Reduced Intensity Transplant

The Bone Marrow Transplantation team at BLK Super Speciality Hospital is specialised in providing world-class treatment for blood diseases, the number of cancers, and immune disorders that were once considered incurable. Our multidisciplinary team of proficient experts offers proactive patient care with close monitoring to establish immunity, tolerance, and improve survival outcomes.

The clinical mission of the unit is to design a patient-centric, disease-specific, reduced-toxicity transplantation regimens to help the patients suffering from high-risk leukaemia or lymphoma and other life-threatening conditions that can lead to bone marrow failure, autoimmune diseases, or immune deficiency.

Our efforts to continuously improve our Medical advancement and quality-of-life outcomes are second to none. We offer reduced-intensity transplantation for older patients, children and others who cannot tolerate the harsh side effects of full-intensity treatments in autologous or allogeneic transplants.
 

What Is Reduced Intensity Transplantation?

A Reduced-Intensity Transplant is also known as a ‘mini’ transplant or non-myeloablative transplant. It is one of the recently innovated modified types of transplant that replaces the patient’s blood-forming stem cells with those of a compatible donor. Patient undergoing reduced-intensity transplant receive lower doses of chemotherapy during the conditioning process. It is suitable for:

  • Older patients
  • Patients who have other medical conditions
    • Diabetes Mellitus
    • Hypertension
    • Coronary artery disease 
    • Chronic Kidney Diseases
    • Chronic Obstructive Pulmonary Disease
  • Patients who have certain infections
  • Patients with less rapidly progressive blood cancers

Usually, a donor can be of two types:

  • Related donor: Such as siblings or a family member
  • Unrelated Donor:  The donor who is not genetically related to the patient but share the same bone marrow.

What Are The Indicators For This Transplantation?

There are various serious health conditions related to blood disorders that require bone marrow transplant as a cure. Such illnesses include:
Malignant disease:

  • Multiple myeloma
  • Hodgkin’s Disease
  • Non-Hodgkin’s Lymphoma (NHL)
  • Neuroblastoma
  • Ewing’s Sarcoma
  • Metastatic Germ cell tumours
  • Medulloblastoma brain tumour
  • Other solid malignancy
  • Refractory Lymphomas
  • Myeloproliferative Neoplasms (MPN)
  • Leukemia
    • Acute lymphocytic leukaemia (ALL) 
    • Chronic lymphocytic leukaemia (CLL) 
    • Acute myelogenous leukaemia (AML) 
    • Chronic myelogenous leukaemia (CML)

Non-Malignant disease:

  • Thalassemia
  • Multiple Sclerosis
  • Severe Autoimmune Diseases
  • Aplastic Anaemia
  • Severe Immunodeficiency disorders
  • Inherited Metabolic disorders

What Is The Procedure Of The Transplantation?

A Reduced-intensity transplant is a newer type of transplant that follows the same course as conventional transplants, but with less taxing levels of drugs. The transplantation procedure includes the following steps:

Step 1: Pre-transplant Process: Patient has to perform some Pre-transplant tests and procedures before the transplant. It will help the doctor to evaluate the current medical condition of the patient. The process includes:

  • Beginning Medical Evaluation
  • Conference for Treatment Plan
  • Central Venous Catheter Evaluation and Insertion
  • Bone Marrow/Stem Cells Harvest: Bone marrow or stem cells required for the transplant are taken from the hip bone or the blood of the donor respectively.

Step 2: Conditioning Process: The conditioning regimen for reduced-intensity uses less chemotherapy and radiation than the standard myeloablative conditioning regimen. Reduced-intensity transplants simply

  • Suppress the immune system of the patient enough so that the stem cells injected can engraft and grow.
  • It may kill some amount of tumour cells if any

Step 3: Reduce Intensity Transplant: This transplant is a modified version of allogeneic transplantation, where the harvested and processed Bone marrow/Stem cells are transplanted into the body using a central venous catheter. These cells then make their way to the bone marrow space in the body, thereby offering a patient with a tendency to reconstitute the bone marrow and help regenerate the blood and immune system.

Step 4: Engraftment: In this process, the patient is seeking comprehensive care with close monitoring to look for the sign of new stem cells take root – or “engraft” – in the bone marrow.

Step 5: Post Engraftment monitoring and continuation of immunosuppression

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

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

Before the transplant:

  • Discuss your medical history in detail with the doctor.
  • If you have undergone chemotherapy take a shower twice or thrice in a day.
  • Take the entire test asked by the doctor, as it will help them evaluate more accurate treatment plan.
  • Avoid drinking alcohol or smoke tobacco for a month before the transplant.
  • One must be prepared both mentally and physically to take the transplant.
  • Avoid eating heavy meals a week before the transplant.

After the Transplantation:

  • Try to follow a strict regime, as asked by your doctor, because after transplant your immune system is weak and you might catch the infection.
  • Administrate all the prescribed medicines on time.
  • Avoid environmental exposure.
  • Try to focus more on maintaining proper hygiene and stay in a neat and clean room.
  • Make hand wash 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?
In this process, a patient receives low doses of chemotherapy or radiation therapy before a transplant, which can cause rare complications like:

  • Infections
  • Skin redness
  • Bleeding
  • Anaemia

Other complications due to transplant include:

  • Pain
  • Chills
  • Fever 
  • Hives
  • Chest pain
  • Graft-versus-host-disease (GVHD) – a condition where donated bone marrow may attack the cells. Thus it is suggested to use the more genetically close donor for transplant and take immunosuppressive medicines advised.

Since Reduced-intensity transplant is a relatively new approach of transplantation, therefore, its outcomes are not yet been clearly defined. However, its success rate is the same as that of traditional transplants as immediate treatment related complications are reduced.

Find Complete Relief from BLK Experts

If you think you are facing similar conditions, or have suffered from them in the past, please contact the BLK Hospital team to schedule an appointment at : +91-11-30403040

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