|Stem Cell Harvest
|Post SCT follow clinic
|OP Procedures (BM Aspiration / Lumbar Punctures)
||Monday to Saturday
||Monday to Saturday
||Monday to Saturday
The Hematology Department looks after people with problems in their blood. This includes leukemia, some forms of anemia (like Sickle Cell) and congenital (from birth) diseases like thalassaemia and hemophilia.
Problems seen include
- Thalassaemia - a genetic problem with the blood
- Bone marrow failure syndromes such as aplastic anemia.
- Blood cancers such as leukemias, lymphomas (cancer affecting lymph nodes) and multiple myeloma.
- Bleeding disorders like hemophilia and platelet related disorders.
About Bone Marrow Transplant – BMT
BMT takes cells from inside the bones from a healthy person and gives them to the person who is sick. The bone marrow is where the white blood cells, RBC and platelets are made. Bone marrow transplants are done for people with leukemia, thalassaemia, myeloma and aplastic anemia.
Treating the disease
First, the bad bone marrow that has caused the disease, like leukaemia, must be killed/destroyed to get rid of the bad cells. This is done with radiotherapy (xray treatment) or large doses of chemotherapy (drugs).
Getting new cells – from relatives
Then the transplant can start. Bone Marrow Transplants come from a living person who is called the donor, this is often a relative – a small operation takes some cells from inside the healthy person's bones to give to the sick person. This is an allogenic transplant. The good donor cells are given to the patient though a needle in the arm – just like a blood transfusion.
Getting new cells – from the patient
Some transplants take the patients own cells – this is an autologous transplant. This is done if there is no relative with blood like the patients blood (no match). First the patient has chemotherapy to get rid lots of the bad cells causing the leukaemia. When in remission the good healthy cells grow Remission is when there are no bad leukaemia cells left. Growth factor is given to help the cells multiply so there are enough for the transplant. Good cells that are very young can be separated from the rest of the cells. These stem cells are so young that they have not yet grown into the different types – leukocytes, lymphocytes etc When the white blood count is high enough the patient has blood taken. This is a bit like donating blood but the blood goes into a cell separation machine. Here the stem cells are taken out (separated). But the rest of the cells are put back in the patient. It just takes 2-4 hours. Autologous transplants are done mainly for patients with multiple myeloma. It mobilizes peripheral blood stem cells.
Bone Marrow Transplant in CMC
The department started its BMT program in 1986. Hematology does about 30 autologous & 80 allogenic bone marrow transplants / stem cell transplants (SCT) a year. There are special rooms for the patients. The rooms stop them from getting infections when the transplants are done. The transplants are done for leukemia, lymphoma, some marrow failure problems and genetic disorders. Bone marrow failure is when the marrow stops making blood cells. Genetic problems are things like thalassaemia. Between 1986 and 2007, over 700 allogenic and about 200 autologous SCT have been done.
Hemophilia is a genetic disease mainly in boys. There is a gene that does not make the clotting factor properly. So, the boys bleed very easily from very small accidents. They also bleed into muscles and joints eg knees and elbows. Treatment: The clotting factors can be injected into patients to stop the problem. BUT the factors are very expensive and in India most people cannot afford them. Care is given for all these problems for patients with hemophilia. The hematologists look after the blood problem. They also work with the Orthopedic surgeons and physical medicine and rehabilitation doctors for the muscle and joint problems. The muscle and joint bleeds cause pain and stop people using their arms and legs properly.
Thalassemia is a genetic disease. The child is born with a gene that makes bad hemoglobin. Patients start getting problems as a child. BMT is used to treat Thalassemia and 60 transplants have been done so far with a success rate of 75% even though most of the patients are in Class II or III.
Molecular Genetics and Antenatal Diagnosis
In most patients and carriers with thalassaemia a test is done that finds the gene causing the problem. A carrier is someone who has the abnormal gene but it does not cause any problems. The test is done by looking at the patients DNA (chromosomes). The department can also give an antenatal diagnosis. This means that when a lady is only 8 weeks pregnant they can look at the baby. They test to see if the baby has the abnormal gene that would give the child thalassaemia.
Financial AID for Patients
The department tries to get money to support for patients who find it difficult to pay their medical bills. This is mainly for the patients on the general ward. Around 450-500 patients are given financial assistance every year. The money comes from the Prime minister’s fund, Chief minister’s fund, charitable trusts and philanthropic individuals who want to help others.
Some of the Investigations & Procedures done at Hematology Unit are:
- Bone Marrow Transplantation
- Stress Cytogenetics
- Expansion of Cells