Bone Marrow Transplant (BMT) in India

WHAT IS BONE MARROW?

Bone marrow is a crucial part of your body because it is important for the proper functioning of your immune system. If your bone marrow is diseased and there aren’t enough white blood cells, red blood cells, or platelets, then your body’s immune system becomes weak and you become prone to infections, disorders, and diseases.

This can do a lot of damage to your body and can potentially lead to fatal infections. This is why bone marrow transplant is done when the bone marrow is not functioning optimally, such as when you have bone marrow disease. The cause of bone marrow destruction or damage varies from person to person and sometimes it is difficult to figure out bone marrow disease symptoms.

A bone marrow transplant could be recommended by your bone marrow transplant surgeon if your bone marrow shows an inability to produce stem cells. Bone marrow transplant helps people suffering from cancer-related diseases and in the case of bone marrow damage due to prolonged chemotherapy and radiation exposure.

With the help of a bone marrow transplant, your bone marrow can be rescued after it has been damaged as new stem cells will expedite the process of stem cell production.

DISEASES AND CONDITIONS

Here are some of the most common problems that cause the need for a bone marrow transplant. If you suffer from any of these diseases, you need to consult with a bone marrow transplant specialist to understand your suitability for bone marrow transplantation.

• Congenital neutropenia: An inherited disorder that causes recurring infections
• POEMS syndrome: A rare blood disorder that damages the nerves and may affect many other parts of the body.
• Aplastic anemia: A disorder in which the marrow stops making new blood cells
• Neuroblastoma: Form of cancer caused due to immature nerve cells found in the body
• Sickle cell anemia: An inherited blood disorder that causes misshapen red blood cells
• Adrenoleukodystrophy
• Plasma cell disorder: A spectrum of progressively more severe monoclonal gammopathies in which a clone or multiple clones of premalignant or malignant plasma cells over-produce and secrete myeloma protein into the blood stream.
• Thalassemia: an inherited blood disorder where the body makes an abnormal form of hemoglobin, an integral part of red blood cells.
• Inborn errors of metabolism
• Bone marrow cancers such as leukemia, myeloma, or lymphoma

procedure is a process through which blood stem cells are transplanted in the bone marrow so that these healthy stem cells replace the cells that have been either damaged or destroyed in the bone marrow marrow is a procedure performed to replace damaged or diseased bone marrow with healthy blood-forming stem cells. The bone marrow procedure is also referred to as a stem cell transplant.

Basically, bone marrow is a soft, spongy tissue found in your bones. It is responsible for producing stem blood cells which further give rise to blood cells including red blood cells, white blood cells, and platelets.

A person may be required to undergo a bone marrow transplant in India if he/she suffers from any of the health complications mentioned below:

• Bone marrow diseases such as aplastic anemia.
• Blood cancers including leukemia or lymphoma.
• Other immune deficiencies and genetic disorders like sickle cell disease.

Types of Bone Marrow Transplant

Depending upon the donor, a bone marrow transplant procedure is categorized into three main types:

• Autologous bone marrow transplant: If the transplant is done using your own stem cells then it is defined as the autologous bone marrow transplant.
• Allogeneic bone marrow transplant: If the transplant is done using the bone cells from a donor based on his/her genetic match then it is defined as an Allogeneic bone marrow transplant.
• Hematopoietic stem cell transplantation: This kind of transplantation involves the intravenous infusion of autologous or allogeneic stem cells for treating hematopoietic function in patients.

Here is the basic procedure followed by the specialists and Doctors at the top bone marrow transplant hospitals in India:

The stem cells in your healthy bone marrow are responsible for producing blood cells, especially leukocytes or white blood cells (WBCs) that are essential for the immune system. Blood cancers and associated treatment such as chemotherapy and radiation treatments deplete your bone marrow. Stem cell transplants help in regenerating new cells from the old cells to help your body create more cancer-free cells. The stem cells can be collected either from your own bloodstream or from that of a donor.

Here’s how the transplant process looks:

Before the transplant:

• Before the blood is drawn out, you or your donor will be injected with medicines to transfer blood-forming stem cells from your bone marrow to your bloodstream.
• The stem cells from you or your donor’s blood will be collected, separated from the bloodstream, and kept in a frozen state.
• You go through a conditioning treatment which involves high or low dose chemotherapy or radiation to kill the cancer cells and your own stem cells so as to replace them with new stem cells.

During the transplant:

• The infusion procedure begins with you sitting in a chair and the infusion passing through a surgical line attached to your neck.
• You will be monitored for any fall in temperature or blood pressure and developing a fever.
• You may experience some side effects such as headache, nausea, and shortness of breath.

After the transplant:

• After the transplant is complete, your stem cells will start grafting to the bone marrow in a period of two to four weeks. Next, they will also start producing white blood cells, platelets, and red blood cells.
• In case the stem cells are from a donor, you will need to take antibiotics and anti-rejection medicines to help your body accept the transfused cells. You may also need transfused red blood cells, platelets, and nutrition.
• You may need to stay in a hospital for a month until your immune system starts functioning. It’s important to stay in a germ-free environment.
• You will need to visit the outpatient section so that the doctors can check your blood and bone marrow for any complications.

Why is bone marrow transplant done?

A bone marrow transplant is a medical procedure that is done to replace destroyed or damaged bone marrow with healthy stem cells. Bone marrow is the soft tissue that is present inside your bones, and it is responsible for producing blood cells. The healthy stem cells that are transferred are immature cells in the bone marrow, they will eventually stimulate the production of healthy blood cells.

What is the life expectancy after a bone marrow transplant?

Overall, the estimated survival of the bone marrow transplant is eighty percent; this means that the patient can have a healthy life for up to 20 years. It’s expected that twenty-five to forty percent of patients, over the age of 60, are expected to survive for three years or more. If the stem cell transplant is done during the first remission, then the disease-free survival rate can range from thirty to fifty percent. The life expectancy and results of the transplant can vary from person to person. However, a successful transplant will allow the patient to return to their normal routine and live a healthy life.

Who needs a bone marrow transplant?

A bone marrow transplant is usually performed when the patient’s marrow is damaged and cannot function properly. This is caused due to chronic diseases, infections, or a terminal illness like cancer. Patients who suffer from the following conditions needs a bone marrow transplant:

• Anemia- a disorder in which the marrow stops producing new blood cells
• Cancer- any cancer that affects the bone marrow like leukemia, lymphoma, and myeloma
• Neutropenia- A genetic disorder that causes chronic infections
• Sickle cell anemia- a genetic blood disorder that can cause distorted red blood cells
• Thalassemia- This is an inherited blood disorder; here, the body produces an irregular type of hemoglobin.