Blood Marrow and Stem Cell Transplant
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Best Bone Marrow Transplant Hospital in Delhi NCR India

Dharamshila BMT Centre is India’s First and Only World Class Facility for Blood and Marrow stem Cell Transplantation for patients without fully matched family donor. The BMT Centre offers holistic care for a broad range of malignant and non-malignant haematological diseases of children and adults.

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An Appreciation Letter Received from a Father

An Appreciation Letter Received from a Father | Blood Marrow and Stem Cell Transplant | Scoop.it
Our daughter Ms. Neelakshi Baruah, 23 years was diagnosed as second relapse of Acute Myeloid Leukemia (AML) at the Dharamshila Hospital and Research Centre
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She remained in remission until April 2014, when she experienced the first relapse. This  was treated at Guwahati with chemotherapy and was referred to Army Hospital (R&R),  New Delhi for allogeneic BMT. In the R&R Hospital, a match related or unmatched donor  could not be procured for Neelakshi and she advised to continue further 1-2 cycles of  chemotherapy back at Guwahati. Unfortunately, in November 2014, Neelakshi was found to have developed morphological second relapse. Again when we contacted R&R Hospital, due to her critical stage because of second relapse the earlier treating doctor advised me to go for urgent treatment at any empanelled Hospital. All the earlier treating doctors told me that there was no hope for survival after second relapse.

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Developing a Haploidentical BMT Program: Tribute to a Master

Out of an estimated 20,000 patients requiring an Allogeneic Bone Marrow Transplantation (BMT) in India, only 500 odd patients receive one. Keeping in mind the resource constraints, the major reason for such disparity lies in the lack of alternate donors. 

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Out of an estimated 20,000 patients requiring an Allogeneic Bone Marrow Transplantation (BMT) in India, only 500 odd patients receive one. Keeping in mind the resource constraints, the major reason for such disparity lies in the lack of alternate donors. Whilst unrelated donor marrow and cord blood from Volunteer Donor Registries and Public Cord Blood Bank meet the need for the ethnic majorities in Europe and the USA, such registries provide for less than 10% of BMTpatients due to both cost and an available match. In our initial screening of 50 patients referred for an Allogeneic BMT, a matched family donor was available in 11 patients and a suitable Haploidentical family donor was available for 49, whereas a fully matched unrelated donor from registries was available for none.

 

With this background, we initiated a HAPLOIDENTICAL FAMILY DONOR BMT PROGRAM IN 2011, planned and conceived by Dr Suparno Chakrabarti. I had joined him in 2012 and since then we have tried to shape the future of HAPLOIDENTICAL BMT in our country.We are pleased to announce that we have completed 50 Haploidentical BMT in 40 patients over the last 3 years.

 

HAPLOIDENTICAL OR HALF MATCHED BMT cannot be performed from unrelated donors and is only possible from close family members. The natural law of tolerance between mother and child is primarily utilised in such transplants. We initiated this program initially for patients with advanced and refractory Acute Leukemia as the procedure was experimental and conceived as high-risk. To our surprise, the initial 5 patients had no major complications and the transplants were successful. However, as the diseases were advanced, 4/5 patients had a recurrence of leukemia after 4-8 months. We did a second BMT from the same donor in all of them and it cured the disease in two of them. Now, that we were convinced about the safety of the procedure, we were encouraged to do BMT from Haploidentical Donors for patients with Aplastic Anemia and Thalasemia as well. After several years of research we think we have perfected the way to do Haploidentical BMT in Aplastic Anemia as well.

 

In addition, we innovated a new technique of improving the outcome of HAPLODENTICAL BMT in blood cancers. We have performed 6 such consecutive transplants with the new method. Two of these patients were young and hopeless with a type of lymph node cancer which responds to no chemotherapy and radiotherapy. Today, 8 months after BMT, they are well and alive without any medications, back to normal life. A 65 year old gentleman with an end-stage blood cancer called myelofibrosis also underwent this sort of HAPLOIDENTICAL BMT and 4 months later he has a normally functioning bone marrow and is off all medicines as well. The other 3 patients are doing equally well; one, back to work overseas and the others likewise.

 

Haploidentical BMT is not about selecting any half matched donor in the family. It is about selecting the right donor for a particular disease, based on our years of extensive research. It is about having the right expertise, infrastructure and about having a dedicated team. Today, we choose HAPLOIDENTICAL donor with suitable criteria over a Matched Family Donor, if the blood cancer is advanced.

 

Our work has been recognised in International forums. As a tribute to the tireless efforts of Dr Suparno Chakrabarti, who pioneered this program, I shall be presenting this experience at the oral session of largest BMT conference in the world hosted at San Diego on February 2015. 

