Bone Marrow Transplant in India
Bone marrow transplant involves replacement of damaged bone marrow with healthy bone marrow cells. Performed on patients with certain cancers or other diseases, a bone marrow transplant means taking stem cells from the bone marrow, sorting them and then giving them back either to the individual they were taken from or to someone who needs them.
Bone marrow is the soft, fatty tissue found inside the bones. The bone marrow contains cells that produce the body's blood cells. The three main types of blood cells produced in the bone marrow include:
• Red blood cells (RBCs), which carry oxygen and nutrients throughout the body
• White blood cells (WBCs), which fight infection and aid in the immune system.
• Platelets, which help in blood-clotting
Bone marrow also contains immature blood-forming stem cells known as hematopoietic stem cells, or HSCs. Most cells are already differentiated and can only make copies of themselves. Furthermore, the stem cells are not specialized, which means that they have the potential to multiply through cell division. In this way, they can either remain stem cells or differentiate and mature into many different kinds of blood cells.
Certain cancers and other diseases prevent hematopoietic stem cells from developing normally. A bone marrow transplant in India replaces such abnormal or damaged stem cells with healthy cells, which helps your body make enough white blood cells, or platelets to avoid infections, bleeding disorders, or anemia.
Stem cells can either be from patient’s own body or from a donor. When stem cells are taken from the patient only, they are usually harvested before one starts chemotherapy or radiation treatment. These healthy stem cells are then stored and used in transplantation after the completion of therapy. The stem cells are delivered in the bloodstream usually through a central venous catheter. The procedure is similar to getting a blood transfusion. Most times, no surgery is needed.
Who needs a bone marrow transplant?
A Bone marrow transplant in India is performed when a person’s bone marrow isn’t functioning properly. The reason could be chronic infections, disease, or cancer treatments. Bone marrow transplant is recommended if you have:
• Certain cancers, such as leukemia, lymphoma, myelodysplasia, and multiple myeloma
• Illnesses that hamper the production of bone marrow cells. For example, aplastic anemia, congenital neutropenia, sickle cell anemia, or thalassemia
• Had chemotherapy that destroyed your bone marrow
There are two kinds of bone marrow transplant in India:
1. Autologous bone marrow transplant: As the term ‘Autologous’ implies, stem cells used in this kind of bone marrow transplant in India are from patient’s own body. The stem cells are collected from patient’s body before he/she receives high-dose chemotherapy or radiations. Those stem cells are stored in a freezer. After the therapy, your stems cells are put back in your body. This is called a rescue transplant.
2. Allogeneic bone marrow transplant: The term allo means other. In this procedure of bone marrow transplant in India, Stem cells are removed from another person, called a donor. Most times, the donor's genes must at least partly match with the patient’s genes. Special tests and examinations are conducted to see if a donor is a good match for you. A brother or sister are usually preferred for this transplant. Sometimes parents, children, and other relatives could also be good matches.
If your medical team fails to find a matched adult donor, there are other options like Umbilical cord blood transplant. This is a type of allogeneic bone marrow transplant in India where stem cells are removed from a newborn baby's umbilical cord. These stem cells are then frozen until needed for a transplant. Umbilical cord stem cells are very immature, so one doesn't need perfect matching for them. However, due to the smaller number of stem cells, blood counts take much longer to recover.
Donor stem cells may be collected in 2 ways:
I. Bone marrow harvest: This harvesting procedure involves a minor surgery, done under general anaesthesia. The marrow is taken from the back of both the hip bones. However, it should always be kept in mind that the amount of marrow removed always depends on the weight of the person who is receiving it.
II. Leukapheresis: Leukapheresis happens in multiple stages. First, the donor is administered several days of shots to move stem cells out from the bone marrow into the blood. Then, during leukapheresis, blood is taken from the donor through an IV line. The part of WBCs containing stem cells is then separated and removed to be later given to the recipient. The RBCs are returned to the donor.
