Bone marrow transplant in India
Bone marrow stem cell transplants in India are performed by some of the leading cancer centres. Till date more than 10,000 successful bone marrow stem cell transplants have been performed till date in India. Patients from across the world visits India for bone marrow stem cell transplant.
What is bone marrow stem cell transplant ?
As per NCI dictionary of cancer terms bone marrow transplant is a procedure in which a patient receives healthy blood-forming cells (stem cells) to replace their own stem cells that have been destroyed by disease or by the radiation or high doses of anticancer drugs that are given as part of the procedure. The healthy stem cells may come from the bone marrow of the patient or a donor. A bone marrow transplant may be autologous (using a patient’s own stem cells that were collected from the marrow and saved before treatment), allogeneic (using stem cells donated by someone who is not an identical twin), or syngeneic (using stem cells donated by an identical twin). Also called BMT.
In simple terms when bone marrow is damaged or destroyed by disease, infection or chemotherapy then it is replaced by new stem cells which travels to the bone marrow where they produce new blood cells and promote growth of new marrow.
Bone marrow is one of the most essential part of the body and creates following parts of the blood :
- red blood cells, which carry oxygen and nutrients throughout the body
- white blood cells, which fight infection
- platelets, which are responsible for the formation of clots
A bone marrow transplant replaces your damaged stem cells with healthy cells. This helps your body make enough white blood cells, platelets or red blood cells to avoid infections, bleeding disorders, or anemia.
Why bone marrow stem cell transplant performed ?
Bone marrow transplants also knows as BMT is performed when a patients marrow isn’t healthy enough to function properly. Some of the reasons of bone marrow transplant are :
- Aplastic anemia, in this disorder bone marrow stops making new blood cells.
- Cancers like leukemia, lymphoma & multiple myeloma effects the bone marrow badly.
- Bone marrow gets damaged due to chemotherapy.
- Congenital neutropenia, which is an inherited disorder that causes recurring infections
- Sickle cell anemia, which is an inherited blood disorder that causes misshapen red blood cells
- Thalassemia, which is an inherited blood disorder where the body makes an abnormal form of hemoglobin, an integral part of red blood cells.
How bone marrow stem cell transplant is performed?
Prior to bone marrow transplant several tests are performed to ensure what type of stem cells are required. There is a possibility that patient undergo chemotherapy or radiation therapy to kill all the cancer cells or marrow cells before patient gets the new stem cells.
During the course of treatment there is a huge vulnerability to immune system of the body. This effects the body to fight any kind of infections. Hence, patients are kept in a very special section of the hospital that’s reserved for people receiving bone marrow transplant.
Procedure of bone marrow transplant is similar to blood transfusion.
If patient is going for allogenic transplant, bone marrow cells will be harvested from the donor a day or two before your procedure. If own cells are used then they are retrieved from the stem cell bank.
During a bone marrow harvest, cells are collected from both hipbones through a needle. You’re under anesthesia for this procedure, meaning patient will be asleep and free of any pain.
Leukapheresis
Leukapheresis is a process in which donor is given five shots to help the stem cells move from the bone marrow into the bloodstream. Blood is then drawn through an intravenous (IV) line, and a machine separates out the white blood cells that contain stem cells.
A needle called a central venous catheter, or a port, will be installed on the upper right portion of patient’s chest. This allows the fluid containing the new stem cells to flow directly into patient’s heart. The stem cells then disperse throughout patient’s body. They flow through patient’s blood and into the bone marrow. They’ll become established there and begin to grow.
The port is left in place because the bone marrow transplant is done over several sessions for a few days. Multiple sessions give the new stem cells the best chance to integrate themselves into patient’s body. That process is known as engraftment.
Through this port, you’ll also receive blood transfusions, liquids, and possibly nutrients. You may need medications to fight off infections and help the new marrow grow. This depends on how well you handle the treatments.
During this time, patient is closely monitored for any complications.
Types of bone marrow stem cell transplant
There are two major types of Bone Marrow Transplant. Type of transplant required depends on the reason for which BMT is required.
