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Bone Marrow Transplantation

How can a bone marrow transplant bring a shattered life back on track?

Let’s meet one of our patients, Alimayu from Ethiopia.

Alimayu is a 46-year-old young businessman from Addis Ababa, Ethiopia. He lives in the Bole area of Addis along with his father and mother, 2 Kids, and a wife. 

He always loved to travel to different places with his wife and children. He was living his dream life in a luxurious house for which he worked very hard. 

Life and his travel business was going great for him until when Alimayu fainted, all of a sudden, while he was taking a review meeting in his office. His colleagues and staff took him to a nearby hospital immediately. The doctor admitted him for observation and started the investigations to find out the root cause of the faintness. His blood test revealed that he had leukemia.

The news ran a strong wave of feelings of shock, disbelief, fear, anxiety, depression, sadness, and many more in Alimayu, his family, and his office staff. None of them are able to believe the news. All of a sudden, life had paused for them.

Alimayu even asked the doctor how it happened? What he had done wrong. 

The doctor said the reason for cancer cannot be determined and asked Alimayu to consult an oncologist on a priority basis.

BMT patient
bone-marrow-transplant

Alimayu consulted the oncologist and they have said that bone marrow transplant is the only curative treatment of leukemia. Since bone marrow transplant is a very costly treatment Alimayu had a difficult question in his mind whether he should go for it or save money for his family’s future. He decided to fight for himself, his family, for the future of his business, and office staff.

Alimayu was searched exhaustively for a cost-effective bone marrow transplant. He got to know about MedicoExperts. He visited the website, read all the information, and left an inquiry. Medicoexpert’s patient care executive got in touch with Alimayu and guided him for the next steps. Alimayu consulted the MedicoExperts empanelled doctors on a video call and understood the detailed procedure including prerequisites, time frame, and commercial implications. He chose the doctor based on the budget, his own analysis, and MexicoExperts recommendation.

Luckily Alimayu’s younger sister’s bone marrow is matched and she is ready to help her brother.   

They came to India and were admitted to the hospital since it’s a long treatment of 30 to 45 days they came prepared for it.

After chemotherapy and bone marrow transplant was conducted. He was advised to be in India for another 3 months.

When the whole process of treatments and follow-ups was concluded, Doctor declared the success of the procedure, and Alimayu, like other fights of his life, won the fight with leukemia. 

The doctor did emphasize to him that it’s because of Alimayu’s quick actions and timely decisions, doctors could produce wonderful results.

Let’s now understand more about the procedure. As a first step, let’s understand what bone marrow is.

bone marrow

What is bone marrow?

The spongy substance found in the center of the bones is called bone marrow. 

Red bone marrow, also known as myeloid tissue, and yellow bone marrow, also known as fatty tissue, are the two types of bone marrow.

Red bone marrow contains blood stem cells that are responsible for generating new red blood cells, white blood cells, or platelets. 

Yellow bone marrow contains stem cells, which produce cartilage, fat, or bone cells and is mostly made up of fat.

bone marrow

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bone marrow transplant in india

bone marrow transplant

What is a bone marrow transplant?

A bone marrow transplant is a treatment that replaces your damaged or diseased bone marrow with healthy bone marrow stem cells. Replacement cells can come from either your own body or a donor.

Transplantation can be used to treat cancers that affect the bone marrow, such as leukemia, myeloma, and lymphoma, as well as other blood and immune system diseases.

types

Types of Bone Marrow Transplant

The cost of the transplant depends upon the type of transplant one has to undergo. Below we have explained the types of BMT treatment approaches:

1. Autologous Bone Marrow Transplant:

The term auto refers to one’s own “self”.

An autologous transplant uses stem cells from your own body. Cancer is treated with high-dose, intensive chemotherapy or radiation therapy. This type of treatment has the potential to harm your stem cells and immune system. That’s why, before starting cancer treatment, doctors remove or rescue your stem cells from your blood or bone marrow.

The stem cells are then returned to your body after chemotherapy, restoring your immune system as well as your body’s ability to produce blood cells and fight infection. This procedure is also known as a stem cell rescue or an Autologous bone marrow transplant.

2. Allogenic Bone Marrow Transplant:

Allo is a term that means “other.”

Stem cells are removed from another person, called a donor. The donor’s genes must, in most cases, at least partially match yours. To determine if a donor is a good match for you, special tests are performed.

It’s most likely that a brother or sister will be a good match. Parents, children, and other relatives can sometimes be a good match. 

