BLK Centre for Bone Marrow Transplant (BLKBMT) is the largest in India and amongst the biggest in Asia. BLKBMT is a stand alone dedicated facility, equipped with ultra-modern infrastructure and internationally trained, widely experienced faculty. The Centre is supported by state-of-the-art laboratory services and transfusion services, along with a fully equipped radiation oncology unit with facility for total body irradiation. The Centre offers both allogenic and autologous transplant using bone marrow, peripheral blood stem cells and cord blood stem cells for various benign and malignant disorders like Thalassemia, Aplastic Anaemia, Leukemia, Lymphomas, Multiple Myelomas and Advanced Paediatric Solid Tumors. BLKBMT has to its credit more than 200 transplants within a short span of two years, including India's first Multiple Donor Transplant.
Key Department Highlights
- BLK Centre for Bone Marrow Transplant is one of the largest centres of its kind across Asia
- The centre has performed the maximum number of transplants in north India
- Each room is supported by separate HEPA filter with triple level air filtration
- Transplants are routinely performed for children as well as adults
- The centre is credited with Delhi’s First MUD (Match Unrelated Donor) Transplant
Hematopoietic Stem Cell Transplantation
Bone marrow transplantation is a procedure wherein stem cells from bone marrow that produce various blood cells like red blood cells, white blood cells and platelets are injected into a recipient. These stem cells are also referred to as hematopoietic stem cells. Nowadays, hematopoietic stem cells may also be obtained from peripheral blood after treatment with certain growth factors or from umbilical cord. Thus, the term “Hematopoietic stem cell transplantation” is now preferred to “Bone marrow transplantation” to include these other sources of hematopoietic stem cells.
The bone marrow is a soft, spongy portion within a bone. It contains immature cells called stem cells that have a continuous ability to produce different types of blood cells i.e. red blood cells, white blood cells and platelets. These are released into the blood stream. Bone marrow is of two types, red marrow and yellow marrow. In children, most of the marrow is red marrow and is rich in stem cells. In adults, however, a large portion of the bone marrow is converted into yellow marrow due to infiltration of fat cells. Red marrow in adults is usually restricted to a few bones like the hip bones, breast bone, ribs, shoulder blades, skull, backbone, and the ends of the arm and thigh bones.
BMT is actually means infusion of stem cells (collected either from bone marrow or peripheral blood or cord blood) into the recipient. The type of bone marrow that is used for the transplant distinguishes the different types of BMT.
- Autologous BMT is done by using the patient's own stem cells.
- Allogeneic BMT involves using the stem cells of a donor. The donor may be a relative, usually a brother or sister, or an unrelated (anonymous) donor. The donor needs to be Histocompatible Leukocyte antigen (HLA) match.
There are three main phases to the BMT process, which will review here:
Although the experience during these phases may be quite different for each patient, a general overview is provided.
Transplant Treatment Process
For your transplant journey, the transplant process is divided into seven steps that guide a patient. The steps begin with how to prepare for the journey and include what to expect along the way.
1. Preparation - The preparation phase begins when the patient arrives at the treatment center and begins the process of medical evaluation, orientation, informed consent, and other preliminary activities.
a. Beginning Medical Evaluation
b. Conference For Treatment Plan
c. Central Venous Catheter Evaluation And Insertion
d. Bone-Marrow/Stem Cells Harvest
2. Conditioning – The conditioning phase begins the actual transplant process. During this phase, high-dose chemotherapy, radiation therapy, or both are initiated. Chemotherapy and radiation therapy are given in doses that obliterate the marrow function and result in the greatest possibility of destroying the disease. Depending upon the chemotherapy agents and radiation therapy administration schedule, some conditioning therapy can be administered in the outpatient setting, thus potentially shortening the inpatient stay.
3. Transplant – The transplant phase is the infusion of donor bone marrow or stem cells. After the conditioning regimen is completed, the patient receives the infusion of bone marrow or stem cells.
4. Waiting for Engraftment – This phase includes close monitoring, supportive treatment, and management of complications while waiting for signs of engraftment (new cell growth).
a) Support, Protection And Close Monitoring
b) Watching And Managing Effects Of Treatment
5. Engraftment and Early Recovery – Approximately 10 to 28 days after transplant, signs that the new bone marrow or stem cells are engrafting (growing and developing) can be expected. Close monitoring will continue along with supportive care. Preparation for the return of the patient to the referring physician or center will begin.
6. Long-Term Recovery – The long-term recovery phase involves leaving the treatment center, dealing with any ongoing clinical issues, and re-establishing life patterns. Patients need to follow up for long term complications of BMT.