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Bone Marrow Transplant In HCG Cancer Centre Mumbai

The haematology and bone marrow transplantation department at HCG comprises experienced and skilled haematologists and BMT experts who specialise in the diagnosis, treatment and management of a broad spectrum of benign and malignant disorders of blood and bone marrow.

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    Benign Haematological Disorders:

    1. Red Blood Cell (RBC) Disorders: The key function of red blood cells is to carry oxygen and the disorders that affect these cells are termed red blood cell disorders. Sickle cell anaemia, aplastic anaemia and thalassaemia are common red blood cell disorders.

    2. White Blood Cell (WBC) Disorders: The key function of WBC is to regulate the body’s immune system. WBC disorders are caused by abnormal white blood cells, also known as leukocytes. WBC disorders are characterised by either very high or very low WBC numbers. Neutropenia and MDS are two major white blood cell diseases.

    3. Platelet Disorders: The primary function of platelets is to support wound healing. Platelet disorders are characterised by either very high or very low numbers of platelets. ITP and dengue are two important platelet disorders.

    4. Bleeding Disorders: Bleeding disorders are caused due to multiple factors. When an injury occurs, the blood does not clot, and this can lead to a multitude of health complications. Haemophilia is one of the bleeding disorders.

    5. Clotting Disorders: Clotting disorders happen when blood clots unexpectedly in the veins and arteries. This affects the blood flow and functioning of the organs. Deep vein thrombosis happens when the clot occurs in the legs, and pulmonary embolism happens when the clot happens in the lungs.

    Malignant Haematological Disorders/Blood Cancers:

    1. Leukaemia: Leukaemia happens when bone marrow starts making abnormal white blood cells in excess quantities. These abnormal cells later enter into the bloodstream. Important leukaemia types include acute myeloid leukaemia (AML), acute lymphocytic leukaemia (ALL), chronic myeloid leukaemia (CML) and chronic lymphocytic leukaemia (CLL).

    2. Lymphoma: Lymphoma starts in infection-fighting cells and is largely seen arising in the lymph nodes, spleen, thymus, bone marrow. More than 60+ types of lymphoma are identified; nevertheless, it is broadly classified into two types – Hodgkin’s Lymphoma & Non-Hodgkin’s Lymphoma.

    3. Myeloma: Myeloma is a type of blood malignancy that arises from plasma cells. This cancer largely affects and damages the bones, immune system, kidneys and red blood cells. Multiple Myeloma is the most common type of myeloma.

    Early detection and timely treatment play a significant role in the successful management of blood malignancies. It’s critical to diagnose and classify the disease correctly with the help of high-end specific tests.

    Chemotherapy, radiation therapy and bone marrow transplantation are the common treatment methods used to treat blood cancers.

    However, bone marrow transplantation is largely preferred as a curative option when the patient is at a high risk of relapse.

    Bone Marrow Transplant

    Stem cell transplant or bone marrow transplant is a medical procedure that replaces the destroyed or damaged bone marrow cells or stem cells with healthy bone marrow cells.

    It involves the extraction of healthy stem cells, filtration and transferring them back to the donor itself (Auto Transplant) or to another individual, who is called the recipient/ donor (Allogeneic Transplant)

    Why is Stem Cell Transplant required?

    The goal of stem cell/ bone marrow transplant is to treat many diseases and a few types of cancer successfully. For some diseases, a stem cell/bone marrow transplant serves as the only potential cure.

    A stem cell/bone marrow transplant becomes necessary when:

    • The existing bone marrow cells are damaged, destroyed or not functioning optimally due to health conditions such as aplastic anaemia, leukaemia, etc. A bone marrow transplantation in this case helps patients have a healthy, functioning marrow.
    • The immune system needs to be regenerated to fight the existing or residual cancers that could not be treated completely with radiation or chemotherapy.
    • The patient suffers from a health condition that affects the production of bone marrow cells or other serious immune system illnesses.
    • The normal functioning of the immune system is to be restored after high doses of chemotherapy and radiation that are given to treat malignant health conditions. This transplant, which is known as rescue, replaces the damaged bone marrow with the healthy bone marrow. This is commonly performed in diseases like lymphoma and neuroblastoma.

    Types

    Bone marrow transplant is categorised depending on the source of the healthy stem cells. In other words, the classification is made based on who the donor is. There are three types of bone marrow transplant:

    1. Autologous Bone Marrow Transplant: As the name says, during an autologous bone marrow transplant, the patient is itself the donor. The stem cells are carefully extracted before the patient receives high-dose radiation or chemotherapy and are stored in the freezer. After the chemotherapy or radiotherapy, the stem cells are put back into the patient’s body, where they start producing normal blood cells.

    2. Allogeneic Bone Marrow Transplant: The term “allo” means different. During an allogeneic bone marrow transplant, the stem cells are extracted from another individual, known as the donor, based on his/her HLA type (genetic match). The HLA type of the donor’s stem cells should match with the HLA type of the recipient’s. Allogeneic bone marrow transplant is further classified into two subtypes:

    • a. Related Donor Bone Marrow Transplant: In this type of transplant, the donor is picked among siblings, parents or children and transplant is initiated after confirming the HLA type matches. When the donor’s genetic make-up matches the recipient’s genetic make-up at least by 50%, it is called a haploidentical / half-matched transplant.
    • b. Unrelated Donor Bone Marrow Transplant: Unrelated donor or matched unrelated donor (MUD) is someone who is unrelated to the patient but has an HLA type that matches with that of the patient’s. Unrelated donors are found through bone marrow registries.

    3. Umbilical Cord Blood Transplant: During an umbilical cord blood transplant, the stem cells are collected from the umbilical cord at the time of the childbirth. These stem cells are tested, typed and stored until they are used for transplantation.

    Diseases That Can be Treated with BMT

    Malignant Diseases:

    • Multiple Myeloma
    • Relapsed Hodgkin’s Lymphoma
    • Relapsed Non-Hodgkin’s Lymphoma (NHL)
    • Neuroblastoma
    • Relapsed Ewing’s Sarcoma
    • Metastatic Ewing’s Sarcoma
    • Medulloblastoma and other Brain Tumours
    • Metastatic Germ Cell Tumours
    • Myelodysplastic Syndromes (MDS)
    • Acute Myeloid Lymphoma (AML)
    • Acute Lymphocytic Leukaemia (ALL)
    • Chronic Myelogenous Leukaemia (CML)
    • Refractory Lymphoma
    • Myeloproliferative Neoplasms (MPN)

    Non-Malignant Diseases:

    • Severe Autoimmune Diseases
    • Multiple Sclerosis
    • Aplastic Anaemia
    • Thalassaemia
    • Severe Immunodeficiency Disorders
    • Inherited Metabolic Disorders

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