Principal Director and Head, Pediatric Hematology Oncology and Bone Marrow Transplant, Fortis Memorial Research Institute, Gurgaon, India
Part 10 of 14 in BMT in Sickle Cell Anaemia and Other Haematological Disorders
Life After Bone Marrow Transplant: Recovery and Immunosuppression
August 6, 2026
Most sickle cell bone marrow transplant patients can stop immunosuppressive medication around one year after transplant, with only 10 to 15% of patients needing it for longer. Dr. Vikas Dua, Principal Director and Head, Pediatric Hematology Oncology and Bone Marrow Transplant at Fortis Memorial Research Institute, Gurgaon, shared this outcome data as part of his Jivo Masterclass on bone marrow transplant in India.
How Stem Cells Are Collected
For a related donor, whether a matched sibling or a haploidentical parent, stem cells are collected in a setting similar to a blood bank. Dr. Vikas Dua describes the process as painless and low-risk for the donor. Collected stem cells can be cryopreserved, and Fortis checks that a sufficient stem cell dose has been collected in-house before proceeding, ensuring the transplant has the best chance of success.
What Happens After Transplant?
Following transplant, patients are monitored closely as the donor stem cells engraft and begin producing healthy blood cells. Immunosuppressive medication is used during this period to prevent the body from rejecting the new cells. Dr. Vikas Dua notes that this medication is usually stopped around the one-year mark for most patients, with only a smaller subset, around 10 to 15%, requiring longer-term immunosuppression due to ongoing chronic complications.
Fortis Memorial Research Institute's Transplant Capacity
Fortis Memorial Research Institute, Gurgaon currently has 20 beds dedicated to bone marrow transplant, with plans to expand to 38 beds within the following year. The centre uses positive-pressure rooms to protect immunosuppressed patients from infection, and is staffed by a team of six paediatric and six adult haematologists. The centre celebrated its 1,000th transplant milestone roughly three years before this masterclass and has since performed over 1,800 transplants in total, more than 150 of them for sickle cell disease specifically.
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This article is based on a Jivo Masterclass session conducted by Dr. Vikas Dua, Principal Director and Head, Pediatric Hematology Oncology and Bone Marrow Transplant, Fortis Memorial Research Institute, Gurgaon, India. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass — Dr. Vikas Dua taught doctors across Africa on July 28, 2024.
FROM THE LIVE Q&A
Dr. Navala Gabriel
Can the same principles apply in children with cerebral palsy?
Dr. Vikas Dua
That's a very good question, but there is no role of bone marrow transplant in cerebral palsy. There are researches going on about whether transplant helps for cerebral palsy, but we don't have an answer in black and white — at the present moment there is no indication for doing a transplant for cerebral palsy.
Frequently Asked Questions
Is there any age limit for successful bone marrow transplant in sickle cell disease?▼
Sooner is better — it is better to do a transplant early — but we have done transplants even for adults. I showed a picture of a Nigerian person, Mr. Buhari, whose transplant was done at the age of 34, and he's doing well.
How much does the treatment cost, including accommodation, if the patient travels to India, and how long would they stay?▼
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.
How do you find HLA compatible donors, and if they have to be found in the family, what criteria are used?▼
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.
How long exactly are transplant children kept immunosuppressed?▼
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.
What is the umbilical cord transplant about, and is it done for all babies or just sickle cell patients?▼
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.
How are stem cells collected from a donor for transplant?▼
For a related donor, whether a matched sibling or a haploidentical parent, stem cells are collected in a setting similar to a blood bank. The process is painless and low risk for the donor, and the collected cells can be cryopreserved.
What share of patients need immunosuppression beyond the first year after transplant?▼
Most patients can stop immunosuppressive medication around one year after transplant, with only 10 to 15% needing it for a longer duration due to ongoing chronic complications.
How many beds does Fortis Memorial Research Institute dedicate to bone marrow transplant?▼
Fortis Memorial Research Institute, Gurgaon currently has 20 beds dedicated to bone marrow transplant, with plans to expand to 38 beds within the following year.
What precautions protect immunosuppressed patients during their hospital stay?▼
The centre uses positive pressure rooms to protect immunosuppressed patients from infection, and is staffed by a team of six paediatric and six adult haematologists.
In This Series: BMT in Sickle Cell Anaemia and Other Haematological Disorders
- 1.Bone Marrow Transplant for Sickle Cell Anaemia
- 2.Why Africa Has No Bone Marrow Donor Registry, and How Haploidentical Transplant Solves It
- 3.What Is the Best Age for Bone Marrow Transplant in Sickle Cell Disease?
- 4.Bone Marrow Transplant for Thalassemia in India
- 5.Cord Blood Transplant for Sickle Cell Disease: Is It Used in India?
- 6.Cost of Bone Marrow Transplant for Sickle Cell Anaemia in India
- 7.HLA Typing and Donor Matching for Bone Marrow Transplant in India
- 8.Matched Sibling vs Haploidentical Transplant for Sickle Cell Disease
- 9.Non-Myeloablative Conditioning: Reducing Infertility Risk in Sickle Cell BMT
- 10.Life After Bone Marrow Transplant: Recovery and Immunosuppression
- 11.Who Needs a Bone Marrow Transplant for Sickle Cell Disease?
- 12.Cure Rates for Sickle Cell Bone Marrow Transplant: What the Data Shows
- 13.Sickle Cell Disease Burden in Africa: Why Bone Marrow Transplant Matters
- 14.What Is Bone Marrow Transplant and How Does It Cure Sickle Cell Anaemia?