Before every bone marrow transplant in India, an extensive evaluation of the patient is done by the team of doctors. The decision to perform a bone marrow transplant will be based on many factors including:
• Patient’s age, overall health, and medical history
• Extent of the disease
• Availability of a donor
• Patient’s tolerance for specific medications, procedures, or therapies
A bone marrow transplant team usually consists of:
• Doctors- Specialists in the fields of oncology, hematology, immunology, and bone marrow transplant.
• Transplant nurse coordinator- The process is incomplete without an expert caregiver i.e., a nurse. She is the one who is responsible for organizing all aspects of care provided to the patient before and after the bone marrow transplant in India. She takes care of the fact that the patient is imparted with thorough knowledge and education; also coordinate the diagnostic testing and follow-up care.
• Dietitians- Professionals who will help the patient meet his or her dietary and nutritional needs. They will work closely with you and your family.
• Physical therapists- The after care is a very important part of the transplantation process. The Physical therapists are there to help patients with movement and also to build endurance after the transplant.
• Respiratory therapists
The preparations for a bone marrow transplant in India vary depending on the disease, type of transplant required, and patient’s tolerance for certain medications.
Usually, the treatment begins with high doses of chemotherapy and/or radiation. These intense therapies, also known as ablative, or myeloablative therapies effectively treat the malignancy making enough room in the bone marrow for the growth of new cells.
After completion of the chemotherapy and radiation treatment, the transplant, either from bone marrow or from peripherally collected stem cells, is administered through the central venous catheter into the bloodstream. The procedure to place the marrow into the bone requires no surgery and is just like a blood transfusion. The stem cells gradually find their way into the bone marrow and begin reproducing and establishing new, healthy blood cells.
Post-transplant, supportive care is given to prevent and treat infections, side effects of treatments, and complications. This includes frequent blood tests, close monitoring of vital signs, strict measurement of input and output, and providing a protected and clean environment.
Bone marrow transplant in India is a major surgical procedure that could lead to some complications including:
• Bleeding in the lungs, intestines, or any other area of the body
• Damage to the kidneys, liver, lungs, and heart
• Blood clotting in the small veins of the liver
• Stunted growth in children who received a bone marrow transplant
• Graft failure
• Graft-versus-host disease (GVHD), a condition where the donor cells attack your body
• Inflammation of the mouth, throat, esophagus, and stomach, called mucositis
- Early menopause
• Stomach problems, including diarrhoea, nausea, and vomiting
The success of a bone marrow transplant in India is directly related to how closely the donor and recipient genetically match.
A patient is regularly monitored for the first few weeks after the transplant. The engraftment is generally complete between 10 and 28 days after the initial transplant. The first sign of engraftment is a rising white blood cell count. This shows that the transplant is starting to make new blood cells.
Typical recovery time for a bone marrow transplant in India is about three months. However, this may go up to a year for full recovery which depends on numerous factors, including the condition being treated, chemotherapy, radiation and donor match.
India is every medical tourist’s preferred destination for bone marrow transplant courtesy two factors- the quality of healthcare and affordability for a bone marrow transplant. The bone marrow transplant in India is amongst the cheapest in the world using highest quality tools and technology.
The cost of bone marrow transplant in India starts from USD 18,000 for nearly 100 days stay in the country. The same cost goes up to USD 400,000 for countries like the US and UK. The Cancer Hospitals in India are well equipped with experienced team of doctors, nurses and other specially trained professionals who constantly work towards improving the quality of life for people with cancer and their families. The cost of bone marrow transplant in India also depends on the type of transplant procedure, type of hospital, level of care etc.
These hospitals have best-qualified professionals with trained support staff that offer highly advanced medical facilities at a fraction of cost what other western nations charge. The doctors and other medical staff ensure that the patients remain motivated throughout the bone marrow treatment and make informed decisions.
Patients coming from abroad could be rest assured about the bone marrow specialists in India who have many years of experience in various bone marrow transplants with positive results. Best bone marrow doctors in India have international fellowships and training with wide medical and clinical experience.