Major hospitals in India have oncology units comprising
surgical oncology, medical and radiation therapy as
well as the crucial Bone Marrow Transplantation (BMT).
The BMT unit with high pressure hipa filters has helped
achieve a very high success rate in the various types
Cord Blood Transplant and Mismatched
Allogeneic Stem Cell Transplant havebeen performed successfully, a feat
that is remarkable and significant, considering the
fact that the treatment costs 1/8th or 1/10th of what
it does in the west. Special surgeons are available
for individual organs.
Plastic surgeons of repute provide
treatment for head and neck cancer, breast cancer and
other malignancies. Facilities offered include tele-therapy
which includes simulation work stations to ensure high
precision and safety during treatment at the 18 MV linear
accelerator or telecobalt machines, brachy therapy and
3-D planning systems. In orthopedics, the Ilizarov technique
is practiced for the treatment of limb deformities,
limb shortening and disfiguration.
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It is slippery & spongy tissue found inside our large bones, these tissues develops red blood cells, white blood cells and platelets.
What are stem cells?
Bone Marrow produces Stem cells like a factory
production, and these cells develop into three different
type of blood cells.
Red blood cells which carry oxygen to all cells in the body.
White blood cells, which are essential for fighting infections.
Platelets which helps the
blood to clot and prevents bleeding. Stem cells are blood cells at the earliest stage
of development in the bone marrow. When the
cells are fully matured, they are released into
the blood stream.
What are the sources of stem cells?
There are three sources of stem cell donations.
The patient's own stem cells are
harvested and preserved in blood bank before transfusion.
If a relative agrees to donate.
Unrelated donor agrees to donate or arranged from any blood banks around the world.
What are the steps for bone marrow stem cells transplant?
Collection or Harvesting
First option: The patient's own
Bone marrow stem cells are collected taken and
frozen in the blood bank (this process is called
autologous transplant). At the time of transplant
these frozen cell are brought from the blood bank
and allowed to settle at its normal condition
before its infusion to the patient.
Second option: It is
collected from related or unrelated donor and
it should match the specification of patient's
bone marrow stem cells perfectly. (This process
is called allogeneic transplant). The transplant
is done immediately after the collection. The
transplant is done through the IV catheter in
the same way as blood transfusion is done.
Infusion or Transplant
The harvested or collected
bone marrow stem cell is transplanted or infused
through IV catheter in the same way as blood transfusion
What precautions are to be taken during blood stem cells transplantation?
The harvested blood stem cells and the patient's
blood stem cells have to be matched perfectly biologically,
therefore the transplant surgeon suggest the patients
blood stem cells as the best choice depending on the
patient's health condition.
What is the procedure of bone marrow stem cell or blood stem cell transplantation?
The patient (donor) is given general anesthesia
and through the process of injection the needle is injected
into the hip bone (pelvis) and the marrow is sucked
with the syringe. This process is repeated 4 to 5 times
on each hip bone for sufficient marrow.
The entire harvesting procedure takes approximately
2 hours. The patient is given blood transfusion if required
to replace the blood loss during the process of blood
marrow collection. After completion of transplantation
process, the patient and the donor are taken to recovery
room for 24 hours and monitored (As done in any type
of operations), and discharged. There is some swelling
and pain from such harvesting, but medication normalizes
this situation within 4 to 5 days. And total recovery
takes place approximately two weeks.
Why donor stem cell or bone marrow transplants are used?
In the treatment of some types of leukemia,
lymphoma and myeloma, allogeneic bone marrow or stem
cell transplants (from a donor) are used to improve
the chances of curing the disease.
A transplant may
be carried out early on in treatment when the disease
is in remission, or if it comes back after being treated.
There are different types of leukemia and lymphoma and
a transplant is not a suitable treatment for everyone.
Whether there is a suitable donor or not is one of the
important factors for doctors to consider. Other factors
that your doctor will take into account when considering
whether to recommend a transplant are your age and general
There are guidelines for sensible upper age
limits, though there are no lower age limits. Guidelines
recommend that for transplants from a donor (allogeneic)
the upper age limit is usually 45-50. The age limits
can be slightly flexible, depending on your general
health and the risk of recurrence of the disease. The
procedure is very demanding, both physically and emotionally.
You may need to stay in hospital for 4-6 weeks or longer
and for most of that time you will usually be in a room
of your own to avoid infection. You will often feel
very unwell during this time.
What are the risks?
A stem cell or bone marrow transplant is
a complicated and specialized treatment. It has many
side effects and possible complications. The main risk
comes during the period that your marrow is recovering,
when you are at risk of possibly life-threatening infections
and bleeding. With allogenic transplants there is also
the risk of graft-verses-host disease, in which
the donor's marrow or stem cells react against your
Very occasionally, the donated marrow or
stem cells do not start to produce new blood cells (this
is called graft failure). If this happens it may be
necessary for you to have either more bone marrow or
stem cells donated by the same donor. Your age and state
of health are key factors to take into account. A transplant
takes a long time and may make you very ill. If you
are at the upper age limit and your general health is
not good, you are more likely to have complications.
You need to weigh up the benefits and risks of this
treatment very carefully.
Great benefit is sometimes
possible as the treatment may give a greater chance
of curing the cancer than any other type of treatment.
However, this has to be weighed against the possible
side effects and the fact that some people die during
the procedure. You will want to discuss this in detail
with your doctor and your family. Most hospitals that
carry out blood stem cell or bone marrow transplants
have a transplant counsellor you can talk to about any
fears or worries that you have.