Bone marrow transplantation is a special treatment for patients suffering from certain diseases or cancers. It is a medical procedure that involves the infusion of healthy blood cells into your body to replace the damaged or diseased ones.
The concept of bone marrow transplant is not new to this world. In India, the first successful allogeneic bone marrow transplant took place at Tata Memorial Hospital, Mumbai in 1983. Since then, India has been a favored destination for medical treatment.
Treating Cancer: India, Your Cost-Friendly Destination For Bone Marrow Transplantation!
It is quite expensive to receive medical treatment in western countries and other developed nations. India, being one of the developed countries, offers medical treatment at about one-tenth of the costs in the US. Other reasons contribute to the reason why people prefer India for their medical treatment.
Internationally Accredited Healthcare Institutions:
- India has several private, public, and government hospitals.
- There are 34 JCI (Joint Commission International International) accredited and more than 84 NABH (National Accreditation Board for Hospitals & Healthcare Providers) accredited hospitals in India.
- These hospitals are well-equipped with the latest, advanced technology and keep abreast of any modification in the medical field.
- Fortis Healthcare group, Narayana Health, Apollo Healthcare group are some of the best-known hospitals for bone marrow transplantation.
Shorter Waiting Times & Timely Treatment:
- As bone marrow transplant is a surgical procedure that requires waiting time, if the donor is a family member or from the bone marrow donation registry.
- In India, it takes comparatively lesser or zeroes waiting period than in the US or UK.
- Indian hospitals and healthcare staff try to keep the waiting period as minimal as possible to avoid complications or negative results.
Medical Staycation:
- India, being one of the popular South-Asian countries, offers tourist attractions in a bundle to explore.
- India has a rich history, magnificent architectural buildings, beaches, great heritage.
- Therefore, one can explore India’s rich culture after being treated and see how localities welcome and help in sight-seeing.
Competitive Pricing:
- As compared to western countries, the cost of medical treatment in India is significantly lower.
- Owing to the hospitals and clinics that are known for world-class facilities, technology.
- Along with timely treatment, these hospitals provide treatment to their domestic and international medical tourists within budget.
Board-Certified Medical Personnel:
- India has well-experienced, highly-qualified medical personnel.
- There are several medical specialties in hospitals that are run by board-certified medical professionals and experienced nursing staff.
- These medical professionals have attained their educational qualifications from prestigious medical institutions across the globe.
Easier Medical Visa Processing:
- If one wants to get treated in India, the person should have a passport with six months validity.
- One should carry along proof of residential address, copy of passport & online visa application form, recommendation letter from home country doctor to specify the reason behind their visit for medical treatment in India, medical documents, passport and copy of attendant as well as proof of relationship with the attendant.
- The application of a medical visa in India is quite simple and easy.
The medical tourism industry is booming at its peak in India and likely to rise in the upcoming years.
Saving Lives: Types Of Bone Marrow Transplant Performed In India!
Bone marrow transplantation is mainly of two types. Bone marrow cells are either collected from the patient’s own body or extracted from another person, who is known as donor. The type depends on from where the bone marrow cells are extracted.
Type of Transplant | Procedure |
Autologous Transplant |
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Allogeneic Transplant |
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Who Requires Bone Marrow Transplant?
Some certain diseases and cancers can be treated from bone marrow transplant and they are:
Malignant/Cancerous Conditions | - Multiple Myeloma |
Benign/Non-Cancerous Conditions | - Sickle cell anemia |
Bone Marrow Donation: Easier And Less Painful!
Only 30% Of people can find an HLA-matched donor in their family and the remaining 70 percent have to find HLA-matched bone marrow from other donors. (Source: Cancer.net)
- If you’re planning to donate your bone marrow cells, it means you have agreed that the doctor can extract cells from your blood or bone marrow for transplantation. These extracted cells are then used in treating cancers.
- Earlier, surgery was the only way to harvest cells directly from the bone. Today, the cells can be collected directly from the body and the process is known as peripheral bone marrow donation.
- Around 77% of donations are peripheral donations.
- Bone marrow donation is a surgical, inpatient procedure in which doctors use a needle to withdraw liquid marrow from the back of the pelvic bone via two small punctures. This process only happens in the case of thalassemia and aplastic anemia, else bone marrow donation is an outpatient procedure in which blood is extracted from the donor.
