DoctorsForGood: A cancer surgeon answers FAQs about bone marrow transplant

By: Dr. Biswanath Gouda

Published On: November 01, 2018

Cancer surgeon Biswanath Gouda answers commonly asked questions surrounding a bone marrow transplant procedure. Read on! 

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According to this report in the Economic Times, the success rate of transplants in cases of uncontrolled blood cancers has been 20% while it is 80% in young and fit patients living with blood disorders like aplastic anemia. 

In 2015, approximately 1500 BMT cases were recorded from 11 centers and since then, a lot more centers have come up. A bone marrow transplant, evidently has been instrumental in saving a lot of lives. 

However, people still remain unaware of this procedure and its potential. We got HPB surgeon Biswanath Gouda, practicing at St. Elizabeth Hospital and Somaiya Superspeciality Hospital, Mumbai, to answer some FAQs surrounding a BMT. Have a look:

What is a bone marrow transplant? 

“A bone marrow transplant is a surgical procedure which is done on patients whose bone marrow is either infected during disease or needs repairing after chemotherapy. 

In a bone marrow transplant, we inject blood cells or marrow cells into the patient. The cells that are injected can belong to the patient itself or can be from another patient as well if they match.”

Under what circumstances is a bone marrow transplant required? 

“There are many cases in which a person might require a bone marrow transplant. The procedure is often conducted for patients suffering from blood disorders like Leukemia, Lymphoma, Anemia, etc. In blood disorders, the blood cells of the patient are defective, and that’s where the marrow helps.

bone-marrow-transplantThe other category of patients include those that have received chemotherapy or radiation. Sometimes due to these treatments, the marrow gets totally destroyed. A BMT then helps in boosting the immunity and survival of the patient. They can fight and survive longer after the treatment is done.”

What is the procedure to indicate whether a person is applicable for a BMT?

“Before undergoing a bone marrow transplant, patients have to visit a Hematologist, who is a specialist in blood cells. There are different criterias and parameters where you asses the blood count, how many blood cells are depleted, what kind of cells would be helpful for the body etc.” 

What are some of the complications that can arise with a BMT?

“There are times when the body can reject the transplant. It’s one of the most dreaded complications that arises. The other complications include internal bleeding, infections. 

In order to avoid these situations, the patients are kept in a very sterile environment  as there should be no scope of infection for the patient. There are some cases where patients also suffer from multiple organ failure.

bone-marrow-transplant-procedureMost of the patients that undergo a bone marrow transplant are incredibly weak due to either chemotherapy or certain blood disorders that they suffer from. Doing a BMT in such patients is a risky business. A patient who is about to undergo BMT should always be counselled about the pros and cons of the procedure.”

What are some of the misconceptions surrounding a BMT?

“In India there are so many spiritual leaders who tell people all kinds of stories. I believe that a patient who is about to undergo a transplant should consult the doctor and not these babas. There are many superstitions that exist regarding medicine, especially transplants. 

More than the patient, its the relatives who fall into such traps and that shouldn’t happen. Most people are half educated through Google and that’s very dangerous. These patients are sick and critical and hence need adequate treatment, without which they can’t survive.”

Is there an age limit for a patient undergoing a BMT?bone-marrow-transplant-young-patients“There is no age limit as such to undergo a BMT. But we usually don’t operate on people above the age of 70 years. The benefits of a BMT are less for this age group. If the patient is healthy and if we believe he/she will be able to benefit from the BMT, then we go ahead otherwise we usually don’t.”

How is a BMT different from a liver or a kidney transplant? 

“A bone marrow transplant is very different from a liver or a kidney transplant- these are called solid organ transplants. It involves getting an organ from a donor, an entire surgical procedure. A BMT is not as extensive. It just involves drilling holes into the hip bones and injecting cells. 

That’s about it. It’s only the word transplant which is comparable here. Nowadays in India, there are many centers that do it prudently. 5 years ago we didn’t have these many centers. Earlier when the patient had to undergo a BMT, he/ she would travel to London or New York.”

How long does a patient need to be in the hospital after a BMT?

bone-marrow-transplant“A patient is usually kept under observation for 2-3 weeks after the transplant, because once a BMT is conducted, we have to make sure the patient’s body is responding well to it. It’s a critical window to judge a patient’s recovery.”

-As told to Rukmini Chopra

We suggest you also read: 

World Heart Day: A Cardiothoracic Surgeon Answers Questions And Clears Misconceptions About Heart Transplants

The Curious Case Of Benjamin Ward: A Neurosurgeon's Take On Treating Depression With Surgery 

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