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New Delhi: Stem cell
transplant in India costs a fraction of what it does abroad but
the country has very few centres where the procedure can be done
and not enough dedicated medical staff, says an expert.
Stem cell transplant, a process by which new cells are introduced
into damaged tissue in order to treat disease or injury, has shown
promise in treating various kinds of diseases, including some
cancers. However, there are only 10-11 centres in India where it
can be done, says Lalit Kumar, professor of medical oncology at
the All India Institute of Medical Sciences (AIIMS) here.
A stem cell transplant can cost up to Rs.1 crore (approx $223,000)
abroad, depending on the type of procedure, and the patient is
asked to deposit the full amount before the transplant, Kumar told
IANS.
In comparison, in India it costs Rs.10-20 lakh in private
hospitals, while in government hospitals it is much cheaper -
Rs.3-6 lakh - depending on the type of procedure, he said.
According to Kumar, stem cell transplant has shown 50 percent
success in treating certain kinds of cancers and even more in
other major conditions like beta thalassemia, a genetic blood
disorder, and aplastic anaemia, a condition where bone marrow does
not produce sufficient new cells to replenish blood cells. Stem
cell transplant has shown 70-80 percent success in treating
non-malignant diseases like aplastic anaemia.
Stem cells can be taken from siblings or family members after
tissue matching, known as allogeneic transplant, from the
patient's blood, known as autologous transplant or can be
harvested from a newborn's umbilical cord, which is a rich source
of such cells.
Among the major hospitals that carry out stem cell transplant are
AIIMS and the Army Hospital in the capital, the Tata Memorial
Centre and Jaslok Hospital in Mumbai and CMC in Tamil Nadu's
Vellore town. There are more than 500 centres in the world where
stem cell transplant is done, he said.
"Around 500 stem cell transplants are done in India in a year,
which is very small compared to the need. We need many, many more
centres in India," Kumar said.
India also needs to set up more stem cell banks and a registry of
donors, like in the West, with complete information such as blood
group and tissue matching to make it easier for matching for a
stem cell procedure, he said.
"A registry of donors is useful when a match can't be found in the
family of the patient for stem cell transplant."
Besides setting up more stem cell transplant centres or setting
aside an exclusive block in a hospital for the purpose, more
trained doctors are needed as well as hospital staff, he feels.
"There should also be more awareness among physicians so that they
refer the patients at the right time for a stem cell transplant,"
he said.
Kumar said there is a better success rate in the case of
thalassemia if the patient is referred by the treating doctor for
a stem cell transplant early.
He added that more awareness should be spread about the procedure
among the patient's family and the community.
"There is a lack of awareness about stem cell transplant among
people. Many people asked to donate stem cells, even among the
patient's own family, feel they will get weakened by donating. And
this is also true among the educated.
"Stem cell donation is just like blood donation," Kumar said.
AIIMS has its stem cell transplant wing on the seventh floor of
the cancer department. There are nine beds, and they are generally
full, the doctor said.
The hospital does about five procedures in a month. For a
procedure called allogeneic, where a genetically similar donor's
tissue is used, like a sibling or even an unrelated donor, great
care has to be taken before and after the procedure.
In some cases, despite matching with the donor, the patient can
reject the graft. Then it involves a long process of giving
immunosuppressants, or medications that help prevent organ
rejection in transplants and reduce inflammation, or steroids to
help the patient in accepting the transplant, he said.
(Ranjana Narayan can be contacted at ranjana.n@ians.in)
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