Requirements To Be A Qualified Donor
Thinking whether you’re an eligible donor or not? Well, the physician conducts a thorough screening process to ensure that you’re healthy enough to donate your bone marrow cells. In general, you must match the following criteria to be a qualified donor:
- The age limit is between 18 and 60 years old to register for donation.
- However, people between 18 and 44 tend to produce quality cells than older ones. Therefore, doctors choose this age group most of the time.
- Autoimmune diseases, bleeding problems, several heart conditions, and HIV/AIDS are some conditions that refrain a donor from a donation. Although, your eligibility as a donor is completely decided by the physician.
There are some conditions where you may be able to donate and they are:
- Diabetes
- Hepatitis
- Mental health issues
- Very early-stage cancer where you haven’t had chemotherapy or radiation therapy
Possible Risks To The Donor Post Donation
The most serious and possible risk is related to anesthesia. General anesthesia is usually safe; however, in some cases, it may negatively react and lead to:
- Postoperative confusion
- Stroke
- Heart attack
- Pneumonia
Other potential side-effects from general anesthesia are:
- Sore throat because of the breathing tube
- Vomiting
- Nausea
Regional anesthesia may cause headaches and a temporary drop in blood pressure.
There are some cases when a donor may face side-effects post-donation and they include:
- Soreness or stiffness from where the marrow was harvested
- Wound or bruising at where the incision is done
- Pain in the hip or back
- Trouble walking in the initial days
What Does A BMT Donor Go Through?
- If you’re having an autologous transplant, then you will not need any donor. However, finding a donor for an allogeneic transplant isn’t a piece of cake. The donor has to go through the Human Leukocyte Antigen (HLA) test.
- Since you share similar genetic markers from your parents, siblings from the same biological parents are most likely to be your donor.
- HLA-match is done based on a special DNA testing laboratory. If the test comes out to be positive, then a thorough physical examination is done to check whether the donor is healthy enough for donation.
- If a family member cannot be your donor, then the transplant center will search for an unrelated donor that includes a search of cord blood units or potential donors may undergo HLA-match to check whether they are a good donor for you.
- If the transplant center is unable to find a perfect match for you, then the healthcare team may suggest a mismatched donor with rare HLA types.
- In other cases, your doctor may recommend a haploidentical transplant in which cells from a related donor matches only half of your HLA type.
Medical Guidelines: Other Criteria For Bone Marrow Donation!
HLA-match is a standard and the very first consideration while selecting a donor. But there are some other factors that your doctor might consider and they are:
- Age, usually younger donors are preferred
- Gender, males are preferred over females
- If the donor is female, then the doctor may consider the number of times she has conceived
- Family medical history
- Weight
- Infection, especially cytomegalovirus (CMV)
How To Be A Donor: Bone Marrow Donor Registry!
- Thousands of people are diagnosed with blood cancers and diseases every day and need life-saving bone-marrow cells.
- Only a small portion of them are lucky enough to get a suitable donor in their family and the remaining ones need to wait and find their voluntary unrelated matched donors.
- If you want to help the needy ones, feel free to join the Marrow Donor Registry India (MDRI) and pledge to become a bone marrow donor.
- Be a Superhero in saving a human life.
Bone Marrow Pre-Transplant Screening: Evaluation Process
A bone marrow transplant is a surgical procedure that requires efforts with a little extra care. Your healthcare team will consider the following criteria before performing this medical procedure and this includes:
- Age
- Overall physical condition
- Diagnosis
- Treatment history
- Availability of a donor in case of allogeneic transplant
However, your medical team will also conduct tests on your vital organs to check the tolerance level of your body. This includes:
- A pulmonary function test to check the state of your lungs
- A chest x-ray/CT-scan to detect any lung problems or infection
- A MUGA scan/electrocardiogram/EKG to check the functionality of your heart
- Blood and urine tests to measure your blood counts, liver function, kidney function, and detect any infectious diseases
- A thorough physical exam
- A dental exam
Bone Marrow Transplantation: How The Procedure Works!
Once you’re given the green signal for bone marrow transplantation, you will receive high-dose chemotherapy and/or total body irradiation (TBI) several days before the transplant. This process is known as a preparative or conditioning regimen. It is done:
- To kill the diseased cells
- To make a room for healthy blood cells in the bone marrow
The preparative regimen is an out-patient procedure which is of three-to-seven days period.
