1. What is Bone Marrow
Transplantation (BMT) ?
DHARAMSHILA BLOOD
AND MARROW STEM
CELL TRANSPLANT
CENTRE

2. What is Bone Marrow
Transplantation?
Stem Cells from the Bone marrow produce
blood cells essential for survival. In
conditions, where a cancer is arising from
the bone marrow or the immune system is
damaged or diseased, healthy blood stem
cells can be transplanted (infused into
patient’s blood steam) after appropriate
treatment to save the life.

3. What are stem cells?
Stem cells are the most primitive cells
which can differentiate to various other
dedicated cells, such as nerve cells, bone
cells, liver cells, blood cells etc. The most
primitive stem cell gets committed to
organ-specific stem cells and thus form
either blood stem cells or nerve stem cells.

4. What are the sources of Blood Stem Cells?
• Bone Marrow : This is the natural reserve for blood stem cells. They are located in
the centre of most large bones in an adult or all bones in children. Given the need of
the body, they form the appropriate number of red blood cells, white blood cells and
platelets, This is conventionally carried out by obtaining bone marrow cells from the
donor under anaesthesia (this is usually obtained from hip bones) and infusing this in
the patient (similar to blood transfusion) after the ‘conditioning’ has been completed.
• Peripheral Blood : Normally, there is only an occasional blood stem cell in our
circulation. However, when a blood grown factor (G-CSF) is injected, this stimulates
the committed stem cells from the bone marrow to spil over in the circulation. If we
count the number of blood stem cells after 3 doses of G-CSF daily, this would have
increased by several hundred times. This is called mobilization. At this time, we can
collect and concentrate these stem cells from the blood itself by a machine called cell
separator, without the use of anesthesia.
• Umbilical Cord Blood : Placental along with the umbilical cord are waste products of
pregnancy. However, in the mid-1980s, it was found that an amazingly high
concentration of stem cells was present in the cord blood which is discarded. Since
the efforts have been made to collect and store cord blood units from random
pregnancies and also directed collections from further childbirth in an affected family
where BMT is found necessary.

5. WHAT ARE THE DIFFERENT TYPES OF
BONE MARROW TRANSPLANTATION?
• Autologous BMT : Standard dose of chemotherapy can
not always cure a cancer and high dose of
chemotherapy or radiotherapy is often needed. However,
such high doses of treatment damage the patient’s bone
marrow irreversibly. The blood stem cells are collected
from the patient before administering high dose
chemotherapy under these circumstances and stored.
This is infused back to the patient once the high dose
chemotherapy has been administered.
• Allogenic BMT : The blood stem cells are obtained from
the peripheral blood or bone marrow of a donor who is
suitably matched to the patient.

6. WHO NEEDS BONE MARROW
TRANSPLANT ?
• Blood Cancers : Any blood cancer (leukemia) or lymph gland cancer (Lymphoma)
which is not completely cured with chemotherapy or recurs after completion of
chemotherapy (relapse), can be cured with BMT in about half of those.
• Thalassemia and other genetic conditions : In these conditions, the defective bone
marrow cells can be killed by chemotherapy and replaced by marrow from a healthy
donor. The chances of success in these conditions, if carried out early enough are 80
– 90%.
• Aplastic Anaemia and related conditions : In these conditions, the bone marrow
does not produce enough stem cells and healthy stem cells can repopulate the bone
marrow with less amount of ‘conditioning’.
• Other cancers : Many other cancers which do not arise from the bone marrow can
be cured by infusing patient’s own stem cells which could be collected and frozen
before administration of high dose chemotherapy. Lymphomas, Brain Tumours and
many other cancers of childhood respond to this treatment called ‘Autologous
Transplantation’.

7. WHO CAN BE A DONOR FOR BMT?
• Donor for BMT has to be matched with the patient in their ‘tissue type’. This
is confirmed by typing their HLA antigens.
• Family Donor : Within a family, there is about 25-30% chance of finding
such a match in a brother or a sister. Parents match with the children in only
one half of HLA type. If there is no match within the close family, the
chances of finding a fully matched donor in distant relatives is remote.
• Volunteer Unrelated Donors : To find a match with a random person is
less than one in a billion. However, if we screen million people of similar
ethnic background, we might find a close match. Based on this concept,
volunteer unrelated donor registries have been set up in all developed
countries and they are the major source of blood stem cells in all these
countries. Several such registries worldwide provide over a million donors
who volunteer to donate marrow if needed. The best chances of finding a
match are within the same ethnic community. Unfortunately, no such
registry exists in India at present.

8. WHO NEEDS BONE MARROW
TRANSPLANT ?
• Blood Cancers : Any blood cancer (leukemia) or lymph gland cancer (Lymphoma)
which is not completely cured with chemotherapy or recurs after completion of
chemotherapy (relapse), can be cured with BMT in about half of those.
• Thalassemia and other genetic conditions : In these conditions, the defective bone
marrow cells can be killed by chemotherapy and replaced by marrow from a healthy
donor. The chances of success in these conditions, if carried out early enough are 80
– 90%.
• Aplastic Anaemia and related conditions : In these conditions, the bone marrow
does not produce enough stem cells and healthy stem cells can repopulate the bone
marrow with less amount of ‘conditioning’.
• Other cancers : Many other cancers which do not arise from the bone marrow can
be cured by infusing patient’s own stem cells which could be collected and frozen
before administration of high dose chemotherapy. Lymphomas, Brain Tumours and
many other cancers of childhood respond to this treatment called ‘Autologous
Transplantation’.

9. CONTACT
If you would like to refer a patient to one of our consultants please contact
us through our referral helpline or e-mail a referral letter.
Whenever you have a general enquiry about our BMT Centre, please do
not hesitate to contact us at
Dharamshila BMT Centre
Dharamshila Hospital And Research Centre, Dharamshila Marg,
Vasundhara Enclave, Near New Ashok Nagar Metro Station, Delhi 110096
(India).
Helpline : +91-8130000120
Ph. No. : +91-43066666, +91-43066518
E-mail : contact@dhrc.in
Web : www.dhrc.in, www.dharamshila.com

10. CONTACT
If you would like to refer a patient to one of our consultants please contact
us through our referral helpline or e-mail a referral letter.
Whenever you have a general enquiry about our BMT Centre, please do
not hesitate to contact us at
Dharamshila BMT Centre
Dharamshila Hospital And Research Centre, Dharamshila Marg,
Vasundhara Enclave, Near New Ashok Nagar Metro Station, Delhi 110096
(India).
Helpline : +91-8130000120
Ph. No. : +91-43066666, +91-43066518
E-mail : contact@dhrc.in
Web : www.dhrc.in, www.dharamshila.com