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Allogeneic Bone marrow transplant cost in India

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Allogeneic bone marrow transplant -- The term allo means other. Stem cells are removed from another person, called a donor. Most times, the donor's genes must at least partly match your genes. Special tests are done to see if a donor is a good match for you. A brother or sister is most likely to be a good match. Sometimes parents, children, and other relatives are good matches. Donors who are not related to you, yet still match, may be found through national or bone marrow registries.

What is Bone Marrow Transplant?

A bone marrow transplant is a step to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fatty tissue inside your bones. The bone marrow produces blood cells. Stem cells are immature cells in the bone marrow that give rise to all of your different blood cells. Before the transplant, chemotherapy, radiation, or both may be given to the patient. This may be done in two ways:

1. 1Ablative (myeloablative) treatment -- High-dose chemotherapy, radiation, or both are given to kill any cancer cells. This also kills all healthy bone marrow that remains, and allows new stem cells to grow in the bone marrow.
2. 2Reduced intensity treatment, also called a mini transplant -- Lower doses of chemotherapy and radiation are given before a transplant. This allows older people, and those with other health problems to have a transplant.

Who needs a bone marrow transplant?

doctors use bone marrow transplants to treat people with a range of malignant and non-malignant diseases, including these:

• ✓Acute leukemia 
• ✓Aplastic Anemia
• ✓Thalasemia
• ✓Sickle Cell Anemia
• ✓Paediatric Cancerous like neuroblastomas
• ✓Peadiatric Immunodeficiencies
• ✓Adrenoleukodystrophy
• ✓Aplastic anemia
• ✓Bone marrow failure syndromes
• ✓Chronic leukemia
• ✓Hemoglobinopathies
• ✓Hodgkin's lymphoma
• ✓Immune deficiencies
• ✓Inborn errors of metabolism
• ✓Multiple myeloma
• ✓Myelodysplastic syndromes
• ✓Neuroblastoma
• ✓Non-Hodgkin's lymphoma
• ✓Plasma cell disorders
• ✓POEMS syndrome
• ✓Primary amyloidosis

Who can Donate Bone Marrow ?

1. 1Anyone from patient family , suitable donor
2. 2One can donate bone marrow through bone marrow registry after the transplant

(The donor can be a family member or someone unrelated to you. Sometimes, people get donated blood-forming cells from umbilical cord blood. Blood and tissue test are done prior to the transplant).

(One cannot donate during the transplant because one has to undergo blood and tissue test to ensure transplant is a success) 

What are the common complications & Risks which can arise with a Bone Marrow Transplant?

Answer :> A bone marrow transplant poses numerous risks. Some people experience minimal problems with a bone marrow transplant, while others can have serious complications that require treatment or hospitalization. Sometimes, complications are life-threatening.

 Possible complications from a bone marrow transplant include:

• ✓Graft-versus-host disease (allogeneic transplant only)
• ✓Stem cell (transplant) failure.
• ✓Organ damage.
• ✓Infections.
• ✓Cataracts.
• ✓Infertility.
• ✓New cancers.
• ✓Death.

What is the Success Rates of Bone Marrow Transplant?

Bone marrow transplant (BMT) has a predictable survival rate of nearly more than 60 percent. Every bone marrow transplant (BMT) case survival varies depending upon the type of transplant chosen like allogeneic or autologous. Even the complete replacement or removal of diseases marrow cells is not enough sometimes although it does efficiently work in most of the cases of transplant. The success and survival rates of any bone marrow transplant (BMT) depends greatly on patient’s condition and requirement. Bone marrow transplant (BMT) does cure some of the diseases and helps in extending life and improves the quality of life as well. But in some rare cases treating one disease leads to remission of another during or after the treatment. But those risks and complications and their chances can be discussed with a specialized doctor before undergoing a bone marrow transplant (BMT). 

How long Patient lives or survive after a bone marrow transplant?

People undergoing a bone marrow transplant (BMT) in India have a good survival rate. India has emerged as a global hub for several affordable but highly effective treatments. So any treatment in India including a bone marrow transplant (BMT) does have a good survival rate like in any other standard developed country but they charge too much unlike Indian economic. Several statistical data has been accumulated to date to support good survival rates offered by Indian BMT done for several diseases and age group patients. A relevant data states that nearly 30% to 40% of above 60 age group patients do survive more than 3 years after BMT done in India. The survival chances increase if younger is the patient age who are being treated and early is the diagnosis stage of the disease. Further, no reoccurrence until 2 years after BMT, even improves the chances of disease-free and longer survival -). 

How long Time It takes in Recovery after Transplant

• ✓the doctor will continue to check the blood each day to determine how well the transplant has worked. They will test whether new cells are beginning to grow in bone marrow.
• ✓If a person’s white blood cell count starts to rise, it indicates that the body is starting to create its own blood, indicating that the transplant has been successful.
• ✓it’s usually about 2 to 6 weeks.

What are the common complications that people who receive bone marrow transplants experience?