- If the preparative regimen is strong enough to disable your immune system, then it is a myeloablative transplant.
- If the regimen fails to disable your immune system completely, then it is reduced intensity or nonmyeloablative transplant.
What Happens During The Day Of Transplant?
- Once the preparative regimen ends, the transplant takes place after one to three days.
- The procedure involves the infusion of healthy blood cells into your bloodstream through the catheter. This process is quite similar to blood transfusion which usually takes 30 minutes to an hour to complete.
- The medical team keeps on checking signs for fever, chills, rash, or chest pain.
- Once the infusion is done, the infused blood cells will start producing healthy new blood cells after days or weeks. This process is known as engraftment.
What To Expect After Transplant: Recovery Period, Risks, And Complications!
The recovery period and/or engraftment process typically depends on the type of transplant.
- If you had undergone an autologous transplant, you may be given drugs, called growth factors, to speed up the recovery of normal blood counts.
- If you were treated with peripheral blood cells, then expect the engraftment process to begin after two to three weeks.
- If you were transplanted with cord cells, the engraftment process may take a bit longer - usually three to five weeks.
After the transplant, you will also be monitored for other complications.
Complication | Medical Treatment |
Infection | - antibiotics to prevent bacterial infections - removing fresh fruits and vegetables from your diet - no live plants and dried flowers in the room - no visitors who are ill or exposed to contagious diseases - air-filtering equipment to remove infectious agents - hand-washing by visitors and nursing staff before touching you |
Blood And Platelet Transfusion | - chemotherapy or radiation destroy the platelets which help blood clot. |
Nausea, Vomiting, And Diarrhea | - Quite common post-transplant that can be controlled with medication. - Antiemetics are given to control nausea. |
Mouth & Throat Sores | - It can be controlled with topical anesthetics or narcotics. |
Hair Loss & Skin Rash | - Skin rash or dark spots on the skin are quite common that usually fade in one to two months. |
Muscle Spasms & Cramping | - Caused by an imbalance of electrolytes in the body such as potassium, calcium, and magnesium. - Intake of electrolyte supplements. |
Bladder Irritation | - the occurrence of bloody or painful urination - can be controlled by increasing the intake of intravenous fluids using a catheter, irrigate the bladder or drug therapy. |
Liver Problems | - temporary liver damage may occur which is mild and reversible. - Resting the liver and avoiding medications harming the liver usually cure the problem. - In some cases, the patient may develop a condition, sinusoidal obstruction syndrome or SOS. - A drug called defibrotide is given to patients who develop SOS. |
Lungs & Heart | - breathing irregularities may occur due to chemotherapy or total body irradiation. - these problems are temporary and usually resolve on their own. |
Fatigue | - Quite common which can be cured by performing a moderate exercise to regain strength and stamina. |
Acute Graft-Versus-Host Disease | - occurs in the case of allogeneic transplants. - two forms: acute and chronic - medications are given to avoid such condition |
Building A Family: Life After Transplant!
Not all patients, who undergo bone marrow transplant, become fertile. Fortunately, there are options available for couples who wish to have children after a transplant.
Men: Artificial Insemination/Sperm Retrieval:
- Men may save sperm in a sperm bank that can be used later to conceive.
- Artificial insemination is not always successful, it can be used to build a family afterward.
- In case, you did not save sperm in the bank, a procedure called testicular sperm extraction could be an option.
- The testicular sperm might still have sperm that can be used to fertilize a woman’s egg in the laboratory.
- The resulting embryo is then planted in a woman’s uterus and this process is called in-vitro fertilization.
Women: In-Vitro Fertilization
- Women may create and store embryos before the transplant that can later be implanted into the uterus, once the surgery is done.
- If she does not have embryos, she may use eggs donated by a donor.
- These donor eggs are then fertilized with sperm and implanted into the uterus.
- Many transplant survivors use this method after transplant for planning a family.
Apart from the above-mentioned methods, the transplant survivors can also opt for adoption method to start a family.
Choosing A Transplant Center: Which Center Is Best For You?
India, being an affordable destination for medical tourists, has several transplant centers. While choosing a transplant center, some things need to be considered and they are:
- Is the transplant center accredited by NABH (National Accreditation Board for Hospitals & Healthcare Providers) and JCI (Joint Commission International)?
