Bone Marrow Transplantation – Dr. Ganesh Jaishetwar

Bone marrow transplant, also called as Stem cell transplant is an advanced treatment which is curable for not only blood cancers but all types of non-cancerous serious blood diseases.

For example, Bone marrow failure, where the blood production from the bone marrow is completely stopped. Also, many genetic diseases, immunodeficiency disorders commonly seen in children, hemoglobin disorders like Thalassemia, sickle cell anemia where the hemoglobin produced is defective and these patients will require life long blood transfusion and with timely bone marrow transplant we can completely cure these blood diseases as well as many blood cancers.

1. What is Bone Marrow Transplant?

Bone marrow transplant is a special treatment where a person’s bone marrow is completely replaced. A person who has various blood diseases or blood cancers, the defective blood system is first completely destroyed with either high dose chemotherapy or chemotherapy plus and radiotherapy. And after destroying the bone marrow which is giving rise to defective blood systems, the healthy stem cells either from a healthy gene matched donor or from the same persons stem cells which are collected priorly, those stem cells are used to form a new blood system which is free from the blood diseases or blood cancer. This entire process is called bone marrow transplant. 

2. What are the conditions where bone marrow transplant offers the best possible cure?

Bone marrow transplant is one of the most advanced treatments with a success rate of more than 70-80% in most of the blood cancers and almost 90% in most of the non-cancerous blood diseases.

3. What are the types of bone marrow transplants?

There are 2 types of bone marrow transplants:

      1. Autologous bone marrow transplant: In this type of transplant, the patient’s own stem cells are used mostly for blood cancers like lymphoma and myeloma. 

      2. Allogeneic bone marrow transplant: HLA (Human Leukocyte Antigen), specific gene match donor is required which can be your family member, international donor or in some cases if there’s no fully matched gene donor we can even do successful bone marrow transplant with half match family member either in the form of patients brothers, sisters, children or the patient’s parents. Half match donors also carry equal success rates in most of the blood related diseases where the transplant is required. 

4. Diseases cured with bone marrow transplant and its success rate.

Bone marrow transplant is the only curative treatment for a vast number of blood diseases. For example, many blood cancers are treated with chemotherapy but chances of cure are very less. Whereas with bone marrow transplant the chances of cure for most of the blood cancers is almost 70-80% and in some blood cancers, the cure rate may also go beyond 90%.

Apart from blood cancer, there are a lot of other blood diseases like bone marrow failure, aplastic anaemia, various genetic diseases in children, various immunodeficiency disorders, various blood disorders like thalassemia and sickle cell anaemia, various uncontrollable disorders like Crohn’s disease, multiple sclerosis.

These kinds of disorders or blood diseases can be completely cured with a bone marrow transplant and the success rate in these kinds of non-cancerous diseases is 80-90%.

5. What are the risks to the donors?

It is very important to understand that the donors who donate the stem cells will not have any kind of risk to their health or their life. Stem cell donation is just like any other blood donation 

For example: platelet donation, the only difference between platelet donation and stem cell donation is the platelets are normally present in the blood so the donor can just give the platelets and then go back to work. Whereas for the stem cells, the majority of stem cells stay in the bone marrow, so to make the stem cells come out of the bone marrow into the blood we need to give donors some injections, which are given subcutaneously just like insulin injections. And with that, the stem cells come into the blood. The stem cells from the blood are collected just like we collect platelets from the donor and in this way the donor won’t have any kind of health risk or life risk when they donate stem cells for bone marrow transplant.

6. Is blood group matching required for bone marrow transplant?

If the blood group is matching with the donor, it is good. But if the blood group is not matching with the donor, bone marrow transplant can still be done with the same success rate. The most important for bone marrow transplant is not blood group matching, it is the gene matching between the patient and the donor which is called the HLA gene (Human Leukocyte Antigen). So even if the donor is not fully HLA gene matched with the patient we can still do the bone marrow transplant if the donor is at least half gene matched with the patient. 

7. What is half match bone marrow transplant?

Half HLA gene match BMT is a special type of advanced bone marrow transplant in which, if the patient doesn’t have full HLA gene match donor in their family and where the transplant is absolutely required and is the only treatment that can cure the patients disease, in that case the half HLA gene match family members, who can be patients brothers, sisters, children or parents can donate the stem cells. And with this half HLA gene match stem cells their bone marrow transplant can be completely successful with a success rate as good as full HLA gene match bone marrow transplant.

8. Can BMT be done during the pandemic?

Bone marrow transplant can be absolutely done during the pandemic. Although, we need to understand one important fact that yes with the covid pandemic there’s a risk to the patient when they are admitted in the hospital for bone marrow transplant as they might get covid infection during their stay. But most of the hospitals are following utmost safety precautions to ensure patients safety. Many blood diseases, blood cancers if not treated in time, carry more risk to the life of the patient. In these circumstances, bone marrow transplant is urgent. If you delay the bone marrow transplant due to the ongoing covid pandemic, the risk to the patient’s life increases as their underlying blood diseases or blood cancers infections are much higher than the possible chance of covid infection. So yes covid pandemic is definitely a concern but when required bone marrow transplant can be safely done with all precautions and safety measures, it is recommended to get it done at the earliest.

9. What are post BMT precautions for patients?

For a bone marrow transplant, the patient gets admitted in the hospital for a period ranging between 2-4 weeks and once the blood system develops in the patient, that is the time we call the first step of bone marrow transplant being successful. At this point of time the patient will be discharged but we need to understand a very important fact that after bone marrow transplant the normal bone marrow transplant takes about 6-12 months to completely recover to normal. So even after the bone marrow transplant the patients need to be extremely careful. Follow up with the blood specialist regularly till their immune system completely recovers back to normal. Apart from this there might be a few complications which can happen post bone marrow transplant for which the patient has to be in a close follow up with their bone marrow transplant specialist for at least 6 months to 1 year post bone marrow transplant. 

10. Are advanced BMT treatments available in Hyderabad?

Yes, all new advanced treatments in the field of blood cancers, haematology or bone marrow transplants are available at Yashoda Hospitals, Somajiguda -Hyderabad and till date, we have successfully done more than 150 bone marrow transplants over the last 5 years and our success rate is 82%.

Whatever blood diseases, blood cancers you or your loved ones might be diagnosed with, we have got all the newest advanced technologies available with a success rate as high as 80-90%. 

In case of any concerns please do revert to us. We are always here at the Yashoda group of hospitals to help you get better.