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Hematopoietic stem cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood. This is an established life saving procedure offered at many centers in USA / Europe, for over 30 years, with about 50,000 cases performed per year worldwide.

Few centers in India have started, with total about 500 cases per year. It is part of all the guidelines in medical field for below mentioned diseases, and is paid by insurance, mediclaim, reimbursed for government employees, many large companies, covered by schemes like ESIC, ECHS etc. This is very different from experimental and yet unproven stem cell transplant done for other diseases like heart, diabetes, liver, kidney, paralysis etc.

This is a medical procedure in the fields of hematology and oncology, most often performed for patients with certain blood cancers, and for some non cancerous diseases such as Thalassemia.

Such a transplant does not involve any surgery / operation. Stem cells are infused like a blood transfusion.

Hematopoietic stem cell transplantation has mainly two types:

  • Autologous: where patients own stem cells are used
  • Allogeneic: where stem cells are collected from donor – mainly brother or sister. If this is not feasible, stem cells can be collected from Unrelated donor or umbilical cord blood bank

Stem cell donation is very safe. Hence similar to blood donation, there are many voluntary donors worldwide. And this list is growing. HLA typing is the test done to find a matching donor. This is a blood test, something similar to blood group.

Following are some of the indications for Stem cell/Bone Marrow Transplantation: only some of the patients with these diseases are candidates for transplant.

  • Autologous
    • Multiple Myeloma, Lymphoma – Hodgkin and Non Hodgkin, intermediate risk Acute Myeloid Leukemia
    • Testicular and other germ cell tumors, Neuroblastoma, Ewing’s sarcoma
    • Recently also being offered for patients with difficult scleroderma, rheumatoid arthritis, systemic lupus erythematosus, pemphigus vulgaris, multiple sclerosis and other autoimmune disorders
  • Allogeneic
    • Aplastic Anemia
    • Thalassemia Major, Sickle Cell Disease
    • Myelodysplastic Syndrome
    • High Risk, relapsed or refractory Acute Myeloid Leukemia / Acute Lymphocytic Leukemia
    • Follicular and other low grade lymphomas
    • Myelofibrosis
    • Chronic Myeloid Leukemia, Chronic Lymphocytic Leukemia
    • Many genetic disorders diagnosed in very young children – such as immune deficiency disorders, metabolic disorders
    • Many other diseases

    Transplant requires extremely specialized centers, with dedicated units and staff. This is a highly complex medical procedure, and needs many support systems. If done well, they provide hope for many difficult or recurrent cancers and other blood diseases.