 

For more information you can visit  : http://www.bmthospitalindia.com

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When Bone Marrow Fails Your Near Ones Must Come to your Rescue: Story of Haploidentical Bone Marrow Transplantation

When kidney fails we look for a new kidney. In the meantime, the patient can be kept well and alive with dialysis. The donor is often a family member with same blood group. However, when bone marrow fails, the world crumbles in front of us. This 

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When kidney fails we look for a new kidney. In the meantime, the patient can be kept well and alive with dialysis. The donor is often a family member with same blood group. However, when bone marrow fails, the world crumbles in front of us. This condition is called APLASTIC ANEMIA. Bone marrow produces millions of cells every minute to keep us alive. There are no artificial means to substitute these cells. Only donated blood and platelets are available to salvage these patients. And yet there is no substitute for white blood cells which are our main and only defense against infections. To replace an empty bone marrow with normal healthy cells from a donor would seem to be a logical treatment for this condition. This process is called a BONE MARROW TRANSPLANTATION (BMT).Cells of each individual carries its own signature in the form of HLA antigens and BMT is not possible without a complete HLA antigen match. There is only one in four chance of finding a match within a family and one in a million chance of finding a match amongst the normal population. The Europeans have circumvented this problem by creating registries of over 10 million volunteer donors which provides 90% chance of finding HLA MATCHED VOLUNTEER DONORS for such patients. Indians rarely find a complete match from such foreign registries. Most of the patients suffering from Aplastic Anemia die from infection or bleeding due to lack of HLA MATCHED DONORS.More importantly the cost of procuring the blood or marrow products alone, from Europe or USA ranges from 10,000-30,000 USD. Similar transplants can be performed from UNRELATED CORD BLOOD UNITS at a similar cost, but the procedure is more challenging.

 

The saying that ‘nature is the mother of all inventions’ is not without reason. HLA antigens are inherited as a set from each of the parents. A mother nurtures a baby in her womb for 9 months without rejecting it even though HLA antigens inherited by the baby from the father  should cause a rejection. This is nature’s example of development of tolerance and thus, a child and the mother are natural donors for each other in most cases even though they are only half matched in their HLA antigens. Based on the pioneering work by doctors from Italy, BMT from a half matched (HAPLOIDENTICAL) donor from the family was developed. Yet, it was challenging and often not reproducible. The researchers from Johns Hopkins and FHCRC, Seattle innovated yet another way of carrying out Haploidentical BMT which was more reproducible.

 

Unfortunately, Aplastic Anemia is a disease more common in developing countries in Asia and Haploidentical BMT has not been widely carried out for this disorder in the Western countries. Even when attempted in Aplastic Anemia, Haploidentical BMT has been a failure more often than not. We have developed a successful method of carryingout Haploidentical BMT in Aplastic Anemia. We have carried out over 10 such transplants in patients with Aplastic Anemia. Our research in this field has been acclaimed internationally and been followed elsewhere. The cost for such transplants is not more expensive than Matched Family Donor BMT.

 

Due to lack of awareness, thousands of patients with Aplastic Anemia die across the country. Most are children and young adults. Haploidentical BMT as we have shown can make a difference to these unfortunate children. Its time the patients and the treating doctors, both are aware of this possibility and help in our endeavour.

 

For more information you can visit : http://www.bmthospitalindia.com

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Center for Bone Marrow Transplant

Center for Bone Marrow Transplant | Blood Marrow and Stem Cell Transplant | Scoop.it
Dharamshila BMT Centre is India’s First and Only World Class Facility for Blood and Marrow stem...
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There are six private and two state-owned BMT centres in Delhi and NCR and one might query intuitively, as to ‘why another one?’. To answer this we need to look at the Indian scenario in the field of BMT. It is estimated that over 30,000 patients per year in our country need a BMT to save their lives and the statistics from Indian Stem Cell Transplant Registry reveal that with over 40 centres across the country, only about 1000 transplants are performed annually.

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THE ROAD TO RECOVERY - STORY OF MS. PAYAL MAJUMDAR

THE ROAD TO RECOVERY - STORY OF MS. PAYAL MAJUMDAR | Blood Marrow and Stem Cell Transplant | Scoop.it
DHARAMSHILA CANCER HOSPITAL - BEST DESTINATION FOR BLOOD CANCER PATIENTS
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JOURNEY OF RECOVERY – STORY OF MS. PAYAL MAJUMDAR

20 YEARS FEMALE FROM KOLKATA


It was in the end of November 2012 when I suddenly had swelling in my neck. At that time I was a fresher in my collage, and was in my collage hostel at that time. I thought this swelling may be because of cold, since in the month of November it’s cold. I informed my parents about this sudden swelling. Next day parents came to pick me up from the hostel. After coming home I went to Kolkata Apollo Hospital for check-up. I had a chest X-ray, and when the reports came my doctor said I’m having SVC syndrome, and I should get hospitalized immediately. I arranged to have different blood tests, biopsy and FNAC. The reports from the analysis of these tests came back with the diagnosis of Stage IVB Primary mediastinal DLBCL.

