Stem Cell Transplant in india

What is a stem cell transplant?

Stem Cells are the cells that are produced in the bone marrow of a human body. They are produced to become any cells that the body requires. Stem cells, when mature, become RBCs, WBCs or blood platelets.
Stem Cell replacement is a procedure in which a patient receives healthy blood cells to replace the damaged stem cells caused by strong chemoradiation while undergoing cancer treatment. Stem Cell replacement is also done to replace the affected stem cells due to naturally occurring diseases. Anemia and bleeding are the most common symptoms of damaged Stem cells in the human body.

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Before a stem cell replacement, the patient is required to undergo strong chemoradiation to prepare for the transplant and this process of conditioning the body to accept new stem cells from a donor is called ‘Conditioning treatment’. After a Stem Cell Transplant, the donor cells move to the bone marrow of the recipient to form new healthy blood cells. This process is called ‘Engraftment’.
Stem cell replacements can be broadly classified into six kinds. They are:

Autologous Stem Cell Transplant
Allogeneic Stem Cell Transplant
Hematopoietic Stem Cell Transplant
peripheral blood Stem Cell Transplant
Bone marrow Stem Cell Transplant and
Cord Stem Cell Transplant

Why is a stem cell transplant done?

Stem cell replacement is a part of the bone marrow transplant. This is done to replace the affected stem cells to improve the bone marrow’s efficiency to produce new blood cells after conditioning treatment or radiation therapy.
After radiation therapy or conditioning, the body is exposed to large volumes of anti-carcinogenic elements that kill cancerous cells. In this process, the bone marrow is also affected and loses its capability to produce new blood cells. At this point, the immune system of the body is weak as there are no white blood cells and stem cells being produced. With a Stem Cell Transplant, the host (patient) is induced with healthy stem cells that move to the bone marrow and form new blood cells and strengthen the immune system to fight the remnant cancer cells that are weakened after radiation.

Types of stem cell transplants:

Autologous Stem Cell Transplant

Autologous Stem Cell Transplant is a procedure that uses the patient’s own blood cells to produce new stem cells. In this process, the patient undergoes ‘Cell mobilization’: a process that encourages the body to produce more stem cells and initiates the movement of the stem cells from the bone marrow to the bloodstream. Stem-cell rich blood is then collected from the patient and processed into a machine that separates the stem cells from the blood. Then, it is stored in sub-zero conditions for later usage.
This rest of the blood is sent back to the patient’s body, after which the chemotherapy treatment begins. Chemotherapy’s strong radiation regimen kills all cancerous cells, but it also destroys the blood-producing cells in the bone marrow.
The major advantage of Autologous Stem Cell Transplant is that it does not expose the patient to any risks in terms of Graft vs host adoption.

Allogeneic Stem Cell Transplantation

In Allogeneic Stem Cell Transplants, the patient receives stem cells from a donor and is executed after the patient undergoes conditioning treatment or chemotherapy. In this process, the stem cell-rich blood of a matching donor is processed in a machine that separates stem cells from the blood and is transferred into the host’s body.
After conditioning treatment and chemotherapy, the blood making cells are severely damaged and hence the immune system tends to be weak.
The new stem cells from the donor are induced into the body for engraftment. In this process, the new stem cells travel to the bone marrow and begin to form new blood cells.
In allogeneic Stem Cell Transplants, the immune system of the host tends to become stronger as the new stem cells form a new immune system and the new blood cells formed also tend to be very effective in removing the remaining cancerous cells in the body. This is called the graft versus tumor effect.
Allogeneic Stem Cell Transplants are successful when the HLA (Human Leukocyte Antigens) found in the white blood cells are the right match. Donors are tested for compatibility with a series of HLA tests.
Most matches in HLAs are from:

HLA-matched unrelated donor
HLA miss-matched family member
Unrelated umbilical cord blood
HLA-matched relative (most often a sibling)

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Hematopoietic Stem Cell Transplant:

Hematopoietic Stem Cell Transplant is an intravenous cell replacement process that induces stem cells to replace the damaged cells affected by radiation treatment.
Hematopoietic Stem Cell Transplant has been in widespread use from the early 1960s and has been prominent in treating and curing carcinogenic and autoimmune diseases. Multiple Sclerosis is often treated with this method.

Peripheral blood stem transplant:

Peripheral blood stem transplant is a form of hematopoietic Stem Cell Transplant (HSCT) that is used in Autologous and Allogeneic Stem Cell Transplants. In this process, the stem cells are collected from the blood rather than the source, i.e the bone marrow. This process is less invasive and can be conducted from an authorized Peripheral blood stem cell (PBSC) center. The same blood that is found in the bone marrow is found in the bloodstream. This process is chosen depending on the type of the disease, the stage of severity, age, and other conditions of the patient.

