October 5, 2022
What is Bone marrow?
Bone marrow is a soft and spongy material found in the centre of long and large flat bones in the human body. It is composed of red bone marrow and yellow bone marrow which is packed with vital cell called “stem cells” which produces haemoglobin, white blood cells and platelets continuously throughout the life span
What are Stem cells?
Hemopoietic stem cell is a parent cell from which all type of blood cells like red blood cells, white blood cells and platelets are formed. Stem cells have infinite potential to proliferate and form functional blood system. Bone marrow will protect and nourish these stem cells.
What is Bone marrow transplantation?
Bone marrow transplantation (BMT) is a modality of treatment where the defective bone marrow is replaced with healthy stem cells. BMT is a medical procedure performed by a team of doctors and nurses in a specialised unit called “Bone marrow transplantation unit (BMTU)”. It is not a surgical procedure.
Is bone marrow transplant same as stem cell transplant?
The two terminologies are synonymous and are used interchangeably. “Hematopoietic stem cell transplant” is the most accepted terminology.
Indications to do bone marrow transplantation
In certain conditions, BMT is the only curative treatment available. The diseases include:
• Aplastic anemia (Bone marrow failure)
• Primary Immune deficiency (Disorder of Immune system)
• Genetic diseases such as thalassemia and sickle cell disease (Disorders where Hemoglobin synthesis is affected)
• Relapsed/refractory leukemia (blood cancer) and lymphoma (Cancer of Lymphatic system)
• High risk solid tumors like Neuroblastoma (cancer of Adrenal gland)
Types of bone marrow transplant:
Depending on type of donor and extent of match there are many types of stem cell transplant:
• Autologous stem cell transplant-
The child is his or her own donor in autologous stem cell transplant. This is the preferred type in treatment in relapsed lymphoma and few refractory solid tumors.
• Allogenic stem cell transplant-
The stem cells for an allogenic transplant come from another healthy person called donor. This is the preferred type in bone marrow failure diseases, disorders of immune system and blood cancers.
• Umbilical cord blood transplant-
Stem cells are taken from the umbilical cord soon after birth and preserved.
How are stem cells are collected from the donor?
A) Peripheral blood stem cell collection: The stem cells can be collected from blood similar to a simple blood donation called “Apheresis”.
B) Bone marrow harvest: This procedure is done under anesthesia, where stem cells are collected directly from bone marrow.
Success of BMT:
The success of BMT depends on the medical condition being treated, type of transplantation, the experience of treating team and facilities at hospital. In conditions like aplastic anemia and thalassemia, the success is as high as 80-95% cases. In high risk cancers, the success rate is often 60-65%.
Is Bone marrow transplant in done in Kasturba Hospital, Manipal?
Yes. The bone marrow transplantation program offers regular services in Kasturba Hospital. The autologous transplantation is being performed from 2014 and allogenic transplantation from 2020. The medical team is proficient in performing all types of stem cell transplantation including half-matched allogenic stem cell transplantation. The unrelated donor registries like DATRI (national) and DKMS-BMST (international) registries are affiliated.
April 14, 2022: Voluntary stem cell donation (HLA) drive at Kasturba Hospital, Manipal organized by DKMS-BMST
Highlights of the BMT services at Kasturba Hospital:
• Equipped with state of art 4-bedded pediatric BMT unit
• Blood bank and Immunohematology unit with stem cell collection facility and 24X7 blood product availability
• Laboratory facility which can carry out specialized tests like monitoring of drug levels
• 24 X 7 Pharmacy services (essential medicines)
• Specialized nursing team
• Social worker, dietician, physiotherapist
• Allied specialties: Radiotherapy, surgical oncology, medical genetics, palliative, and supportive care services, fertility preservation and reproductive medicine, endocrinology, cardiology, and gastroenterology services.
Pediatric BMT unit, KH, Manipal: 4-bedded HEPA filtered rooms
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