Bone Marrow Transplant for Thalassemia in India

For a matched sibling donor transplant, roughly it is around $25,000 for the transplant; for a half-match transplant it is around $35,000. For accommodation and other logistics you need $10,000 more — so roughly $35,000 for a full match and $45,000 for a half match. The stay is around three months.

We do HLA typing of the patient and siblings — there's a 25 to 30% chance the siblings are a complete match to the patient on HLA. So you need to do HLA typing and you will come to know whether you have a full match in the family or not.

Usually after one year we stop all the immunosuppression — only 10 to 15% of patients need it for a longer duration, but in the majority of patients we stop immunosuppression after one year of transplant.

When a newborn baby is born, from the placental side of the cord, 25 ml of stem cells are collected and go to a public bank or a private bank, and later, if you want to do a transplant, you can use that unit. You can do it for any condition, but in India we don't prefer cord blood transplants because there are quite a number of issues with them — that's why we prefer adult donor transplants over a cord blood unit.

There is no role of bone marrow transplant in prostate cancer — none, and no research on it either. On registries: the biggest bank is in Germany, the second biggest in the US, but there are many other banks in other parts of the world — there isn't even a single bank in Africa. That's one of the reasons transplants aren't happening in Africa, other than South Africa and some in Benin City, Nigeria. All of you need to come together and have your own registry, so that if somebody requires stem cells, you have your own bank — you people have to come out with the solution.

India is described as the thalassemia capital of the world, and Indian transplant centres, including Fortis Memorial Research Institute, Gurgaon, have built extensive clinical experience treating the condition given its scale in the country.

The first successful thalassemia transplant was performed in 1981, more than a decade after the first successful bone marrow transplant for leukaemia in 1969.

Many of the same principles apply to both conditions, including HLA typing, the choice between a matched sibling and haploidentical donor, and modern conditioning protocols, even though thalassemia and sickle cell disease are genetically distinct.

Yes. As with sickle cell disease, a haploidentical parent donor is an option for thalassemia transplant when no matched sibling is available.