Best Countries for Bone Marrow Transplant

For bone marrow transplants, India shines with its advanced medical facilities and experienced transplant teams, providing comprehensive care at affordable rates. Turkey offers cutting-edge technology and skilled specialists, ensuring successful transplant procedures. Thailand boasts modern hospitals and a focus on medical tourism, providing quality care for bone marrow patients. Spain stands out for its top-tier healthcare infrastructure and expertise in complex medical procedures, including bone marrow transplants, ensuring optimal outcomes for patients.
Best-countries-for-BMT

Bone Marrow

Bone marrow is the term for the soft material that fills the middle of the bones.

The two different forms of bone marrow are red bone marrow, also known as myeloid tissue, and yellow bone marrow, also known as fatty tissue.

Blood stem cells, which produce new red blood cells, white blood cells, or platelets, are found in the red bone marrow.

Stem cells can be found in the yellow bone marrow, which is primarily composed of fat but can also create cartilage, fat, or bone cells.

Bone Marrow Transplant

A bone marrow transplant is a medical procedure that uses healthy bone marrow stem cells to replace damaged or diseased bone marrow. One can receive replacement cells from either the body or a donor.

Leukaemia, myeloma, lymphoma, and other cancers of the bone marrow, as well as other disorders of the blood and immune system, can all be treated by transplantation.

A bone marrow transplant is also called a stem cell transplant or a hematopoietic stem cell transplant.

A bone marrow transplant replaces the diseased or non-functional bone marrow with healthy stem cells. When they’re mature, they leave the marrow and enter the bloodstream.

Where to get these stem cells?

  • Bone marrow: Spongy tissue inside of bones. These stem cells can be derived from the patient’s body or a full-match or half-match donor.
  • Cord blood cells: In a few cases, these stem cells can also come from the cord blood cells preserved at the time of the patient’s birth.
  • Peripheral blood stem cells (PBSC): Blood-forming cells from the circulating blood.

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Reasons to Undergo Bone Marrow Transplantation

ase of a persistent ailment. When someone has one of the following conditions, BMT can replace the damaged bone marrow:

  • For cancers such as leukemia, lymphoma, and multiple myeloma.
  • In the case of sickle cell anemia and thalassemia which are two inherited blood cell diseases.
  • In the case of aplastic anemia, which is one of the conditions where the bone marrow stops making new blood cells.
  • To replace the bone marrow that has been lost as a result of large doses of chemotherapy or radiation used to treat certain cancers.
  • BMT can replace the damaged bone marrow due to recurrent infections as a result of congenital neutropenia.

A bone marrow transplant does not involve major surgery; rather, it’s likewise to a blood transfusion. BMT is like receiving blood or medicine through an IV.

  • In a bone marrow transplant, bone marrow cells are collected from a donor’s bloodstream through a needle.
  • They are then injected into a bone, characteristically a pelvic bone.
  • The new cells enter the bloodstream through an intravenous (IV) catheter or tube. Consequently, the cells find their way into the recipient’s marrow.

However, it’s an entire medical course as before the transplant, chemotherapy (chemo) is administered, and sometimes radiation is to terminate the diseased cells and marrow. Then, the healthy cells are given.

Different types of transplants

There are different types of bone marrow/stem cell transplants. The 2 main types are

Autologous transplant

  • Stem cells for an autologous transplant come from the patient’s body. In cases where cancer is treated with high-dose, intensive chemotherapy or radiation therapy treatment damages the patient’s stem cells and their immune system. That’s why doctors remove, or rescue, the patient’s stem cells from their blood or bone marrow before starting the cancer treatment.
  • After chemotherapy, the stem cells are injected back into the body, restoring the immune system and the body’s ability to produce new blood cells and combat infection. This process is also called an auto transplant or stem cell rescue.

The process

  • The patient will receive a daily dose of injections that will stimulate stem cell production at a faster and higher rate. These injections contain growth factors that supplement stem cell formation and differentiation.
  • After a few days, the patient will visit the hospital for a process known as ‘apheresis.’
  • Apheresis is a technique to draw blood from the patient’s body, circulate it in a specialized machine, separate stem cells from the blood, and finally, direct the blood back to the patient.
  • The collected stem cells are purified and frozen for further use.