Depending on the relation of the donor and matching of tissue, Allogenic BMT is further classified into 3 types. They are;

  1. Complete Matched Sibling Donor BMT: In this, the donor is most likely to be a brother or sister of the patient. These are often a complete match to the patient’s tissue.
  2. Haplo-identical BMT: It is a type of Allogenic BMT in which parents are usually a donor to the patient since they are a half match for their children. In cases, where a complete match is not found and the patients do not have any sibling, the expert surgeon considers parents to be a donor and perform Haploidentical BMT.
  3. Unrelated Donor BMT: In cases, where there is no sibling and parents are also not a match for the patient, then Unrelated Donor BMT is the solution, in which a donor who is unrelated to you is made available for the transplant from the Donor Match Registry.

3. Umbilical cord blood transplant:

This is a type of allogeneic transplant. Right after birth, stem cells are extracted from a newborn baby’s umbilical cord. The stem cells are frozen and kept until a transplant is required.

Because umbilical cord blood cells are so immature, perfect matching isn’t required.

Blood counts take much longer to recover due to the lower number of stem cells.

umbilical cord blood transplant
Reasons to undergo lungs transplant

Reasons to undergo Bone Marrow Transplantation Surgery

A bone marrow transplant is a decisive option when there is a prolonged complaint. The diseased bone marrow can be replaced by BMT treatment for the enlisted concerns when one is suffering from:

  • Cancer such as Leukaemia, Lymphoma, Multiple Myeloma.
  • Inherited Blood Cell Diseases such as Thalassemia and Sickle Cell Anaemia
  • Conditions in which the bone marrow stops producing new blood cells such as Aplastic Anaemia
  • Replacing the damaged bone marrow due to high doses of chemotherapy or radiation to treat certain malignancies
  • Congenital Neutropenia which results in recurrent infections

Why choose India for bone marrow transplant?

Advantages of Bone Marrow Transplantation in India

  • Cost-effectiveness and trustworthiness make India a great choice for a bone marrow transplant procedure.
  • A staggering 60-90% success rate amongst the best bone marrow transplant hospitals in India.
  • A stay in the hospital for 30 days and 90 days stay in the country, is required.
  • Time-bound, special schemes with some associated hospitals for MedicoExperts patients

India - an advanced cost-effective option for BMT treatment

With the ever-advancing field of medicine and research technology, the pool of doctors and surgeons in India are erudite and with years of expertise in treating life-threatening diseases.

The infrastructure and technology of the top hospitals in India are at par with the facilities available in the western counterparts.

At one-third of the cost with the best surgeons in India, one can be assured of quality treatment and holistic care. Efforts have been also taken to reduce the cost for bone marrow transplant by focusing on newer strategies and advanced technologies to bring about effective healthcare.

Lung transplant in India

Reasons to choose India over other countries:

  1. Economy and standard of living: The cost for bone marrow treatment in India is much more affordable as opposed to undergoing treatment in the US, Thailand or any European country. Even the stay, consultation, facilities and everything else will also cost much lower when compared to the western counterparts.
  2. Options: India has a wide range of hospitals to choose from; that offer care and treatment according to one’s budget. With the advancement in the field of medicine, the hospitals also try their best to bring down the cost to make treatment cost-effective and available to all strata of society. There is also the promising possibility of choosing doctors whose expertise and experience will help you heal better. The cost differs greatly based on the chosen surgeon.
Sr.No. Countries Average Cost (USD) Average Cost (INR)
1 India $15,000 – $90,000 ₹10,69,095 – ₹64,14,569
2 USA $350,000 – $800,000 ₹2,47,36,250 – ₹5,65,40,000
3 United Kingdom $233,310 – $583,275 ₹1,64,89,184- ₹4,12,22,960
4 Germany $100,000 – $250,000 ₹70,67,500 – ₹1,76,68,750
4 United Kingdom $49,999 – $100,000 ₹35,33,679 – ₹70,67,500

Bone marrow transplant

Before undergoing a bone marrow transplant you must undergo a series of tests to ensure your general well-being. Once your doctor is happy with the results of the tests your doctor will insert a tube called the center catheter inside the vein of the chest. 

The stem cells and medicines are administered into your body through this central line. Besides administering medicines and stem cells, this central line is also used to collect blood from your body.  

