Blood and Bone Marrow Transplant for Blood Cancer

With our state of the art set for Blood and Bone Marrow Transplantation Center at Universal Hospitals placed in the heart of Pune city with an excellent success rate. Universal hospital, Pune is also a trusted name in BMT for international patients, as the hospital has highly qualified team and has also very stringent infection control norms which are critical for BMT patients. BMT research is available at Universal Hospital, Pune.

Indications

Autologous Transplant (Stem Cells collected from patients own body) -

  • Hodgkin's & Non Hodgkin's Lymphoma: For Relapsed / Refractory cases,it is standard research and in most such cases, it is the only curative option.
  • Myeloma: Although Not curative, it is Standard research as a part of initial research, as it prolongs survival substantially.
  • Leukemia: Acute Myeloid Leukemia as part of consolidation research to increase chance of cure in this disease.

Allogenic Transplant (Stem Cells collected from doner person's body) -

  • Thalassemia
  • Several Other Genetic Disorders especially with Single Gene Defects
  • Aplastic Anemia
  • Chronic Myeloid Leukemia
  • High Risk AML & Relapsed AML
  • Relapsed ALL (Acute Lymphocytic Leukemia)
  • As an option in several Advanced or Refractory Haematological Malignancies eg. Follicular Lymphoma, CLL, Myeloma etc.

Objectives

The procedure serves mainly 3 purposes -

  1. Replacing a missing gene e.g. in Thalassemia, Sickle cell disease and many genetic disorders. These are diseases where the person is otherwise normal except for one missing gene and replacing that gene is curative.
  2. Allows use of high doses of Anticancer therapies, which may lead to loss of bone marrow. Without stem cells support, marrow will recover only after a long time, resulting in high complication rate from infections or bleeding.
    Infused stem cells provide early recovery of blood cells. It considerably lowers the risk of low blood counts due to marrow suppression. Thus it is one form of "Supportive Research" and not a research of cancer by itself. This is the case in Autologous (self)Ttransplant and in majority of Allogeneic Transplants.
  3. Some "Graft versus Disease activity" more commonly known as "Graft v Leukemia effect" in Allogeneic Transplant, especially evident in Chronic Myeloid Leukemia.

Sources

  • Sources of Hematopoietic stem cells:-

    Bone marrow is the tissue that is found inside our bones.It is a spongy texture and is rich in stem cells. Bone marrow is collected from the Iliac Crest (hip bone) in the operating room.

  • Peripheral blood stem cells (PBSB):-

    Stem cells are collected from the circulating blood stream using a process called Apheresis.

  • Umbilical cord blood:-

    The cord of new born babies is a rich source of stem cells.

Process

What are Stem Cells?

Blood cells grow in the same way as other human cells. They develop in the bone marrow from a parent cell known as "stem cell". These stem cells begin to divide and mature until they are fully developed, forming all the different types of blood cells - white cells, platelets and red blood cells. Stem cells are usually found inside the bone marrow spaces of large bones, however, they can also travel from bone to bone to other by way of blood system. A very small percentage of the white blood cells circulating through our veins are stem cells.

Process

There is no surgery involved in transplant, for the patient or donor. It is very safe procedure for a donor. Nothing is lost permanently in the body e.g. as in kidney transplant. Stem cells are infused into the patient through a live blood transfusion. Stem cells are regenerated in few days. For the same reason there are over 1 Crore (10 million) volunteer donors for stem cell transplant in USA.

Types

The stem cells can be collected from patient's own body or can be harvested from another person. This other person is known as Donor.


Autologous Transplant

Stem cells are taken from the patient either by bone marrow harvest or Apheresis (peripheral blood stem cells) and then given back to the patient after conditioning research.

Allogeneic Transplant

The donor has the same hla type as the patient. Stem cells are taken either by bone marrow harvest or Apheresis (peripheral blood stem cells) from a HLA matched donor, usually a brother or sister.

Other donors for allogeneic bone marrow transplants include the following:-

  • An identical twin - a syngeneic transplant is an allogeneic transplant from an identical twin. Identical twins are considered a complete genetic match for a transplant.
  • Unrelated transplants (UBMT or mud, for matched unrelated donor) - The HLA matched stem cells are from an unrelated donor, usually found through the national registries.
  • Umbilical Cord blood transplant - Stem cells are taken from an umbilical cord immediately after delivery of an infant. The stem cells are tested, typed, counted and frozen until they are ready to be transplanted.

Preparing for BMT

Having a transplant can be very demanding, physically and emotionally. 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 research?
  • What are the risks of the research?
  • 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 researchs available to me?
  • Can one predict how the disease will progress?
  • Who can visit me?
  • Will my research 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?