Allogenic transplant

  • Stem cells for an allogenic transplant typically, come from another person, called a donor. The donor’s stem cells are injected into the patient after the patient has chemotherapy and/or radiation therapy. This is also known as an ALLO transplant.
  • Many people have a “graft-versus-cancer cell effect” during an ALLO transplant. ALLO transplants treat cancer when the new stem cells recognize and destroy cancer cells that are still in the body.

The process

  • The stem cells from an allogeneic source can be collected in two different ways – through apheresis or surgery.
  • The doctor will suggest the option that works best for the donor as well as the patient.
  • If the doctor advises apheresis, the donor will undergo a similar procedure listed above. But, if the doctor deems surgery a more suitable choice, the donor will have to undergo one.

Finding a donor: A match is a healthy donor whose blood proteins, called human leukocyte antigens (HLA), closely match the patients’ i.e., HLA typing.

Siblings from the same parents are often the best match, but another family member or an unrelated volunteer can be a match too. If your donor’s proteins closely match, the chances to get a serious side effect called graft-versus-host disease (GVHD) are less. In this condition, the healthy transplant cells attack the patient’s cells.

When a donor match is not found:

  • Umbilical cord blood transplant: stem cells from umbilical cord blood, which connects a fetus to its mother before birth are used for the transplant. After birth, it becomes obsolete.
  • Parent-child transplant and haplotype mismatched transplant: Cells from a parent, child, brother, or sister are a 50% match. These types of transplants are, however, more often used, to expand the use of transplantation as an effective cancer treatment.

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Bone Marrow Transplant Procedure

The initial phase

  • Patient’s eligibility for the procedure- a thorough physical evaluation, including routine blood tests and functional analysis of the heart, lungs, and liver.
  • Deciding which type of surgery is best suited to the patient. Accordingly, find a donor match.
  • Implanting an intravenous catheter- into a vein in the neck or the chest. This catheter will stay put during the treatment to infuse transplanted stem cells and medication into the patient’s body.

During procedure

  1. Collection of stem cells
  2. Conditioning
  3. Reduced-intensity conditioning
  4. Bone marrow transplant

Post-operative procedure

  • After the transplant into the patient’s body, the stem cells gradually reach the bone marrow via blood. With time, these stem cells differentiate and start producing different types of blood cells. This process is called engraftment and can take anywhere between 2 and 4 weeks.

Bone Marrow Transplant Cost

The following table indicates details about Bone Marrow Transplant Cost in India:

Type of TransplantAutologous BMTAllogenic BMT
  Full Match (HLA testing >80%)Half Match (HLA testing <80%)
CostUSD 15,000USD 22,000USD 40,000
DonorNot RequiredRequired
ChemotherapyRequiredRequired
Stay in Hospital25 – 35 Days1 Month
Stay in Country2 Months2 Months
Accommodation CostStarting 20 USD/DayStarting 20 USD/Day

Risks and side-effects

During this period, the patient will remain susceptible to multiple risks and complications, including

  • Infections
  • Mucositis or Mouth sores
  • Veno-Occlusive Disease of the Liver (VOD)
  • Interstitial Pneumonia Syndrome (IPS)
  • Graft-versus-Host Disease
  • Graft Failure
  • Cataracts
  • Infertility
  • New cancers

Success rate of transplants for patients with non-malignant diseases

  • With a matched sibling donor- 70%-90% survival.
  • With unrelated donors-36%-65% survival.

The survival rates after transplant for patients with acute leukemia in remission are

  • With related donors-55% to 68%
  • With unrelated donors26% to 50%

In the case of Autologous Bone Marrow transplant along with chemotherapy have improved survival rates with certain cancers such as:

  • Ewing sarcoma
  • Wilms tumor
  • Germ cell tumor
  • Neuroblastoma

Autologous transplants have not enhanced the survival rates with:

  • Paediatric malignant cancers
  • Metastatic Ewing sarcoma.

