Introduction

Bone marrow is a small, soft, spongy tissue located inside the bones. Bone marrow produces cells called stem cells, which play a most important function in the body by the production of red blood cells, white blood cells and platelets. The production of these cells helps in oxygen supply all over the body and also protects the body against infection. During a defect in the normal functioning of these bone marrow cells, doctors recommend bone marrow transplantation. This defect can occur due to a disease, such as cancer, aplastic anaemia, etc. Under such conditions, when normal drug therapy fails, transplantation is required to ensure the survival of the patient. However, there are various debates on the availability of technology and bone marrow cost in India. 

Types of bone marrow transplantation

There are three different types of bone marrow transplantation:

• Autologous transplantation: In this kind of transplantation, the patient’s own cells are collected when their disease level is at a low level and are then reintroduced. This method is usually followed when the chances of rejection are very low and when there is no chance of disease relapse. 
• Allogeneic transplantation: This procedure involves the collection of stem cells from a healthy individual and then transferring them to the patient. Stem cells from the donor should match the patient cells exactly for transplantation. Donors considered here shall include brothers, sisters or any compatible siblings.
• Haploidentical transplantation: In this method, stem cells that are 50% matched to healthy individuals are selected for transplantation. Donors include parents, cousins, siblings, etc. This method has increased the success rate of transplantation and, thereby, the chances of survival of the patients.
• Synergistic transplantation: This rare method includes the transplantation of cells that are usually donated by identical twins. There is a minimal chance of rejection from the patient, making this transplantation highly successful. 

Procedure for stem cell transplantation

It includes various steps such as pre-screening of the patient and the healthy donor, organ selection, stem cell collection and later, the infusion:

• Step 1: Pre-screening test for the patients: In this preliminary step, the patients are screened thoroughly to determine if they are fit for transplantation. It includes liver tests, kidney tests, lung function tests, 2D echo, ECG, CT scan, MRI, biopsies, etc. This screening gives complete information about the patient if the patient is fit for transplantation 
• Step 2: Donor selection and matching: Screening of the donor is also conducted in order to reduce the risk of rejection. The donor’s blood samples are also collected and checked via all routine tests, including CT scans, MRIs, biopsies, etc.
• Step 3: Collection of the stem cells: After screening the patient and the donor, stem cells are collected from the donor or the patient itself if they are fit for transplantation. After the collection, it is filtered and preserved under a suitable temperature.
• Step 4: Conditioning therapy: During this step, the patient undergoes their prescribed therapeutic regimen, such as chemotherapy and radiation therapy, with the aim of destroying the diseased bone marrow cells and preventing rejection during transplantation.
• Step 5: infusion of stem cells: Once the patient completes the above-mentioned steps, the collected stem cells are then injected intravenously. Once these cells reach the exact site, they start to grow and form new cells, retaining their normal functions and further reducing the risk of death to the patient.

Advancement in bone marrow transplant in India 

Over recent years, there has been a steep rise in the advancements in bone marrow transplantation in India, which has efficiently reduced the cost burden and improved the overall survival of patients. However, bone marrow test prices in India are still a concern in many parts of the nation. However, the best hospital for bone marrow transplant in India offers discounts and financial assistance. 

• CAR-T (chimeric antigen receptor T-cell therapy): This is one of the most booming topics in the field of cancer. This therapy usually involves the destruction of the cancer cells by using the patient’s own T cells. These cells are genetically modified and introduced into the patient’s body, carrying special structures called CAR-chimeric antigen receptors with the capacity of the cancer cells. This is the most highly recommended therapy in relapsed or refractory cancers, such as leukaemia, lymphoma, and multiple myeloma.
• Next-generation sequencing: This advancement helps to identify the genetic changes that are causing the disease. Therefore, a modification in the genetic level can be achieved to prolong the patient’s life. This allows the better usage of personalised medicine and helps achieve the desired treatment outcomes.

It has been observed that there is a huge rate of success for these transplants in India. It has effectively reduced the cost burden of curing the underlying disease, preventing the disease relapse and providing a better quality of life to the patient. The major concern is bone marrow test cost in India. However, some committees try to offer assistance. Getting a consultation from the best bone marrow transplant doctor in India would reduce the long-term costs. 

Conclusion

There are various advancements globally in the field of bone marrow transplantation, and India holds a special place by contributing to the fullest. Healthcare in India has grown a lot in the past decade, and it has been the same with bone marrow transplantation. We could also see many future advancements in India. Additionally, we could also see a cut cap in bone marrow treatment cost in India.