What is Bone Marrow Transplantation/Stem Cell Transplant?
A bone marrow transplant (BMT), also called stem cell transplant, is a medical procedure that involves the replacement of unhealthy or diseased bone marrow with genetically healthy functioning bone marrow. The infused stem cells during stem cell transplantation, later develop into red blood cells, white blood cells and platelets.
Types of Bone Marrow Transplant
Based on the source of the new bone marrows or the donor, there are two types of bone marrow transplant:
- Autologous Bone Marrow Transplant: In this technique, the patient is the donor. Doctors harvest healthy bone marrows before performing chemotherapy or radiation therapy. Once the bone marrow treatment is done, they inject back the bone marrow in the patient’s body again that helps to build and restore new marrows.
- Allogenic Bone Marrow Transplant: Bone marrow is extracted from a genetically compatible donor. A close relative or family member can be a suitable match for the transplant. However, in order to find the best match blood tests are conducted to find matching HLA.
- Umbilical Cord Blood Transplant: In umbilical cord blood transplant, the stem cells are taken from the umbilical cord of a newborn. Although the blood cells are still naive indicating that they are not active enough to attack other cells. It is a type of allogeneic bone marrow transplant.
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Diseases for which a Bone Marrow Transplant is required
Bone marrow transplant is a probable treatment option to cure the following diseases:
- Aplastic Anemia
- Sickle Cell Anemia
- Multiple myelomas
- Immune deficiency disorders
- Hurler’s Syndrome
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Before performing a bone marrow transplant the following diagnostic tests are performed:
- Physical Examination
- Imaging Tests
- Bone Marrow Biopsy
- Blood Test
During the Procedure:
The procedure of a bone marrow transplant can be divided into three parts:
- Harvesting: The first part of the procedure includes bone marrow harvesting from the donor. It is collected from the hip bone as bone marrow concentrate is the highest here. Through the punctures made on the skin above the hip bone, the doctors extract bone marrow and blood through a special needle. Bone particles and fat are removed from the collection. The procedure takes about 2 hours.
- Conditioning: The next step includes chemotherapy or radiation therapy that destroys the damaged or diseased bone marrow in the patient’s body and suppresses the immune system. Conditioning is done so that new bone marrow can be produced once the donor bone marrow is introduced in the body.
- Transplant: After conditioning the patient is given a few days to rest so that the drugs can flush out of their system. Through a central line the donor bone marrow is injected into the patient’s body. As bone marrow transplant is a painless procedure, an anaesthetic is not provided to the patient.
After the Procedure
After the transplant, the patient has to stay at the hospital for a few weeks so that the new marrow settles and starts functioning. He/she have to go for frequent visits to the doctor so that his/her condition’s progress can be checked. Almost 6–12 months are required for a complete recovery after a bone marrow transplant. Till then the patient requires ample rest and be careful of infections.
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Factors Affecting the Cost of Bone Marrow Transplant
Some of the following factors may affect your cost of treatment:
- The kind of hospital you opt for. Some of the best hospitals well-known for bone marrow transplant procedure are BLK Super Specialty Hospital New Delhi, Apollo Hospital Chennai, Tata Memorial Center, Indraprastha Apollo Hospital, Fortis Hospital Mumbai, Medanta - The Medicity Hospital Gurgaon and more.
- Room– Standard single room, deluxe room, super deluxe room for the number of nights specified (including nursing fee, meals, room rate and room service)
- Operating room, ICU
- Fee for the team of doctors (Anaesthetist, Physiotherapist, Dietician)
- Standard test and diagnostic procedures
- Type of bone marrow used
- If the bone marrow is taken from a donor. In case the matching donor isn't available, then doctors search for unrelated bone marrow whose bone marrow cells matches with the needy one from bone marrow registries.
- How many bone marrow injections are being given and how they are being given (intrathecal administration or intravenous administration)
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