Autologous Transplants
Autologous transplant uses the own bone marrow to replace damaged stem cells. This is done by harvesting your cells before beginning a damaging therapy to cells like chemotherapy or radiation. However, this type of transplant can only be done if you have a healthy bone marrow.
Allogenic transplants
Allogenic transplant is done when patient’s bone marrow is completely damaged and is unable to function properly. This involves use of cells from the donor. Donor must be close genetic match. HLA typing test is conducted on the donors and patient and then it is matched. However, these patients have very high risk of complications such as GVHD. Patient is also put on medications to suppress the immune system so that body doesn’t attack the new cells. Success of allogenic transplant depends on how closely donor cells matches with patients cells. 
Complications associated with bone marrow stem cell transplant
Bone marrow transplant or BMT is a major medical procedure and lot of precision and care is required along with requisite infrastructure in the hospital to carry out the procedure. One may experience following after BMT –
- a drop in blood pressure
- a headache
- nausea
- pain
- shortness of breath
- chills
- a fever
Apart from the this one may also incur some other complications but generally depends on the age, overall health, disease that’s been treated for and type of transplant one has received.
Complications can be mild or very serious, and they
can include:
- graft-versus-host disease (GVHD), which is a condition in which donor cells attack your body
- graft failure, which occurs when transplanted cells don’t begin producing new cells as planned
- bleeding in the lungs, brain, and other parts of the body
- cataracts, which is characterized by clouding in the lens of the eye
- damage to vital organs
- early menopause
- anemia, which occurs when the body doesn’t produce enough red blood cells
- infections
- nausea, diarrhea, or vomiting
- mucositis, which is a condition that causes inflammation and soreness in the mouth, throat, and stomach.
Best hospitals for bone marrow stem cell transplant in India
- BLK Hospital, New Delhi
- Artemis Hospital, Gurugram, Delhi NCR
- American Oncology, Hyderabad
- Mazumder Shaw Narayana, Bangalore
- Narayana Multispecialty Hospital, Howrah
- Fortis Hospital, Gurgaon
- Apollo Cancer Institute, Hyderabad
- Apollo cancer Institute, Chennai
- Medanta medicity, Gurgaon
- Dharamshila Hospital, Delhi
Cost of bone marrow stem cell transplant in India
An Allogenic fully matched bone marrow stem cell transplant in India cost approximately $25,000 USD in India.
Allogenic half match would cost between $ 29,000-35000 USD
Aulogous stem cell transplant will cost between $ 16,000 – 20,000 USD
Bone marrow stem cell transplant in India is commonly performed now in India. Patients from many countries like USA, UK, Europe, Africa, Bangladesh, Afghanistan, UAE etc now a days come to India for bone marrow stem cell transplant.
BEST DOCTORS FOR BONE MARROW STEM CELL TRANSPLANT IN INDIA
Dr. Dharma Choudhary – BLK Bone Marrow Transplant Centre, New Delhi is arguably India’s leading doctor for bone marrow stem cell transplant with more than 2000 successful transplants to his credit. He is known for his successful career as a top BMT surgeon, Dr. Choudhary’s expertise in Thalassemia Bone Marrow Transplant, Thalassemia Stem Cell Transplant. Dr. Dharma Choudhary is the pioneer in India for his work in Allogenic Bone Marrow Transplant for Thalassemia Major and Aplastic Anemia during his period at Sir Ganga Ram Hospital Delhi. Dr. Dharma Choudhary has made it to the list of top 10 Hematologists and Bone Marrow Transplant Specialist of this generation in India. Known for his High success rates in Bone Marrow Transplant, Dr. Dharma Choudhary is a lifelong member of the Indian Society of Hematology & Transfusion Medicine. He is also popular among international patients from different corners of the world mostly from Afghanistan, Iraq, Oman, Uzbekistan, Sudan, Kenya, Nigeria, and Tanzania.
