Kerala - Thiruvananthapuram   

Cancer centre sets up bone marrow transplant unit

Thiruvananthapuram: The Regional Cancer Centre (RCC) has acquired a modern bone marrow transplant (BMT) unit, which will help the institute offer both autologous and allogeneic bone marrow transplants to those suffering from acute leukaemias or myelomas.

The BMT unit, with sophisticated machinery and patient care units that meet international standards, has been set up at a cost of Rs.2.5 crore using the State Government’s Plan funds (2006-07). With this, the RCC has become the first ever institution in the Government sector in the country to offer this expensive but life-saving procedure.

Health Minister P.K. Sreemathy will inaugurate the unit on October 6. Some other equipment acquired by the RCC, including a radiotherapy simulator and three X-ray units would also be inaugurated on the day.

Bone marrow is the soft tissue inside bones, which produces the red and white blood cells and platelets, which are vital for the body’s immune functions. When certain diseases of the blood, like leukaemia, occurs, the high dose of chemotherapy used to destroy the cancer cells can also damage the normal blood cells, requiring a BMT.

One way of transplanting bone marrow is to take it from a donor’s hip bone, separate the stem cells and then infuse it into the patient’s veins. This will be naturally carried to the bone cavities, where it will generate fresh marrow. But this is a painful procedure and is done under anaesthesia. Of late, after discovering that a good yield of stem cells can be harvested directly from blood, specialists use the method called Peripheral Blood Stem Cell Transplant (PBSCT) for drawing stem cells, which are then transplanted on the patient.

RCC has been using this method in a limited way for its multiple myeloma and lymphoma patients. It has so far done about 50 cases and the outcome has been good. About 150 new cases of paediatric leukaemia and over a 100 cases of the disease in adults are treated at RCC every year.

The BMT can be autologous or allogenic. Autologous transplant involves isolation of healthy marrow or stem cells from the patient’s own blood before he undergoes high-dose chemotherapy. This is cryo preserved and re-infused to the patient’s body after completion of the chemo treatment.

Allogenic transplant involves a donor, usually a sibling, whose tissue exactly matches the patient’s. Stem cells harvested from the donor are then put into the patient’s veins.

This is a very complicated procedure as despite a perfect tissue match there is always the possibility of graft rejection.

The post-transplant period is highly critical because the patient’s immune system will not be functioning properly and he/she will be at serious risk of developing infections. The recovery period could be anywhere from four to six weeks.

The decision as to which of these procedures can be opted for a patient depends on the type of the disease and how far it has damaged the bone marrow. If the marrow has undergone extensive damage, an autologous transplant may not be possible. In the case of leukaemia, allogenic transplant is required.

A bone marrow transplant is not a procedure for every one and is adopted for those who fail the standard treatment or whose cancer has been coming back.

The cost of autologous BMT will come to nearly Rs.4.5 lakh at the RCC and could be more expensive in the privet sector.

Apart from sophisticated machinery for stem cells separation and cryo preservation, much of the investment has gone into creating the specialised nursing unit with a highly sterile environment for post-transplant recovery.

The RCC is also trying to augment its blood bank facilities as a lot of blood products are required for the patient in the post-transplant period.

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