Transplant with mismatched patient and donor

(Stem Cells News image)

In an interview with ETHealthworld, Dr. Sachin Jadhav, Group In-charge – Haematology & Bone Marrow Transplantation, Gleneagles Global Hospitals, Bengaluru, talks about the innovations and challenges seen in this field.

What is Bone marrow transplant and how is India placed in this field? How do you see it globally?

Bone marrow transplant (BMT) is when we change the bone marrow. Bone marrow is what is present inside the bones and is a factory where all the blood cells are manufactured or created. Inside the bone marrow, we have stem cells which are like a seed that gives rise to red cells, white cells and platelets. So when we talk of bone marrow transplant what we are actually changing or transplanting is the stem cell.

This process is actually a stem cell transplant to regenerate the bone marrow in some patients. Bone marrow transplantation as a modality of treatment started in the late 1970s. The successful transplants started happening in late 1970s, although many doctors had attempted the treatment way before this but there was very little success (…)

Today, there are over 1500 to 2000 hospitals around the world which are doing good work in stem cell transplant. In India, however, because this is a reasonably new field and accessibility to this treatment has grown in the last five to seven years, there are about 30 to 35 centres which do bone marrow transplant.

Out of these there are about 10 to 15 hospitals which are doing good numbers and giving reasonably good outcomes as well. So if we compare population wise, there are 1500 plus centres in the world but our country which has 1/7th the population of the world has only 15 to 20 good centres (…)

When transplantation was initially attempted, the recipient’s body would reject a donor’s stem cell. That was one of the biggest challenges in the beginning. Today we are at a point where rejection is only 5%. In 95% of our patients, the new bone marrow takes up, the graft takes up and it starts functioning.

Subsequently a newer problem came up as transplant became successful, the new graft which has come from a donor stem cell, would start attacking the recipient’s body. This complication is called GVHD. GVHD earlier used to take lives of almost 100% of patients; today life threatening GVHD happens in only 10%. That is another improvement which has happened in the last five years (…)


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