Bone marrow transplant:

Bone marrow transplant is a procedure that replaces the cells that are produced by the bone marrow. Bone marrow is a soft tissue that is present inside the bones in the form of a soft tissue. Stem cells are produced by the bone marrow and these stem cells become red blood cells, white blood cells, and blood platelets or form new stem cells if required. Certain cancerous and non-cancerous diseases affect the bone marrow and hence the stem cells being produced are also affected. In a bone marrow transplant, the cells are either replaced through an invasive procedure from the bone marrow or through a non-invasive intravenous procedure through the veins. Invasive bone marrow tissue transplants are only recommended when the disease is a potential threat and if the patient’s physical conditions and age supports it.

Cord blood Stem Cell Transplant:

Cord blood Stem Cell Transplant is a process that is witnessing increased adoption across the world. Like the peripheral blood and bone marrow, the umbilical cord is also a rich source for stem cells. Cord blood Stem Cell Transplants are most effective in treating children and have seen efficient results in the case of adults.
With a cord blood Stem Cell Transplant, the chances of the patient experiencing Graft vs host disorder is significantly reduced. Adding to that, Cord blood Stem Cell Transplants are the least risky in terms of transmission of diseases when compared to the other types of Stem Cell Transplants.
Preserving Cord blood stem cells is also easier, as they have a longer shelf life. Though a definitive figure on its shelf life has not been released, there are cases where cord stem cells from 10 years ago were used successfully.

Diseases that require Stem cell transplantation

Multiple myeloma
Leukemia
Non-Hodgkin lymphoma:
Hodgkin lymphoma
Myelodysplastic syndrome (MDS)
Myelofibrosis
Aplastic anemia
Autoimmune diseases

Risks

It is important to know the risks associated with Stem Cell Transplants as they help the treating doctors and the patient involved make an informed decision about the treatment options.
Major risks associated with Stem Cell Transplants include:

Graft Vs Host Syndrome
Scaly skin, itching, and Rash
Nausea, Vomiting, and abdominal cramps
Jaundice
Dry mouth, damaged lungs, esophagus and other organs
Loss of appetite
Weight loss
Infections
Cataract and Infertility

Transplant Procedure

The process of undergoing a Stem Cell Transplant is risky and not every patient is advised to undergo this process due to factors which include the patient’s prior medical history, his/her ability to withstand the radiation treatment and its side effects. For some patients, a reduced intensity of allogeneic treatment is advised.
Salient factors that are considered before a patient is administered Stem cell replacement are:

The patient’s general health conditions
Previous medical history
Severity of the condition
The probability of the body responding to the treatment
Availability of stem cells either from self or a donor

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Dr. Pawan Kumar Singh

Specialist: Bone Marrow Transplant Surgeon
Experience:16+ years
Hospital: BLK-Max Hospital

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Head – Haemato Oncology & Bone Marrow Transplant (Unit-1)
Dr. Pawan Kumar Singh is a Hematologic Oncologist and Bone Marrow Transplant Surgeon with 16+ years of experience.
Interests are hematopoietic BMT in both malignant & Non-malignant hematologic disorders (especially Thalassemia & Aplastic Anemia).

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Has performed more than 500 bone marrow transplants for both malignant and non-malignant blood disorders including aplastic anemia and thalassemia.
Dr. Singh has done successful Haplo BMT for SCID in an 8 months old child.
He has established BMT UNIT at Jaypee hospital for MUD transplant and got PBSC product from national (Datri) and international registry (DKMS).
Performed 50 BMTs in last 18 months at Jaypee hospital (MSD/MFD-20; Haplo-6; Auto-2 and MUD-4).
He has published a book named MCQs in Haematology and presented 3 papers at Annual meeting, 2015 of EHA in Vienna.
He is doing almost 8 bone marrow transplants every month.

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Dr. Gaurav Kharya

Speciality: Pediatric Haemato Oncology BMT Specialist
Experience:15 Years of experience
Hospital: Indraprastha Apollo Hospital

About Doctor:

Gaurav Kharya is a Clinical Lead at Center for Bone Marrow Transplant and Cellular Therapy, Senior Consultant in pediatric hematology oncology and immunology at Indraprastha Apollo Hospitals, New Delhi.
He completed his graduation from Netaji Subhash Chandra Bose Medical College, Jabalpur Madhya Pradesh. Following this, he did his post-graduation DCH in pediatric from Baba Raghav Das Medical College, Gorakhpur, UP.
In 2009, he joined his fellowship in pediatric hemato-oncology & BMT at Sir Ganga Ram Hospital which he completed in 2011.