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Inability to Give Correct Cost Of Treatment/ Package Cost For Bone Marrow Transplantation

Inability to Give Correct Cost Of Treatment/ Package Cost For Bone Marrow Transplantation | Blood Marrow and Stem Cell Transplant | Scoop.it
Inability to Give Correct Cost Of Treatment/ Package Cost For Bone Marrow Transplantation
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Most patients of Haematological disorders, who have been advised Bone Marrow Transplantation, (BMT) fail to understand why correct package cost for Bone Marrow Transplantation cannot be given on telephone /web inquiry or otherwise, before examining the patient and having a final diagnosis after detailed investigations.

 

One must understand some basic facts about Bone Marrow Transplantation, its process and the variable factors which will increase or decrease the cost of BMT for every patient.

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Are We Failing Our Children With Thalassemia?

Are We Failing Our Children With Thalassemia? | Blood Marrow and Stem Cell Transplant | Scoop.it

Thalassemia is the commonest genetic disorder in India and over 10,000 children are born per year with the major form of the disease. The disease in the severe form is called Thalassemia Major. It happens when the genes for thalassemia are inherited from both the parents

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Thalassemia is the commonest genetic disorder in India and over 10,000 children are born per year with the major form of the disease. The disease in the severe form is called Thalassemia Major. It happens when the genes for thalassemia are inherited from both the parents. Usually the child becomes listless and irritable a few months after birth. By 6-9 months, most children require blood transfusion for survival. Blood transfusion needs to be regular as in every 4-6 weeks as needed to keep the hemoglobin levels above 12 gm% and not letting it drop below 9 gm%. Such a transfusion schedule if started in time and carried out rigorously, results in normal growth and development of the child. However, this comes at a cost. Blood contains a lot of iron and our body cannot naturally get rid of the iron if in excess. In a normal individual, iron comes from the food and the body can increase or decrease the iron absorption from the gut depending on its requirement. If the same iron is injected in our body as it happens with blood transfusion, the iron cannot be excreted and it builds up. Like everything in excess is bad, so is iron. Excess iron gets deposited in the heart and the liver amongst other places and results in dysfunction and ultimately failure of these organs and death.

 

Getting rid of the excess iron from the body by medicines is called CHELATION. The first such drug was Desferrioxamine. This could only be injected through the veins or under the skin. The children with thalassemia needed small pumps to continuously inject the drug under the skin for 8-10 hours usually at night. As these children grow up, they resent these restrictions and often do not adhere to the chelation schedule. Even in western countries the children developed severe iron overload during the adolescence and early adulthood which significantly reduced their lifespan. The average survival for children with thalassemia in developing countries barely exceeded the second decade.

 

The researchers had been toiling for two decades to find an oral drug to rid the body of the excess iron. The first such attempt produced a drug called Deferiprone. It was effective and yet had unexpected life threatening toxicities. As a result, the drug was not approved for use in the western countries and was introduced in India due to resource constraints. The struggle continued until recently, when a new drug called Deferasirox was launched which produced results similar to the injectable form of desferrioxamine with no surprising new side-effects. Can this change the future of the thousands suffering from thalassemia in our country?

 

We have perhaps built the perfect cart but yet struggling to find the horses. We can rid the iron by oral tablets and can live happily ever after, but can we support these children with enough blood and safe blood? Unfortunately, voluntary and dedicated blood donation cannot suffice the need of the millions of children given the poor infrastructure of blood banks in our country. More importantly, over 50% of those children transfused for over several years develop transfusion transmitted infections such as hepatitis B or C and HIV. Properly screened blood on a regular basis with continuous chelation can make these children step into their adulthood like any of us. But the reality does not allow the children with thalassemia lead a perfect life like their peers in Europe.

 

Should we continue to fail our children suffering from Thalassemia Major?

 

For more information you can visit : http://www.bmthospitalindia.com

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Dharamshila Hospital BMT Centre : A New Beginning

Dharamshila Hospital BMT Centre : A New Beginning | Blood Marrow and Stem Cell Transplant | Scoop.it
Why Dharamshila BMT Centre?There are six private and two state-owned BMT centres in Delhi and NCR an..
Bone Marrow and Stem Cell Transplant's insight:
Why Dharamshila BMT Centre? There are six private and two state-owned BMT centres in Delhi and NCR and one might query intuitively, as to ‘why another one?’. To answer this we need to look at the Indian scenario in the field of BMT. It is estimated that over 30,000 patients per year in our country need a BMT to save their lives and the statistics from Indian Stem Cell Transplant Registry reveal that with over 40 centres across the country, only about 1000 transplants are performed annually. So is our venture just to add a few numbers to the mammoth need of our population? If all the centres performed 4 transplants per month, which we are sure they are capable of, the need would be largely met. Then why is that not happening? The answer lies in the fact that BMT is dependent on availability of HLA matched donors from the family. However, this is available to only 20% of the patients by simple law of inheritance. Yet, Europe, USA and Japan meet their needs largely through Volunteer Unrelated Donor Registries which currently boast of 20 million donors. In India, such registries are in their infancy and the chance of finding a match from the foreign registries is less than 10%. More importantly the cost of procuring the blood or marrow products from Europe or USA ranges from 10,000-30,000 USD. Similar transplants can be performed from unrelated cord blood units at a similar cost, but the procedure is more challenging.
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