Dr. Sanjeev Kumar Sharma is a practising Hematologist with an experience of 19 years. He is located in New Delhi. Dr. Sanjeev Kumar Sharma practices at the BLK Super Speciality Hospital in New Delhi. The BLK Super Speciality Hospital is situated at 5, Radha Soami Satsang Rajendra Place, Pusa Road, New Delhi. Sanjeev Kumar Sharma is an esteemed member of Registered member Indian Society of Hematology and Blood Transfusion (ISHTM), Registered member of Delhi Medical Association (DMA)Registered member Indian Society of Hematology and Blood Transfusion (ISHTM), Registered member of Delhi Medical Association (DMA) and Member of Indian Society for Atherosclerosis Research (ISAR).
He pursued his MBBS in the year 1999 from University Of Delhi, Delhi. He completed his MD in the year 2006 from University Of Delhi, Delhi. He has also done his DM in the year 2012 from All India Institute Of Medical Sciences, New Delhi.
.Dr Sanjeev has been awarded with Best Citizen of India Award.
Dr. Revathi Raj is a Hematologist and Pediatrician in Apollo Hospital, Teynampet, Chennai and has an experience of 24 years in these fields. Dr. Revathi Raj practices at Apollo Speciality Cancer Hospital in Teynampet, Chennai and Apollo Children’s Hospitals in Thousand Lights, Chennai. She completed MBBS from Madras University, Chenai, India in 1991,Diploma in Child Health (DCH) from The Tamil Nadu Dr. M.G.R. Medical University (TNMGRMU) in 1993 and FRC.PATH.(U.K.) from The Royal College of Pathologist in 2008. She is a member of Indian Medical Association (IMA). Some of the services provided by the doctor are: Eosinophilia Treatment,Neck Pain Treatment,Chelation Therapy,Biochemistry and Blood Transfusion etc. Dr Revathi is credited with one of the largest series in bone marrow transplants in the country. She has successfully treated hemophilia & sickle cell disease. She has specialist interest in blood disorders in children.
Dr. Sharat Damodar – Narayana Bone Marrow Transplant Centre, Bangalore Dr. Sharat Damodar completed his MBBS from St. Johns Medical College, Bangalore and later completed his MD from DNB college. He is currently serving as Vice President of Mazumdar Shaw Medical Centre, Narayana Health City. He is a celebrated Oncologist who has performed more than 1000 Bone Marrow & Stem Cell Transplants and also won Chairman’s Award for Best Doctor in 2015. Dr. Sharat field of expertise is bone marrow & stem cell transplant, cord blood transplantation & lymphoma. Key procedures performed by Dr. Sharat Damodar are Bone marrow & stem cell transplant, cord blood transplantation, leukemia / lymphoma. Dr. Sharat has performed more than 1000 successful bone marrow stem cell transplants in his career til date.
Dr. Ramaswamy N V at Aster Medcity, Kochi is a Hematologist with more than 18 years of experience, Dr. Ramaswamy is an expert in management of malignant and non-malignant diseases of the blood, in patients of all ages. His areas of special interest are hemato oncology and stem cell transplant. Dr. Ramaswamy is expert in bone marrow stem cell transplant, prostate cancer, lung cancer, stomach cancer, colon cancer, & blood related disorders. He is specially interested in immunosuppressive drugs, targeted therapy, hodgkins lymphoma, myeloma, lymphoma, strocytoma, osteosarcoma, stereotactic radiosurgery, blood cancer, leukemia, sickle-cell anemia, germ cell tumour (GCT), thalassemia, non hodgkin lymphoma, and all forms, type and stages of cancer.
Dr. Pawan Kumar Singh – Artemis, Gurugram, Delhi (NCR) is having experience of performing more than 300 bone marrow transplants (including Autologous/Allogenic/Haplo/MUD) for both malignant and non-malignant blood disorders including thalassemia and aplastic anaemia. Done successful Haplo BMT for SCID in an 8 months old child. Successfully done MFD BMT for HLH in a 2 yr old child.