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Kharya has vast experience in transplanting children with various blood disorders, benign or malignant, immunological diseases etc nationally and internationally.
Kharya is credited for doing the first haploidentical bone marrow transplant for sickle cell disease in India & also for doing in-vitro TCR alpha beta CD 19 depleted haploidentical BMT in a 4-month-old baby suffering from severe combined immunodeficiency who is the smallest child transplanted in the country so far.
Along with his team members at different centres, he has done more than 700 bone marrow transplants so far. His area of interest is alternative donor transplant such as haploidentical transplants and matched or mismatched unrelated donor transplants.

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Dr. Rahul Bhargava

Specialist: Hematologic Oncologist, BMT
Experience:23+ years of experience
Hospital: Fortis Memorial Research Institute

About Doctor:

Rahul Bhargava is a Leading Haemato-oncologist in India with over 23+ years of experience.
He has performed 100+ adult bone marrow transplants which are record-breaking in the whole of North India.
He is a Director of Haematology & Bone Marrow Transplant at Fortis Memorial Research Institute hospital, Gurgaon.

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He has successfully completed 400+ transplants to his credit.
Brings along with him an International experience; worked in Vancouver, Canada where he specifically trained in Umbilical cord transplant.
Member of various prestigious organizations, American Society of Bone Marrow Transplant, American Society of Paediatric Haemato-Oncology, International Society of Paediatric Oncology to name a few.
During his extensive career, Dr. Bhargava has dealt with enumerable adult and paediatric patients suffering from a wide range of Congenital and Acquired ailments. This includes Acute and Chronic blood conditions such as Blood Cancers, bleeding disorders along with inherited immune deficiency syndromes and metabolic disorders.
He is the first Indian doctor to perform and propagate a Stem Cell Transplant procedure for patients suffering from Multiple Sclerosis
The first Haploidentical Stem Cell Transplant in Gurgaon was performed by him on a patient suffering from Fanconi Anaemia patient

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Dr. Dharma Choudhary

Specialist: Hematologic Oncologist, BMT Specialist
Experience:20+ years of experience
Hospital: Sanar International Hospital

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Director and HOD
Dr. Dharma is a highly acclaimed clinician in the field of Hematology & Marrow transplant and he is widely acknowledged for his patient-centric approach.
With more than 20 years of experience.

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Dr. Dharma has accomplished over 1800 stem cell transplants, out of which he has done more than 1300 transplant procedures independently on both Pediatric and Adult patients suffering from hematological disorders.
He has been credited to set up two large Blood and Marrow transplant programs in Delhi and Mumbai.
Dr. Dharma has a special interest in transplants for Hemoglobinopathies (Thalassemia Major & Sickle Cell disease), Bone Marrow failure syndrome (Aplastic anemia /Fanconi anemia), Haploidentical transplant, Graft versus Host disease.
He did post-graduation in Internal Medicine, DM in Clinical Hematology from AIIMS (All India Institute of Medical Sciences, New Delhi) & Fellowship in BMT through the prestigious Leukemia/BMT Program of British Columbia, Canada.
He is a life member of the Indian Society of Hematology & Transfusion Medicine (ISHTM) and his work experience includes working with several governments and private healthcare institutions.
He is also a recognized teacher, guide, and examiner for DNB in Hematology.
Dr. Dharma has authored more than 60 publications in reputed international journals of high impact.
He has conducted seminars, delivered guest lectures, and presented scientific research across the globe in various meetings including ASBMT, APBMT, EBMT, and ISBMT.
He has a passion for training, teaching, and developing hematology and BMT services globally.

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Dr. Ashok Kumar Vaid

Speciality: Paediatric Oncology, Haematology & Bone Marrow Transplant
Experience:35+years of experience
Hospital: Medanta hospital gurgaon

About Doctor:

Chairman of Division of Medical & Paediatric Oncology, Haematology & Bone Marrow Transplant at Medanta Hospital, Gurgaon.
He holds an expertise in Treatment of organ specific cancers, Leukemias and Lymphomas.
He worked as the Head of the Department of Medical Oncology, Artemis Health Institute, Gurgaon.

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Awarded with the Padma Shri, the fourth highest civilian award, by the President of India on 14th April, 2009.
Member of prestigious organizations like Breast Cancer Foundation of India. Member of Indian Society of Medical & Pediatric Oncology (ISMPO), Indian.
Association of Gynae Oncologists, Indian Medical Association, American Society of Clinical Oncology, Association of Physicians of India, etc…
Ashok has been the founder member of Indian Cooperative Oncology Network (ICON), a life member of European Haematology Association, and European Society of Medical Oncology.
He has the unique distinction of having carried out the first 25 bone marrow transplants in any private sector hospital in North India.
Ashok has attended several workshops and conferences so far in the field of medical oncology.
He was worked as a Senior Resident, Tata Memorial Hospital, Mumbai, in 1990

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Dr. Rahul Naithani

Speciality: Bone Marrow Transplant, Hematology Oncology
Experience:11+ years of experience
Hospital: Max Hospital Saket

About Doctor:

Naithani is a young and energetic clinical hematologist, working as a Director – Bone Marrow Transplantation & Clinical Hematology at Max Healthcare from May 201.1
He worked at the prestigious The Hospital for Sick Children (Sick Kids) Toronto, Princess Margaret Hospital, Toronto, Canada. Then he returned from Canada and joined Max Healthcare in 2011.
He has set-up the Hematology & Bone Marrow Transplant program at Max Healthcare.