Once the central line is placed your doctor will start chemotherapy or radiation therapy to:

  • Shrink the cancerous growth
  • Suppress the immune response, especially before an allogeneic stem cell transplant

Once the chemotherapy or the radiation therapy is done your doctor will administer the harvested stem cells. 

The harvested stem cells replace the bone marrow cells within a few weeks.

Typically it is a painless procedure and you might be awake while your doctor administers the stem cells through the central line.

It usually takes a few weeks to replace diseased bone marrow with healthy bone marrow. Once engrafted the new healthy bone marrow proliferates and begins to form healthy blood cells.

Your doctor will regularly monitor your health and several other tests to manage infection or other complications.

Soon after a bone marrow transplant, your doctor will even suggest red blood cells and platelet transfusion for you for some time, until the new bone marrow cells begin to proliferate.

Also, your doctor may ask you to visit them regularly for a few years after the treatment to manage late complications.

Procedure

Steps involved in BMT Procedure in India

Treatment cost

Which country is best for bone marrow transplants?

Once your doctor advised you about a bone marrow transplant the first thing that comes to your mind is where you should get this treatment done. While considering a suitable country for the treatment you must ensure various factors like:

  • Affordability of the procedure in that country
  • Survival ratio of people who underwent bone marrow transplants in the country you have chosen.
  • Availability of the latest treatment and world-class-healthcare facility
  • The cost of the stay in the country you have chosen
  • The success rate of bone marrow transplant in your chosen country

Other than checking for the affordability and availability of world-class treatment, you must consider the following factors too:

  • Connectivity ease to the country you have chosen from your country, 
  • Safety of the selected country.
  • Ease of local communication in the chosen country

While we usually consider Western countries for treatment as we are impressed by their latest advances in healthcare facilities. However, the cost of getting treated in those countries is a bit too much.

Contrary to the western nations India provides you with a viable option for treatment as Indian hospitals ensure that you get advanced treatment while charging you almost half of what it would have cost you in Western nations.

Treatment cost

How to choose the best doctor for your bone marrow transplant in India?

Choosing the best haematologic oncologist for bone marrow transplants is very important. By choosing a good doctor you can ensure efficient treatment.

An experienced and well-trained doctor helps to replace the diseased bone marrow with healthy bone marrow. If you are unsure about selecting a doctor, you must ensure that:

  • The doctor is board certified
  • The experience and expertise of your doctor in transplanting bone marrow

How to choose the best hospital for bone marrow transplants in India?

Although it is a tedious job to select a hospital for bone marrow transplant in India you must ensure that the hospital offers world-class healthcare facilities and is equipped with the latest healthcare devices for the treatment. 

Apart from choosing a hospital that offers the latest medical approach, you must also ensure that the hospital has a dedicated unit for people undergoing transplants for efficient pre and post-transplant care.

Treatment cost

Cost of bone marrow transplant in India

Depending on the condition of the patient, the concerned doctor may suggest to undergoing radiation therapy or chemotherapy. The cost for the same will have to be additionally added to the above-listed cost, based on the type of transplant one has to opt for.

1. The cost of one cycle of chemotherapy is anywhere between USD 500 to USD 1000 (INR 35643 to INR 71286)

2. The cost for radiation therapy is approximately USD 3500- USD 5500 (INR 249503 to INR 392075)

3. The mentioned cost is exclusive of any post-operative complications, over-stay charges, inter-disciplinary conditions, or use of any special drugs, consumables or blood components.

When planning your bone marrow transplant in India, we recommend you to be prepared and aware of every minuscule aspect, so as to avoid any surprises. We, at MedicoExperts, are open and ready to answer any query you may have.

Treatment cost

The cost of bone marrow transplant in India according to the type of transplant is as follows:

Sr.No. Procedures Evaluation Cost (USD) Treatment Cost (USD)
1 Autologous Bone Marrow Transplant 1300 – 1800 15000 – 24500
2 Allogenic Bone Marrow Transplant 1300 – 1800 25000 – 37500
3 Haplo Bone Marrow Transplant 1300 – 1800 36000 – 50000
4 Unrelated Bone Marrow Transplant 1300 – 1800 65000 – 90000

The different steps of Autologous Bone Marrow transplant in India are as follows.

This procedure takes several days to complete. To increase your stem cells, you will first receive injections (shots) of a medication. The stem cells are then collected through a vein in your arm or chest by your medical team. The cells will be kept in a safe place until they are required.

This step can take anywhere from 5 to 10 days. You’ll be given a lot of chemotherapy. Patients may also receive radiation therapy.

