BMT, A Ray of Hope For Blood Cancer Patients

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BMT, A Ray of Hope For Blood Cancer Patients

Sunday, 03 July 2022 | HEALTH PIONEER

BMT, A Ray of Hope For Blood Cancer Patients

Even today, 90-95 per cent of the population cannot afford Bone Marrow Transplant (BMT), a special therapy for patients with blood cancers or blood disorders. Unfortunately, 90 per cent cancer centres in the so-called cancer grid are neither planning or allowing BMT units to come up. The Government must make it mandatory to have a BMT centre in each State and all the big cancer hospitals, Dr Rahul Bhargava tells THE HEALTH PIONEER

Last week, Fortis Memorial Research Institute (FMRI) at Haryana’s Gurugram celebrated its completion of 1,000 plus Bone Marrow Transplants (BMTs) at its various sites across the country.

Survivors of blood cancers and blood disorders such as thalassemia or aplastic anemia at the event echoed sentiments and were thankful to their doctors that they got a second chance of life given that the disease is still considered as a death sentence.

In 2020, BLK Super Speciality Hospital in Delhi too crossed 1,000 BMTs. It celebrated the milestone with much fanfare with the BMT recipients who included young, middle-aged as well as elderly persons.

So what’s so special about the BMT procedure that is becoming a sort of achievement in the sector?

“BMT is a suitable treatment for both cancerous and non-cancerous conditions such as sickle-cell anaemia or thalassemia. Relapse in BMT is less compared to the relapse in chemotherapy and therefore, BMT is a well-preferred treatment for blood cancers. In recent years, haploidentical BMT has been observed to give as good a result as a full-matched BMT. With scientific progress and better drugs, India is achieving the current BMT success rates,” explained Dr Rahul Bhargava, one of the leading haematologists in the country and Principal Director, Hematology, Fortis Memorial Research Institute, Gurugram.

However, a lot remains to be done. Though BMTs are on a steady rise in India, with about 3,000 transplants being performed yearly, there remains a gap as a significant number of patients with blood disorders are also adding up, Dr Bhargava said.

He pointed out that while America conducts 930 BMTs in a centre itself, just 3000 BMTs are being conducted in 72 centres across India.

In fact, it is less than 10 per cent of the actual requirement in India. Even today, 90-95 per cent population cannot afford it. No cancer centre is complete without a BMT unit. Unfortunately, 90 per cent cancer centres in the so-called cancer grid are neither planning or allowing BMT units to come up. The Government must make it mandatory to have a BMT unit in each State and all the big cancer hospitals, he suggested.

Moreover, the number of physicians dealing with only blood cancers is few and far between in the country – around 350 to 400 for a population of 1.38 billion. The challenge is that the diagnosis gets delayed.

Explaining the BMT procedure, Dr. Bhargava said: “BMT is like blood transfusion where we collect the stem cells from the peripheral blood after giving growth factors. The growth factors allow the stem cells to move out from the bone marrow to peripheral blood. It is collected from the same machine from which the platelets are collected.

“Once these stem cells are collected they are either stored or they are transfused through the veins in the body. “

Talking about the  recent advancements in the sector, he said in blood cancer, apart from chemotherapy, BMT needs to be done so that the survival rate is increased from the existing 40 per cent to 70 per cent. Moreover, recent advancements like CART-T are on the way which promises increased life to more patients.

Besides the costs involved in setting up a BMT, the sustainability, costs of improvement programmes, the required accreditation, HLA and blood banking; quality assessments, well-trained doctors and nurses are essential. The BMT should be covered under the Ayushman Bharat Scheme, so that more patients can be covered.

Also, there is a need to increase the donor availability, points out the doctor who has helped set up a few BMT centres in Government hospitals like in Bikaner and Indore.

“Only 30 per cent of patients have an HLA-matched sibling or family donor in India. Therefore, large donor registries should be created. Since BMT is not a surgery but involves only changing the blood through the recipient’s arms and transporting it to the bone marrow, creating a donor pool and spreading its awareness will make BMT accessible to people.

“With BMTs, we are successfully curing incurable diseases like leukaemia, myeloma, thalassemia and also improving the quality of life for the patients.

“Therefore, large donor registries should be created. Since BMT is not a surgery but involves only changing the blood through the recipient’s arms and transporting it to the bone marrow, creating a donor pool and spreading its awareness will make BMT accessible to people,” he stressed.

It’s not that there has been no success in the sector. In cancers like Multiple Myeloma, if survival was three years, now it is six to eight years. Similarly, in Chronic Myelogenous Leukemia (CML) where the survival was five, it is now 30 years. So many people are getting cured due to newer sophisticated drugs in the sector. So, one must understand that blood cancer is no longer a death sentence and if detected early, it can be cured. It’s time we end the stigma; spread awareness about the disease to ensure early diagnosis and treatment, said the doctor.

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