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He has already performed more than 260 BMTs for various indications.
He is deeply involved with scientific research and has to his credit more than 100 scientific publications in National and International Medical Journals.
He is one of the Best Pediatric Hemato Oncologists in Bangalore, committed to offering comprehensive medical care.

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Dr. Nitin Sood

Speciality: Hematologist
Experience:17+years of experience
Hospital: Medanta Hospital Gurgaon

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Dr. Nitin Sood is a hematologist with 17+years of experience.
He was awarded a bursary in 2011 by UK Myeloma Forum American Society of Hematology and First Prize by British Society of Hematology 2009.
Dr. Sood is a member of the General Medicine Council (GMC), UK; Royal College of Physicians, London; Royal College of Physicians, Edinburgh; Royal College of Pathologists (Haemato-oncology), UK and Membership of the Royal College of Surgeons (MRCS).

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He completed his MBBS from Govt. Medical College, and then followed MD (General medicine) from Delhi University, DNB (General Medicine) from National Board of Examination and FRC (Pathology) from Royal College of Pathologists.
His clinical interests include Haemato-oncology, haematology, Haemostasis and thrombosis, etc.

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Dr. Sameer A. Tulpule

Speciality: Haematology-oncology & Bone Marrow Transplantation
Experience:18+ years of experience
Hospital: Kokilaben Dhirubhai Ambani Hospital

About Doctor:

Dr Sameer Tulpule is an adult haematologist with over 18 years of experience in the field. He trained in haematology at the renowned Guy’s and St. Thomas’ Hospital in London.
Before joining KDAH, he worked as a Consultant in myeloid disorders and stem cell transplantation at the Sheffield Teaching Hospitals NHS Foundation Trust, UK.
He was the lead clinician for the South Yorkshire Network in myeloproliferative disorders, chronic myeloid leukemia and stem cell transplantation.

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Dr Sameer Tulpule also worked as a medical officer for Anthony Nolan which is the largest stem cell registry in the UK. Whilst at Anthony Nolan, he undertook research in stem cell transplantation looking into immune reconstitution following cord blood transplantation as well as after donor lymphocyte infusions following allogeneic stem cell transplantation.
He is a member of the Indian Society of Haematology and Blood transfusion, British Society of Haematology and American Society of Haematology.

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Dr. Chezhian Subash

Speciality: Haematologist and BMT Specialist
Experience:23+ years of experience
Hospital: MIOT Hospital Chennai

About Doctor:

Chezhian Subash is the Consultant Haematologist and BMT Physician at MIOT International.
Having trained in India and the UK, Subash has extensive experience in general haematology, laboratory haematology, haemato pathology and transfusion medicine.
His areas of interest are primarily haemato-oncology and bone marrow transplant; he is also a specialist in treating myeloma and lymphoma, besides alternate donor transplant and mismatched transplants.

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As an honorary Senior Clinical Lecturer for Hull York Medical School Dr. Subash taught house officers and senior house officers besides undergraduate students.
Chezian Subash has several papers and presentations to his credit and has been recognised for his work.
He is the recipient of several awards that include: Dr. K.C. Paul Prize for proficiency in Clinical Medicine in 1994 and Maharaja of Cochin prize for proficiency in Physiology in 1991.
He is a member of numerous prestigious associations such as the Royal College of Pathologists, Royal College of Physicians of London, and the British Society for Haematology.

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Dr. Rohan Halder

Speciality: Haemato Oncology & BMT(Paediatrics)
Experience:11+years
Hospital: Artemis Hospital

About Doctor:

He gained experience in management of a variety of plasma cell disorders, lymphomas and extra nodal lymphomas.
He started his training in Haemato-oncology from Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow.
His DM training in Clinical Hematology from All India Institute of Medical Sciences,(AIIMS) New Delhi,

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He underwent extensive training in hematology and an intense training in hematopoietic stem cell transplant.
During his DM training he was awarded the Indian Council of Medical Research grant for thesis which is granted to the 50 best post graduate thesis every year.

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Providing a doctor’s opinion and proper quotation
Selecting the best hospital and doctor as per your case
Arranging a call with the doctor (if the case required)
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Providing full guidance how to get Visa from your country
Providing total cost including treatment, air tickets, accommodation, and food
Assitance to book flight ticket from your country
Arranging airport pick up/ drop
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Booking accommodation and guest house as per your budget/ prefrence
Providing help in money exchanging
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