• ✓infections
• ✓nausea, vomiting, or both
• ✓diarrhea
• ✓mucositis, which involves inflammation and soreness in the throat, mouth, and stomach
• ✓graft failure, in which the transplanted cells do not produce new blood cells
• ✓anemia
• ✓early onset menopause
• ✓infertility
• ✓cataracts
• ✓organ damage
• ✓graft-versus-host disease, in which the donor cells attack the person’s body
• ✓bleeding in the brain, lungs, or other organs

Some people die as a result of complications from bone marrow transplants.

A person who receives a bone marrow transplant may also experience reactions that can follow any medical procedure, including:

• ✓shortness of breath
• ✓a drop in blood pressure
• ✓headaches
• ✓pain
• ✓a fever
• ✓chills

Workup or Pre Invesgitagation Bone Marrow Transplant

• ✓HLA antigens
• ✓Blood tests, including testing for exposure to hepatitis and HIV (the AIDS virus)
• ✓Bone marrow biopsy
• ✓Chest x-ray
• ✓Dental x-ray
• ✓Electrocardiogram (ECG)
• ✓A heart function study (RVG)
• ✓Lung function tests (PFTs)

Types of Bone Marrow Transplant?

Answer :> There are three kinds of bone marrow transplants:

1. 1Autologous bone marrow transplant -- The term auto means self. Stem cells are removed from you before you receive high-dose chemotherapy or radiation treatment. The stem cells are stored in a freezer. After high-dose chemotherapy or radiation treatments, your stems cells are put back in your body to make normal blood cells. This is called a rescue transplant.
2. 2Allogeneic bone marrow transplant -- The term allo means other. Stem cells are removed from another person, called a donor. Most times, the donor's genes must at least partly match your genes. Special tests are done to see if a donor is a good match for you. A brother or sister is most likely to be a good match. Sometimes parents, children, and other relatives are good matches. Donors who are not related to you, yet still match, may be found through national or bone marrow registries.
3. 3Umbilical cord blood transplant -- This is a type of allogeneic transplant. Stem cells are removed from a newborn baby's umbilical cord right after birth. The stem cells are frozen and stored until they are needed for a transplant. Umbilical cord blood cells are very immature so there is less of a need for perfect matching. Due to the smaller number of stem cells, blood counts take much longer to recover.

What is the life expectancy after a bone marrow transplant?

Answer :> Patient who have undergone bone marrow transplant may live an additional 15 years after the treatment however live expectancy differs in many cases due to type of disease the patient has prior to the treatment. Consult a doctor for more accurate result based on the disease the patient has that led to bone marrow transplant.

What are the Preparation before the transplant?

Answer :> You will need to undergo several health tests and exams at the transplant centre before the transplant team can decide whether the surgery will be safe for you. These tests include:

• ✓Blood and tissue type tests
• ✓Test for HIV and hepatitis.

What are the tests during the transplant?

Answer :> During the transplant the most important test to undergo is blood and tissue test because the donor has to be a match for the patient which significantly increases the survival rate in patients.

Who needs a bone marrow transplant?

Answer :> Bone marrow transplants may be needed if the bone marrow has been destroyed by a disease. A bone marrow transplant can be used to replace diseased, non-functioning bone marrow with healthy functioning bone marrow. One may undergo bone marrow transplant for conditions such as leukaemia, aplastic anaemia, and sickle cell anaemia.

What happens if a bone marrow transplant fails?

Answer :> Transplant failure can lead to serious bleeding or infection. Transplant failure is suspected in patients whose blood cells counts do not start going up within 3 to 4 weeks of a bone marrow or peripheral blood transplant, or within 7 weeks of a cord blood transplant.

What are the long term side effects of a bone marrow transplant?

Answer :> Long-term side effects of bone marrow transplant are as follows: -

1. 1Infertility, which means you cannot become pregnant or make a woman pregnant when you want to.
2. 2Cataracts, a condition in which the lens of the eye gets cloudy and vision is more difficult.
3. 3 Early menopause for women.
4. 4Thyroid problems.
5. 5Lung or bone damage.
6. 6Risk of developing another cancer.

Who can be a donor for an Allogeneic transplant?

Answer :> The donor can be a family member or someone unrelated to you. Sometimes, people get donated blood-forming cells from umbilical cord blood. Blood and tissue test are done prior to the transplant.

What is Umbilical cord blood transplant?

Answer :> Umbilical cord blood is an alternative hematopoietic stem cell source for patients with hematologic diseases who can be cured by allogeneic hematopoietic cell transplantation. Initially, umbilical cord blood transplantation was limited to children, given the low cell dose infused.

Who can donate Bone marrow?

Answer :> (One can donate bone marrow through bone marrow registry after the transplant).

(The donor can be a family member or someone unrelated to you. Sometimes, people get donated blood-forming cells from umbilical cord blood. Blood and tissue test are done prior to the transplant).

(One cannot donate during the transplant because one has to undergo blood and tissue test to ensure transplant is a success) 

What is bone marrow registry?

Answer :> Bone marrow registry refers to the details of the donor such as gene type which might be needed for transplant. One has to enrol to a bone marrow registry to be a potential donor.

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