Allogeneic Bone Marrow Transplant

Allogeneic Transplant Hospital in Delhi

The Centre for Bone Marrow transplant at BLK-Max Super Speciality Hospital is one of the most recommended units for patients needing highly specialised treatment for blood-related disorders. A team of internationally trained haematologists, haematopathologists, transfusionists and transplant physicians provide optimum patient care using a multidisciplinary approach in order to develop a more effective treatment plan and to build upon the existing understanding of the current medical condition.

The Centre offers world-class treatment facilities using advanced technology and the latest therapies to treat most of the complex conditions requiring allogeneic transplantation, with the aim of improving the quality of life of patients and their families.

What Is Allogeneic Transplant?

Allogeneic transplantation is a type of transplantation that requires a donor (a healthy person) to donate stem cells/Bone marrow, which is transferred to that patient’s body after high-intensity chemotherapy or radiation. The donor can be a genetically similar person like a brother or sister or an unrelated person whose bone marrow matches with the patient’s bone marrow. The process of Allogeneic Transplant includes:

The transplant process can be done either by using bone marrow harvesting or Peripheral blood stem cells:

  • Bone Marrow Harvesting:This process involves the extraction of liquid bone marrow from the back of the pelvic bone by sedating the donor using general or regional anaesthesia and making several incisions that are less than one-fourth inch long and does not require stitches.
  • Stem Cells Harvesting: The process of harvesting Peripheral blood stem cells from the donor’s body is called Apheresis. In this process, the blood is taken from the donor’s arm and is transferred to a special centrifuge called an apheresis machine, where stem cells are isolated from the blood, and the remaining blood is transferred back to the donor through another arm, and the stem cells are used for the transplantation process.

Body Location- Generally, bone marrow harvesting is done from hip bones, pelvis and sternum.

 Alternate names- Bone marrow transplant is also known as Stem cell transplant.

What Are The Indicators For This Transplantation?

There are various serious health conditions that require bone marrow transplant as a cure. Such illnesses include:

Non-Malignant Diseases

  • Bone Marrow Failure States, including:
    • Severe aplastic anaemia
    • Fanconi’s anaemia
    • Paroxysmal nocturnal haemoglobinuria (PNH)
    • Pure red cell aplasia: Acquired and inherited (DBA)
    • Amegakaryocytosis / congenital thrombocytopenia
  • Immunodeficiency states
    • Severe combined immunodeficiency (SCID)
    • Wiskott-Aldrich syndrome
    • Chediak-Higashi syndrome
    • Congenital neutropenia
  • Metabolic disorders
    • Hurler's syndrome (MPS-IH)
    • Adrenoleukodystrophy
    • Metachromatic leukodystrophy
    • Gaucher’s disease
    • Nieman picks a disease
    • Osteopetrosis
  • Hemoglobinopathies
    • Beta-thalassemia major
    • Sickle cell disease

Malignant Diseases

What Is The Procedure Of The Transplantation?

Allogeneic transplantation is a process that offers great chances of curing the disease related to blood and bone marrow cancers and other disorders. In order to ensure high safety and better outcomes, some preparation is made by the doctor before the surgery, which a patient must follow.

Step 1: Pre-Transplant Process: A patient has to take a series of Pre-transplant tests and procedures to ensure their general health and the status of their current medical condition. This process of evaluation may take several days.

  • Beginning Medical Evaluation-  The patient undergoes various tests to check the overall health of the individual.
  • Central Venous Catheter Evaluation And Insertion- A catheter (thin tube) is inserted into the neck or chest. The catheter acts as a pipeline through which medications and stem cells are infused.
  • Bone-Marrow/Stem Cells Harvest

Step 2: Conditioning Process: After the completion of the medical evaluation, a patient has to undergo the conditioning process. In this process, either chemotherapy or radiation therapy or a combination of both is given to the patient to:

  • Destroy any type of cancer cells in case of malignancy
  • Preparing the patient’s bone marrow for the growth of new stem cells.
  • Suppressing the patient's immune system

Step 3: Allogeneic Transplant: The patient undergoes cytotoxic treatment where the harvested and processed bone marrow/Stem cells are transplanted into the patient using a central venous catheter. The liquid bone marrow/stem cells travel through the bloodstream of the patient into the different places inside the bones. The transplant offers a patient’s body a tendency to create new blood cells in a process known as engraftment.

Step 4: Engraftment: In this process, the patient is under close monitoring for the sign of the growth of new stem cells along with supportive care.

Step 5: Post Engraftment Monitoring And Continuation Of Immunosuppression

Follow up

After bone transplantation, the patient will stay in the hospital or visit the hospital every day for a couple of weeks. Initially, the count of red blood cells, white blood cells and platelets will be less, so antibiotics will be prescribed to prevent infection. But gradually, within 2 to 6 weeks, the number of blood cells increases to normal levels.

What Are The Precautions One Must Take Before And After The Transplantation?

A patient must take some very important precautions before and after the transplantation process, which include:

Before The Transplantation:

  • Tell your doctor in detail about your medical history or if you are taking any medication.
  • After chemotherapy, patients must shower twice a day thoroughly in order to remove the excreted drug in the form of sweat through the skin.
  • Perform the entire test prescribed by the doctor.
  • Do not drink alcohol or smoke tobacco.
  • Prepare yourself both mentally and physically for the transplant.
  • Do not eat a heavy meal a day before the transplant.

After The Transplantation:

  • Try to follow a strict regime, as asked by your doctor, because after the transplant, your immune system is weak, and you might catch an infection.
  • Administrate all the prescribed medicines on time.
  • Avoid environmental exposure.
  • Try to focus more on maintaining proper hygiene and staying in a neat and clean room.
  • Make handwashing a regular habit.
  • Get a proper vaccination as prescribed by the doctor.
  • Try to maintain a healthy weight and take a balanced diet

Are There Any Complications Involved?

Generally, a patient receives high doses of chemotherapy or radiation therapy before a transplant, which comes with complications such as:

  • Infections
  • Mouth and throat sores
  • Nausea
  • Stomach and intestinal irritations
  • Skin redness
  • Bleeding
  • Anaemia
  • Organ problems, such as liver and lung problems

Other complications due to transplant include:

  • Pain
  • Chills
  • Fever
  • Flushing of the face
  • Nausea and vomiting
  • Hives
  • Chest pain
  • Graft-versus-host-disease (GVHD): a condition in which new bone marrow from the donor attacks healthy cells. Thus it is suggested to use the more genetically close donor for transplant.

The success rate of allogeneic transplant is less as compared to autologous bone marrow transplant as it requires an external donor for transplantation.

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