neuroblastoma

  • POEMS syndrome

  • Germ Cell tumours

  • Aplastic anaemia

  • Thalassemia Major

  • Multiple sclerosis

  • Primary Immune Deficiency Syndrome

  • Other haematological and storage disorders

  • Immunodeficiency disorders

  • Plasma cell disorders

  • Primary amyloidosis

  • Inborn errors of metabolism


What Are the Different Types of Bone Marrow or Stem Cell Transplants?


Following are the various types of bone marrow transplantation:


Autologous Bone Marrow Transplant: Autologous bone marrow transplant uses the patient's stem cells. This is done when the patients undergo a high-dose of therapy that may also destroy healthy stem cells. The cells are collected and may be refrigerated. They are then infused into the patient’s body.


Allogeneic Bone Marrow Transplant: In some diseases, the autologous bone marrow transplantation is not able to cure the disease. In such cases, stem cells from a genetically matched donor are transplanted into the patient. There are various types of allogeneic bone marrow transplantation, depending upon the source of donor cells:


a) Related Donor Transplant: In this type of transplant, the donor is the close relative of the patients. The sibling is a close match while an identical twin is a perfect match. 

b) Half-Matched Family Member Donor Transplant: In case there is no option for close match sibling, the transplant physician may opt for half-matched transplantation. The donor in such a transplant includes biological parents, siblings, or children. 

c) Matched Unrelated Donor Transplant: When there is no donor in the family which fulfils the transplant criteria, the transplant physician may look into an international registry to find matched unrelated donor.  


Criteria and Requirement


Criteria for Recipient: Following factors are considered by the surgeon before giving go-ahead for transplant surgery:
 

  • The patient is suffering from the haematological condition for which the only option is a bone marrow transplant.

  • Health and performance status including age, liver function, kidney function, Karnofsky performance score (performance score for cancer patients), age, and mental health.

  • HCT comorbidity index which determines the severity and prevalence of comorbidities in various organs.

  • The psychological issues that might affect the procedure of recovery of the patient.


Criteria for the Donor:
 

  • HLA matched or haploidentical. 

  • Should not have any heart, lung, or kidney disease.

  • Should have overall good health.

  • Should not have HIV or any condition transmitted through blood.

  • Should not be suffering from any type of cancer.


​Finding a Donor


The transplant first searches for the donor in the family of the patient. If there is no matched donor, the doctor will search for a donor in the International/national bone marrow registry. If no unrelated donor is found, the patient’s siblings can be chosen as a half-matched donor. 


Recovery Time and Lifestyle Changes


For the first one of transplantation, the patient should be kept in complete isolation to reduce the risk of infection. In general, the patient requires at least 3 months after allogeneic transplantation, and one month after autologous transplant for initial recovery.


Following lifestyle changes should be adopted by the patient after bone marrow transplant:
 

  • Take a balanced diet and avoid food that carries the risk of infection.

  • Avoid crowded places.

  • Stay away from sick people.

  • Avoid drinking alcohol and quit smoking.

FAQ's

Bone marrow is a spongy tissue inside your bones that makes blood cells. A bone marrow transplant is a procedure to replace the blood-forming cells (stem cells). First, the patient receives chemotherapy, radiation, or both, to kill cancer cells and healthy cells in the bone marrow. Then, the patient receives new stem cells through an IV. The new stem cells make healthy blood cells.

It is estimated that the overall survival rate for 20 years after hematopoietic cell transplantation is 80.4%. Patients who do have the recurrence of original disease and survive for 5 years after transplant have a high chance of survival for the next 15 years.

Generally, the hospital stay is around 21-30 days depending upon the type of surgery, speed of recovery, underlying medical condition, and surgical complications. The patient should visit the hospital for a routine check-up.

The patient is taken care of by a multidisciplinary team of experts along with the trained nurses. The vital parameters of the patient are under constant monitoring, and the recovery process is evaluated routinely.

We have an experienced team of doctors and nurses, who are well trained in various complications post-transplant.

On average, hospital stay for BMT is between 20-35 days and requires further follow up, the duration depends on the type of BMT and indication. 

Yes, it helps to prevent Transfusion-Associated Graft-Versus-Host Disease (TGVHD), a rare but fatal complication. The condition arises due to lymphocytes from the transfused blood component attacking the recipient's tissues.

Bone Marrow Transplantation

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