Stem Cells Transplant for Nigerian Patients in India

Stem cell transplant​

Stem cell transplant (also known as a hematopoietic stem cell transplant (HSCT) or bone marrow transplant) is a therapy to replace damaged or diseased blood-forming stem cells with healthy stem cells. It is primarily used for some types of blood cancer, inherited blood diseases and some immune-deficiency diseases.

Conditions Treated

Stem cell transplantation may be considered for such diseases as:

• Leukemia
• Lymphoma
• Multiple myeloma
• Myelodysplastic syndromes
• Severe aplastic anemia
• Sickle cell disease
• Thalassemia
• Some genetic immune diseases
• Selected metabolic disorders

How the Procedure Works?

The treatment generally involves:

Evaluation—Collection of stem cells—Preparation for stem cells—Infusion of stem cells—Recovery and follow-up. Chemotherapy (sometimes with radiation) may be administered before transplant to destroy abnormal cells or to "treat" the marrow. The stem cells are then given via an IV line. During the next few weeks, the cells travel to the bone marrow and start to make more blood cells.

Recovery After Stem Cell Transplant

• The recovery depends on the type of disease, type of transplant, age, health of the patient and complications. Patients need to be monitored closely because they can develop an infection, bleeding, complications of the organs and following allogeneic transplant, complications such as graft-versus-host disease (GVHD). Support to follow up can involve blood tests, infection prevention, medications, nutritional support and monitoring of blood-cell recovery.

Stem Cell Transplant in India

India has dedicated centres for Hematology and Bone Marrow Transplants for autologous, allogeneic and haploidentical transplants. Nigerian patients usually receive a medical-record assessment, donor-matching (if necessary), treatment planning, hospitalisation and post-transplant follow-up.

Types of stem cell transplant​

The main types of stem cell transplants are determined by sources of the stem cells. There are several major types of:

Autologous Stem Cell Transplant

An autologous transplant is when the patient's own stem cells are harvested prior to intensive chemotherapy or other treatments. The cells are preserved and then the patient is given them back.

Commonly used for:

• Multiple myeloma
• Some types of lymphoma
• Certain other cancers

The main advantage is that it is the patient's own cells that are being transplanted, thus reducing the risk of graft-versus-host disease.

Allogeneic Stem Cell Transplant

An allogeneic transplant is a transplant of healthy stem cells from another person (a donor). Donor can be a sibling, a relative or an unrelated matched donor.

Commonly used for:

• Leukemia
• Myelodysplastic syndromes
• Severe aplastic anemia
• Some inherited blood diseases
• Some immune-system disorders

The immune cells from the donor may also be able to kill remaining abnormal cells; this is referred to as the graft-versus-tumor effect. But there is also the possibility of graft-versus-host disease (GVHD) in allogeneic transplantation.

Stem cell transplant 

• In a haploidentical transplant, a donor is half matched with the patient. Sometimes parents, children or siblings can be donors.
• This method has increased the number of patients who are able to receive transplants from an individual that does not match them completely.

Cord Blood Stem Cell Transplant

• Stem cells are harvested from the umbilical cord blood of children after they are born. Cord blood may be stored in dedicated cord blood banks, and can be used when an appropriate donor has not been found.
• It may be helpful where it is difficult to locate an appropriate adult donor.

Syngeneic stem cell transplant 

• In a syngeneic transplant, stem cells come from an identical twin. The genetic characteristics of the donor and recipient are virtually identical, so the chances of immune problems are relatively low.

Autologous stem cell transplant​

• An autologous stem cell transplant (ASCT) is a stem cell transplant in which a person's own stem cells are removed, frozen and then reinfused after they have received high-dose chemotherapy. It is not a transplant, unlike allogeneic transplants which do need a donor.

How ASC Transplant Works?

The treatment typically goes like this:

• Medical evaluation – Physicians determine the stage of disease, health of patient, organ function and eligibility for transplant.
• Stem cell mobilisation – Medicines are administered to make the bone marrow release stem cells into the blood.
• Stem cell collection – Blood Stem cells are taken from the blood by a process known as apheresis.
• Cryopreservation – Cells are collected and stored in a freezer until they are required.
• Intensive chemotherapy (High-dose chemotherapy): Chemotherapy is given at high doses to kill cancer or abnormal cells.
• Infusion of stored stem cells – The patient's stored stem cells are thawed and given through an intravenous line.
• Engraftment and recovery – stem cells migrate to the bone marrow and start producing new blood cells.

Conditions Commonly Treated

Autologous transplantation is very well established in:

• Multiple myeloma
• Hodgkin lymphoma
• Non-Hodgkin lymphoma
• Chosen other cancers and blood disorders
• The feasibility depends on the diagnosis, the disease response, previous treatments, age and health status of the individual.

Benefits

• Does not need a donor
• Absence of any donor immune cells causing graft-versus-host disease (GVHD)
• Permits doctors to apply chemotherapy doses that would otherwise cause a lot of damage to the bone marrow.
• Afterwards blood-cell production can be restored by the patient's own stem cells that were collected before.

