Hospital in Gujarat, India : Bhailal Amin General Hospital, Vadodara, Gujarat, India

Introduction

Bone Marrow Transplantation

An interview with Dr Seema Bhatwadekar, Haematologist & Haemato-oncologist, Vadodara

A ‘stem’ of hope…

While stem cell therapy is expanding the frontiers of medical science, the bulwark of this science is Bone Marrow Transplantation (BMT).

A technique pioneered in the USA in the 1960s, BMT today offers a ray of hope to patients suffering from blood-related disorders, such as blood cancers, thalassaemia, sickle-cell anaemia, etc.

Vadodara joins the elite club of about 25 centres in India that offer this established therapy. Bhailal Amin General Hospital(BAGH) now offers this facility, in collaboration with Dr Seema Bhatwadekar, Consultant Haematologist & Haemato-oncologist. She throws more light on the treatment and services at BAGH.

	What is Bone Marrow Transplantation?
	The general perception of a transplant is that it is some kind of a surgery. A bone marrow transplant does not involve any major surgical procedure. It is a procedure in which stem cells are harvested from the peripheral blood or the bone marrow or from cord blood and they are transfused to the patient. These stem cells then home in and engraft in the patient’s bone marrow. There are two types of transplants, Autologous & Allogeneic.
	What’s the difference between the two ?
	The difference is in the source of stem cells, indications and post-transplant care. Autologous harvests stem cells from the patient’s own body, whereas Allogeneic uses stem cells from a different donor. Stem cells are transfused intravenously. Post-transfusion, stem cells home in to the bone marrow and proliferate, gradually restoring the patient’s normal blood cell count. Because the patient’s immunity is compromised in the post-transplant period, care needs to be taken as patient is susceptible to life-threatening infections. In many ways, a BMT is revolutionary because it gives a new lease of life to patients suffering from potentially fatal hematological disorders.
	If a bone marrow transplant offers so much, why is it still limited to a few cities across India?
	The biggest limiting factor is the infrastructure required. You cannot do a BMT in every hospital because the support infrastructure can’t address multiple issues that a BMT throws up. For example, one needs a blood bank and apheresis unit, a microbiology and pathology team that can respond fast and 24 X 7, a multi-specialty team of experienced doctors and a state-of-the-art ICU. Even the air that the patient breathes must be handled by a dedicated air handling unit so that the risk of infection is minimized. The nursing team handling the patient should be specially trained and sensitized to the needs of the patient. Diet needs to be well-cooked and steamed in a pressure cooker.
	How many days of hospital stay does this procedure require?
	It depends on the kind of BMT that is done, the extent of the underlying disorder, the age of the patient, the progress of the patient during and after the treatment, etc. An average estimate is a three-four week hospital stay.
	How do you see the future of stem cell therapy ?
	It is an exciting, cutting-edge science. But it takes time for any procedure / treatment to be established before it is offered on a consistent basis. BMT is one such established procedure. Vadodara now offers a local option, thus significantly reducing total cost of treatment and the inconvenience that the patient’s relatives face in an alien city.

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