- What is the experience of a transplant center in treating patients suffering from the same disease as you have? Some centers specialize in treating particular diseases.
- Will your insurance policy cover your medical expenses at the transplant center you choose?
- Is the center far from your hotel, accommodation, or home? How will you coordinate your follow-up care with local physicians?
- Will the staff provide emotional care services to you, your family, and the caregiver?
- Where does the center stand at treating your particular disease successfully?
It is better to be careful while discussing success rates with transplant centers as the success rate is measured based on different parameters. It can be measured either by the number of patients alive after one year or alive and disease after one or three years after transplant.
Transforming Lives Through Bone Marrow Transplantation: ‘Cost Factor’
- The cost of bone marrow transplantation varies based on various parameters such as type of BMT - autologous or allogeneic, hospital - private, public or government, cancer, patient’s overall health condition, age, etc.
- The cost also includes specialist fees, hospital fees, diagnostic tests, duration of stay in the hospital.
- If the patient is traveling from another country, then the cost also includes airfares, visa fees, traveling, accommodation, food, and other basic amenities, type of room - VIP or standard, total stay in India, etc.
India stands amongst the first top ten medical tourism destinations in the world because it offers budget-friendly medical treatment and so is bone marrow transplantation.
Country | Autologous BMT | Allogeneic BMT | Haplo-identical BMT |
USA | USD 2,00,000 | USD 2,00,000 | USD 2,50,000 |
India | USD 30,000 | USD 35,000 | USD 35,000 |
Mexico | USD 35,000 | USD 40,000 | USD 40,000 |
Europe | USD 2,00,000 | USD 2,00,000 | USD 2,50,000 |
Best Bone Marrow Transplant Doctors in India
Some of the best BMT doctors in India are:
- Dr. TPR Bharadwaj: He is a well-experienced Hematologist with 43 years of experience. He is currently associated with Apollo Hospitals, Greams Road, Chennai. He is a Bone Marrow Specialist and has been honored with several awards and recognitions.
- Dr. Manas Kalra: He is a pediatric Hematologist and Oncologist with more than 13 years of experience. He specializes in managing pediatric cancers, solid tumors, adolescents, young adults, and adults undergoing bone marrow transplants.
- Dr. Rahul Bhargava: He is currently associated with Fortis Memorial Research Institute, Gurgaon as the Head of Hemato-Oncology and Bone Marrow Transplant Department.
- Dr. Srikanth M: He is a well-known Hematologist with more than 21 years of experience. He is currently associated with Apollo Hospitals, Greams Road, Chennai.
- Dr. Nitin Sood: He is a highly-qualified Hematologist at Medanta, the Medicity, Gurgaon. He has nearly 16 years of experience and his clinical interests are Hemato-oncology, Hematology, Thrombosis, etc.
Best Bone Marrow Transplant Hospitals In India
Some of the best BMT hospitals in India are:
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Medanta, The Medicity, Gurgaon:
It is the biggest unit for the best bone marrow transplant hospitals in Gurgaon. Established in 2009, the hospital holds a capacity of 1,250 beds. The hospital has a team of well-experienced medical personnel having expertise in performing bone marrow transplant surgery. -
BLK Super Specialty Hospital, New Delhi: It is one of the best hospitals to offer bone marrow transplantation. It holds a capacity of 650 beds. The hospital is well-known for bone marrow transplant for treating various cancers.
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Fortis Hospital, Mulund, Mumbai: It is a well-known hospital that comes under the Fortis Healthcare Group network. Established in 2002, it has a capacity of 300 beds.
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Gleneagles BGS Hospital, Bangalore: It is a multi-specialty Hospital that is popular for multi-organ transplant, bone marrow transplant, cardiology, oncology, and neurology.
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Columbia Asia Hospital, Bangalore:
Established in 2014, this multi-specialty hospital is well-known for bone marrow transplantation, cardiology, oncology, organ transplant, and bariatric surgery.
Role Of Vaidam Health In Your Medical Treatment Journey
India has several JCI (Joint Commission International) accredited hospitals. It becomes difficult for a medical tourist to select the best hospital and doctor within their budget.
This is where Vaidam Health makes your medical journey worthy. The patient relation team provides the right information that a patient needs as per their medical requirements and budget.