Cost of stem cell transplant in Nigeria​

The cost of stem cell transplant in Nigeria varies depending on the type of transplant, underlying disease, hospital, conditioning treatment, medication and complications.

What Affects the Cost?

Key cost drivers are:

• Type of stem cell transplant
• Patient's underlying disease
• Donor matching and HLA testing for a patient's new organ transplant.
• The process of collecting and processing stem cells.
• Conditioning chemotherapy
• The fees for hospital and isolation rooms.
• Blood and platelet transfusions.
• Antibiotics, antifungals and other drugs
• Treatment of infections or other complications.
• Length of hospitalization
• Follow up and monitoring after transplant.

Stem cell transplant in Nigeria​

An advanced treatment option called stem cell transplant or hematopoietic stem cell transplant (HSCT) or bone marrow transplant (BMT) involves replacing damaged or diseased blood-forming stem cells with healthy stem cells. The use of this treatment has also increased in Nigeria especially in Lagos via special programmes.

Stem Cell Transplant Process in Nigeria

A routine treatment program might involve:

Initial consultation, HLA/donor testing, medical evaluation, conditioning treatment, stem cell collection/processing, stem cell infusion, engraftment, post-transplant monitoring. A multi-disciplinary team and follow up are required. Medication management, monitoring of the graft, surveillance for recurrence and complications are the reasons why post-transplant monitoring is important, says LUTH.

Stem cell transplant side effects​

Side effects of a stem cell transplant are due to the use of intensive chemotherapy or radiation therapy prior to the transplant and to the fact that the body's immune system is suppressed during the first few months following the transplant until the new stem cells have taken hold. Side effects will depend on the type of transplant, disease being treated, conditioning treatment and general health.

Common side effects which are short term include:

• Fatigue and weakness
• Nausea and vomiting
• Loss of appetite
• Mouth and throat sores (mucositis)
• Hair loss
• Diarrhea or constipation
• Fever and infections
• Low blood levels of red blood cells (anemia)
• If you have a white blood cell count below normal, you may be at higher risk for getting infections.
• Thrombocytopenia (low platelet count) that can lead to bruising or bleeding

Important Complications

• Infections

• Graft-versus-host disease (GVHD)

• Organ complications

• Graft failure

Long-Term Side Effects

Patients with certain characteristics may have:

• Persistent fatigue

• Fertility problems

• Hormonal changes

• Cataracts

• Bone-density problems

• Secondary cancers

• Recipient with allogeneic transplant who developed chronic GVHD.

• Emotional/psychological problems

• Likely to become more susceptible to some infections.

Stem cell transplant cost​

The stem cell transplant cost also depends on a number of factors such as the country, type of transplant, illness being treated, donor needs, hospital and complications.

What Is Included in the Cost?

The following are typically included in a transplant estimate:

• Pre-transplant medical evaluation

• Tests for donor and HLA.HLA and donor testing.

• The collection and processing of stem cells.

• Conditioning chemotherapy

• Stem-cell infusion

• Protective/isolation hospitalization

• Transfusions of blood and platelets.

• Supportive medicines such as antibiotics

• Monitoring during engraftment

• Follow-up investigations

Conclusion

Stem cell transplant is a critical treatment method for certain people who have serious blood cancers, inherited blood disorders, bone marrow failure and certain immune disorders. Treatment outcomes have been enhanced and the number of people receiving transplants has increased with advances in transplant technique, donor matching, conditioning therapy and supportive care. It is a complicated process, however, and can be risky with careful consideration of each patient's history and thorough follow-up being required. Patients who are interested in stem cell transplant should speak with a highly experienced hematologist or transplant specialist to find the best treatment for their condition, donor availability and general health.

Stem Cell Transplant for Nigerian patients in India GetWellGo

Get Well Go is regarded as a leading supplier of healthcare services. We help our Nigerian clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency

• Fair costs.

• 24-hour availability.

• Medical E-visas

• Online consultation from recognized Indian experts.

• Help in choosing the best hospitals in India for Stem Cell Transplant.

• Expert hematologist with proven results in success. 

• Assistance during and after the course of treatment.

• Language Support

• Travel and Accommodation Services

• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking

• Local SIM Cards

• Currency Exchange

• Arranging Patient’s local food

FAQ

• What diseases can be cured with a stem cell transplant?

It can also be used to treat diseases like leukemia, lymphoma, multiple myeloma, severe aplastic anemia, sickle cell disease, thalassemia, myelodysplastic syndromes and some immune disorders.

• Does stem cell transplant hurt?

The infusion of the stem cells is usually painless. But chemotherapy and recovery can make people tired, nauseous, have sore mouths, get sick and become weak.

• What are the chances for recovery after stem cell transplant?

Recovery is individual and will be different for each patient. Blood cell production may start to improve in a few weeks but it can take months or more for the immune system to get back to normal and for activities to resume.

• Does stem cell transplant cure?

Stem cell transplantation may offer long-term remission or cure for some diseases and control the disease or lessen the chance of it recurring for others. Success is dependent on underlying disease and patient related factors.