This is the day of your transplant. Each dose of stem cells takes about 30 minutes. This is referred to as an infusion. The stem cells are reintroduced into your bloodstream via the catheter by your medical team. There’s a chance you’ll get more than one infusion.

Your recovery and growth will be closely monitored by your doctor, and you will be prescribed antibiotics to prevent infection. Any side effects will be treated by your medical team.

The different steps of the Allogenic Bone Marrow transplant in India are as follows.

Before the ALLO transplant can begin, a compatible donor must be found. Blood testing will determine your HLA type. Then, with your permission, your health care team will conduct HLA testing on potential donors in your family and, if necessary, search a volunteer registry of unrelated donors.

Cells will be extracted from your donor’s blood or bone marrow by your medical team. If the cells come from the bloodstream, your donor will receive daily injections (shots) of medication to boost white blood cell counts for a few days before the collection.

The stem cells are then extracted from the patient’s bloodstream. If your donor’s cells come from bone marrow, he or she will undergo a bone marrow harvest in a hospital operating room.

This step can take anywhere from 5 to 7 days. To prepare your body to receive the donor’s cells, you will receive chemotherapy with or without radiation therapy.

This is the day of your transplant. Through the catheter, your health care team injects the donor’s stem cells into your bloodstream. Donor cell retrieval usually takes less than an hour.

Antibiotics and other drugs, including medications to prevent and/or manage GVHD, will be given to you during your initial recovery to reduce your risk of infection. Any transplant-related side effects will be treated by your medical team. Find out more about bone marrow transplant recovery in the sections below.

Success rate of Bone Marrow Transplant in India

The success rate of bone transplant in India differs from hospital to hospital with a collective average ranging from 60-90%. This is a result of extremely qualified and highly skilled surgeons and highly equipped, hospitals with strict patient care, cleanliness and infection control policies. The percentage of relapse noticed in cases of autologous transplant patients is comparatively low.

Frequently Asked Questions and patient concerns:

1. How do I know which bone marrow transplant is best for me?

The consulting surgeon will review your reports and decide on the best-suited option for your treatment.

We at MedicoExperts, ensure that you get nothing but the best diagnosis and treatment for your ailment. Be assured to get the best treatment advice from the chosen best surgeons in India.

2. What is the difference between bone marrow transplants and stem cell transplants?

In a stem cell transplant, the stem cells are collected from the patients’ own blood and used; while in the case of a bone marrow transplant, the bone marrow is extracted from the donor and injected into the patient who has undergone high-dose therapy.

3. What are the commonly noticed side-effects of undergoing bone marrow transplant?

Besides the higher risk of infection due to a stressed immune system, the commonly noticed side effects are but are not limited to,

  • Nausea and vomiting
  • Fatigue
  • Low levels of platelets, which can decrease how well blood can clot
  • Low levels of red blood cells, which can cause anemia
  • Diarrhea

4. How long will I take to recover from my treatment?

Recovery after Bone Marrow Transplant is long and tiresome, both physically and emotionally for the patient and family. The initial 3 months are critical enough for the recovery of the patients.

They need complete monitoring during this span since there are high chances of complications and the risk of rejection of the transplant. The patient may complain of fatigue, weakness and is unable to concentrate for the first few weeks post-surgery, however full recuperation may take up to 1-2 years.

An estimated stay of around 2-3 months is required in India for the Bone Marrow Transplant Surgery and complete recovery, post which the patient can fly back to his/her country.

5. How soon can I resume my normal work and daily routine?

After a complex and prolonged BMT treatment in India, it is justified to be anxious and return to a daily routine to seek normalcy.

However, once you are done with the transplant, you should be diverting all your energy in regaining your strength and stamina. Staying positive will help you heal better. It will also be advisable to avoid crowded public places, as you will be prone to infection due to lowered immunity functions. Generally, it takes about 3-6 months for a patient to feel better and stable, however, this also depends on certain environmental factors like cleanliness, etc.

6. What can I expect from my bone marrow treatment in India?

BMT procedure is a treatment associated with a number of risks and complexities. It is, therefore, crucial to know if the treatment is suitable for you. BMT procedure is recommended in cases when;

  • All other treatment options undergone by the patients have failed
  • There is a higher risk of relapse or the disease to return without a transplant.
  • The benefits of Bone Marrow Transplant prevail over the risks and complications associated with the surgery
  • The patient is in otherwise good condition and has matched stem cells available from either a sibling or parents and family member.

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