Two medical oncology consultants at Curie Centre of Oncology, a private cancer care centre in St. John’s Medical College Hospital, who have completed 10 autologous bone marrow transplants (ABMT) including the first-ever for brain tumour in India, are now ready to perform allogenic procedures for thalassemia and Sickle Cell Anaemia cases for non-cancerous conditions. These patients are usually children and can withstand the allogenic (donor marrow) more effectively than adults.

Dr. Radheshyam, bone marrow transplantation specialist and Dr. Ganesh, oncologist and haematologist, Curie Centre of Oncology told Pharmabiz .com that early cancerous conditions including blood cancers like lymphomas, leukaemia and multiple mylomas can be treated through this procedure.

The specialists, who performed the first-ever bone marrow transplant in Karnataka in January 2003, said the procedure could also be performed for paediatric cases suffering from Neuroblastoma, Wilms tumour, brain tumour and Rhabdomyosarcoma. Among adults the procedure is performed for early stages of breast cancer, small lung cancer, testicular and ovarian cancer.

Bone marrow transplant is a specialised procedure performed by trained medical oncologists. The patient’s stem cells are collected, cryo-preserved and given back to the patient after he is administered high dose chemotherapy.

To perform allogenic transplants, medical oncologists must be first familiar with Autologous BMTs. The procedure for selecting a donor is same as kidney transplants but is more complex and costs more. There are increased side effects but children can tolerate alien blood better. Usually, after allogenic transplant patients must guard against host-versus-graft diseases and hence post operative care is vital.

While most cancers are treated with surgery, chemotherapy and radiotherapy, advanced and even some early cancers cannot be cured. However, now with bone marrow transplants, some of the chemo-sensitive cancers can be cured using high dose of chemotherapy

Chemotherapy is not only toxic but also kills the non-cancerous cells. With ABMT, this is avoided as stems cells of the patient are first collected before the high dose of chemotherapy is administered. The procedure begins with the peripheral stem cell transplant where a Granulocyte colony-stimulating factor (G-CSF) injection is administered to stimulate the stem cells (bone marrow). Then the stem cells are spilled into the blood which is drawn while the patient is on a cell separator system. The concentrated blood stem cells are preserved in liquid nitrogen under -80deg. C to -180 deg, C environment conditions.

After the transplant, the patient is kept isolated in a sterile facility which has equipment and infrastructure worth Rs. 10 lakh. A close relative of the patient is trained to handle his needs and provide the psychological support along with the nursing staff. The entire procedure takes a month because of procedures like preparation, harvest of bone marrow, isolation and reintroduction of bone marrow, recovery, radiation and follow-up. The cost of the procedure would cost around Rs. 5 lakh. Currently in India the procedure is conducted at CMC Vellore, All India Institute of Medical Sciences (AIIMS), New Delhi, Apollo Hospital, Chennai and Tata Memorial Hospital Mumbai.

To set up a facility to offer ABMT would cost Rs. 10 crore. The hospital must be equipped with a good blood bank, they stated. Oncologists at Curie Centre access the TTK Rotary Blood Bank for ABMTs, they added.