Sion Hospital in Mumbai to expand bone marrow transplant facility after a decade of life-saving work

In 2015, the Lokmanya Tilak Municipal Medical College and General Hospital (LTMGH) at Sion in Mumbai became the first civic hospital to have introduced the bone marrow transplant facility. In these ten years, the hospital has carried out 104 bone marrow transplants among children.

A decade on, the hospital is now looking at expanding the existing BMT treatment facility, given the "long list of patients-in-waiting." The hospital staff reportedly said that given that all permissions from the Brihanmumbai Municipal Corporation were in place, the work for the new BMT facility, with 5 BMT beds and a four-bedded step-down room similar to an ICU, is scheduled to begin soon, in the Eknath Gaikwad Health Centre building, on the second floor.

At present, the hospital has only one BMT bed and four step-down rooms, which means that at any given point the hospital can conduct BMT of just one patient and that process for a single patient can last anywhere from a month to 45 days before they are shifted to the step-down room. Children with aplastic anaemia, primary immunodeficiency that is T cell migration defect, are the ones who need bone marrow transplants, and that too, without a delay post their diagnosis.

"Given that a month's time is required for the treatment, ideally we could have treated more than 104 patients, about 120, in this past decade. However, infrastructure challenges became hurdles. Even now, we have seven to eight patients on the waiting list at any given point in time, and this does not include the emergency patients we see every week. So, once we expand we can conduct at least four to five BMTs simultaneously against just one which we do now," said Sujata Sharma, in-charge, division of paediatric haematology, department of paediatrics, Sion Hospital.

Diseases of the bone marrow cells can be treated by completely replacing the bone marrow with an entirely new set of healthy stem cells, that are HLA-matched, which means the tissues of a prospective donor and recipient are compatible because mismatched donor and recipient tissues can lead to rejection of the tissues. In many cases, bone marrow transplant is carried out by using the patient's own stem cells, especially when treating solid tumours like neuroblastoma. BMT using stem cells from a donor is done for various conditions, including blood cancer or leukemia, thalassemia, and certain metabolic disorders.

Interestingly, since the past few years, parents expecting a child opt for stem cell banking because medical research reportedly claims that the blood left over in the umbilical cord and placenta after a baby is born has special cells in it that "which can treat and even cure some serious diseases."

The baby's umbilical cord blood, say experts, is rich in life-saving stem cells that have powerful regenerative properties which can potentially cure many diseases. The blood is collected immediately upon the baby's birth and stored by a private cord blood banking company, and whenever later in life if the need arises and if the child or someone else in the family develops a life-threatening disease, those stored stem cells can come to the rescue.

This is because "the umbilical cord blood contains cells called hematopoietic stem cells which can turn into any kind of blood cell and can be used for transplants that can cure diseases such as blood disorders, immune deficiencies, metabolic diseases, and some kinds of cancers. Research is revealing more and more ways it can save lives. It is precious — almost magical — and absolutely worth keeping," writes Claire McCarthy, senior faculty editor at Harvard Health Publishing.

Another development lately has been that of the possibility of a transplant of stem cells from a half-matched donor. Haploidentical transplant has been a life-saving solution for children suffering from critical conditions that require bone marrow transplants. "This breakthrough significantly expands donor possibilities, reduces dependency on fully matched donors and helps to overcome the challenges posed by donor registry shortages and high costs," say experts.

As per a research study published in Transplantation and Cellular Therapy, a bone marrow transplant with a half-matched donor led to a 79.4 per cent survival rate one year after transplant. In India, though, this is a new area and requires to be researched further, for accurate data collection.

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