Individually set up BMT unit at Jaypee Hospital and made SOPs for each and every important steps for successfully running the BMT unit. Made BMT UNIT at Jaypee hospital the transplant centre for MUD transplant and got PBSC product from national (Datri) and international registry (DKMS).
Performed 50 BMTs in last 18 months at Jaypee hospital (MSD/MFD-20; Haplo-6; Auto-2 and MUD-4).
Dr Joydeep Chakrabartty – Kolkata completed his MBBS from a renowned university in Calcutta and then went to the United Kingdom for his post graduate studies. He went on to obtain the MRCP (UK) and FRC PATH (UK), and FRCP (Glasgow) credentials during the course of his career. The latter being awarded for his role in leading and establishing services in Medicine. He has a special interest in the areas of Bone Marrow Transplantation (BMT), especially mis-matched high end transplants for all conditions especially Acute Leukemias. He has worked in reputed institutes in the UK including St Bartholomews Hospital and in the prestigious Bone Marrow Transplant Fellowship at The Imperial College, Hammersmith Hospital, London.
Dr. Joydeep Chakrabartty has worked for many years in Medicine and in reputed Critical care units before taking up Hematology. He has encountered and managed not only all hematological emergencies and conditions but his previous general medicine and ICU exposure gives him the edge in managing very sick patients i.e. patients undergoing Bone Marrow Transplant, Acute Leukemia’s etc. He is also very competent in the laboratory diagnostic part of hematological diseases. Upon his return, Dr. Chakrabartty helped in the formation and successful running of many Bone Marrow Transplant departments across the country. Dr. Joydeep Chakrabartty has written many articles for leading journals and has also written chapters in text books.
Dr Radheshyam Naik at Bangalore is the pioneer in the field of Medical Oncology with more than 25 years of strong academic experience in his field. He received advanced training from the world’s leading institutions including M.D. Anderson Cancer Institute, USA, International School for Cancer Care, Oxford, UK, University of New South Wales, Australia, to name a few.
Regarded as an eminent oncologist and having experience of visiting renowned cancer hospitals around the world, Dr. Radheshyam has had an excellent academic career in managing all types of cancer and haematological disorders, with several peer-reviewed publications in leading journals. He is pioneer in conducting various Drug trials conducted over 50 chemotherapy drugs in nationally and internationally trials.
He has special interest in Bone Marrow Transplant programme and also undergone advanced trainings at Hadassah University, Israel; Detroit medical center, The New York hospital USA , Cornell Medical center and at Harper Hospital, Michigan, USA.
Dr. Radheshyam has been a major contributor in developing the field of Haematology and Bone Marrow Transplantation in Karnataka. He performed the first intra-arterial chemotherapy through port in Karnataka and also is credited for performing the first Bone Marrow Transplant in Karnataka.
Dr. Shrinath Kshirsagar is hematologist/ hemato-oncologist and bone marrow transplant physician based in Mumbai. He has over 8 years of experience in this field. He has completed his super-specialty training from prestigious Tata Medical Center. He was a part of team which did more than 200 bone marrow transplants over two years. He has many national and international publications. He was principle investigator in one of the clinical trial in the field of leukemia.Key procedures performed by Dr. Srinath are Bone marrow & stem cell transplant, cord blood transplantation, leukemia / lymphoma. Significant advances have been made in understanding the biology of Leukemia over the last few decades. This has translated to recognition of novel targets for therapy, novel therapeutic options and targeted therapy which have in turn significantly improved the clinical outcomes of patients with Leukemia. Dr. Shrinath Shirsagar is the well Experienced doctor for such advanced Leukemia and Lymphoma treatment in Mumbai. With the 8 years of experience He is specially interested in immunosuppressive drugs, targeted therapy, hodgkins lymphoma, myeloma, lymphoma, strocytoma, osteosarcoma, stereotactic radiosurgery, blood cancer, leukemia, sickle-cell anemia, germ cell tumour (GCT), thalassemia, non hodgkin lymphoma, and all forms, type and stages of cancer.
