Autologous Bone Marrow Transplant

In an autologous transplant, the patient’s own stem cells are collected before high-dose chemotherapy and stored. After chemotherapy destroys the diseased marrow, the stored stem cells are given back to the patient through a drip to rebuild healthy bone marrow. This type is commonly used for multiple myeloma and certain lymphomas where the patient’s own cells are unaffected by the underlying disease.

Allogeneic Bone Marrow Transplant

In an allogeneic transplant, stem cells come from a matched donor, either a family member or an unrelated matched donor. The donated stem cells replace the patient’s diseased marrow and also help the immune system fight any remaining cancer cells. Allogeneic transplant is used for leukaemia, aplastic anaemia, thalassaemia and other conditions where the patient’s own cells cannot be used. Donor compatibility is assessed through HLA (tissue type) matching before the procedure is planned.

The Bone Marrow Transplant Process at Kamineni Hospitals

Step 1: Pre-Transplant Evaluation

Before a bone marrow transplant is confirmed, the haematology team at Kamineni Hospitals evaluates the patient’s diagnosis, disease stage and overall fitness. Tests include bone marrow biopsy, blood tests, organ function assessment (heart, lungs, kidneys and liver), infection screening and HLA typing for allogeneic cases. A multidisciplinary team reviews each case before finalising the transplant plan.

Step 2: Donor Matching (for Allogeneic Transplant)

For allogeneic transplants, a suitable donor is identified through HLA matching. A close family member, typically a sibling, is tested first. If no family match is available, the search is extended through matched unrelated donor registries. The degree of match directly affects transplant planning and post-transplant management.

Step 3: Conditioning

Before the transplant, the patient receives high-dose chemotherapy, sometimes combined with radiation, to destroy the diseased bone marrow and suppress the immune system. This is called the conditioning phase. The intensity of conditioning depends on the patient’s diagnosis, age and overall health.

Step 4: Stem Cell Infusion

Stem cells, either the patient’s own harvested cells or donor cells, are infused through a central line into the bloodstream. The cells travel to the bone marrow and begin producing healthy blood cells. This process, called engraftment, typically takes two to four weeks.

Step 5: Post-Transplant Care and Monitoring

After the transplant, patients are monitored closely for signs of engraftment, infection, graft failure or graft-versus-host disease (in allogeneic cases). Blood counts are checked daily during the early recovery period. The haematology team at Kamineni Hospitals manages immunosuppressant medicines, infection prevention and long-term follow-up care.

Conditions Managed During and After Transplant

• Graft-versus-Host Disease (GvHD): A complication of allogeneic transplant where donor cells attack the patient’s tissues, managed with immunosuppressants.
• Infections: Patients are at higher risk of serious infections during the period of low blood counts and are managed with preventive and therapeutic medicines.
• Graft Failure: Rare cases where the new stem cells do not engraft adequately are managed by the transplant team.
• Organ Complications: Heart, lung and kidney function are monitored throughout the transplant and recovery period.

Diagnostic Tests and Workup

• Bone Marrow Biopsy: confirms diagnosis and disease stage before transplant planning
• HLA Typing: tissue matching for donor identification in allogeneic transplant
• Complete Blood Count (CBC): baseline and daily monitoring during transplant
• Liver and Kidney Function Tests: organ fitness assessment before conditioning
• Echocardiogram and Lung Function Tests: cardiac and respiratory fitness evaluation
• Infection Screening: viral and bacterial screening before conditioning begins
• Bone Marrow Aspirate: disease response assessment at key stages