Transplants of younger patients have a higher chance of success.

Survival rates are higher in case both the donor and recipient are cytomegalovirus (CMV) negative

Life expectancy after a bone marrow transplant

People have more probability of surviving for another 15 years after a bone marrow transplant, who have been able to survive at least 5 years after a hematopoietic cell transplant without any signs and symptoms of relapse of the original disease. However, a normal life expectancy is not completely achieved.

No matter whether BMT has a great success rate, however, there may be factors on the life expectancy depending on are

  • Age and overall health of the patient.
  • Any underlying disease and its chances of recurrence.
  • Presence of any other medical condition.
  • Type of transplant.
  • Preparations are done before the transplant.
  • The health of the donor.

Recovery post-BMT

  • Recovery from a bone marrow/stem cell transplant takes a long time and has stages, starting with intensive medical monitoring after the transplant day.
  • There has to be a schedule of regular medical check-ups over the coming months and years, which must be followed most religiously.
  • The exhaustive chemotherapy treatments that are administered before the transplant damage the immune system so that the body could accept the transplant without attacking the stem cells.
  • Infections are likely to surface and are quite common. Regular blood tests and many other tests rule out emergencies, check immunity and keep a check if the donor cells have been accepted and responding properly.
  • In case of an ALLO transplant, the medications will include drugs to prevent and/or manage GVHD.

Best countries to undergo a bone marrow transplantation

  • The cost of any medical therapy should not be the main priority when it comes to your health. Nonetheless, it is equally competent to conduct in-depth research and avoid wasting hard-earned money. The US and the UK rank among the top nations for having bone marrow transplants. But not everybody can afford it.
  • A number of nations have remarkable BMT success rates. Together with numerous accomplishments and medical advancements, these nations also provide therapies at incredibly low costs. One of these nations can be one’s ideal vacation spot as they offer hospitals that have received international accreditation, top business leaders, and cutting-edge technology.
  • When compared to Western counterparts, the cost of the stay, consultation, amenities, and everything else will all be significantly reduced.

When choosing a country for the treatment, patients must consider several things, including:

  • The cost of the procedure in that nation.
  • Type and location of the hospital.
  • Experience of the surgeon.
  • Patient’s age.
  • Patient’s relationship to the donor.
  • Type of Bone Marrow Transplant.
  • The medical condition of the patient.
  • Post-surgical complications.
  • Additional lab or examination tests like X-ray, ECG, etc.
  • The survival rate of recipients of bone marrow transplants in the nation that has been selected.
  • The availability of cutting-edge medicine and a top-notch medical facility.
  • The cost of living in the nation that has been selected
  • The success rate for bone marrow transplants in the country has been circled out.

One must also consider the following aspects in addition to determining whether or not world-class treatment is both affordable and accessible:

  • Easy access from your country to the chosen country, safety in the chosen country.
  • Easy access to the local language in the selected nation.

India

Affordability: India is the greatest and most affordable choice for receiving a bone marrow transplant due to its rapid rise in medical research and technology. Hospitals & Infrastructure:
  • Numerous hospitals in the nation have received accreditation from reputable groups like Joint Commission International (JCI).
  • India’s hospitals provide the best care and treatment because they are equipped with the most up-to-date medical technology, state-of-the-art equipment, and unwavering infrastructure.
  • The necessary equipment for the surgery is offered by all bone marrow transplant institutions in India, including HEPA filter rooms, modular operating rooms, and cutting-edge labs.
  • These hospitals are investing considerable resources into developing fresh, cutting-edge medical approaches that could either eliminate the need for BMT or make it more effective.
  • Innovative therapeutic modalities like CAR-T cell therapy, effective BMT employing half-matched donors, and therapies like T-cell depletion with memory cell infusion have been implemented by hospitals in India.
  • India has a wide range of hospitals to choose from; that offer care and treatment according to one’s budget. There’s a possible option to even select medical professionals whose training and experience will accelerate recovery.
Competent & skilled medical staff
  • India has a sizable population of knowledgeable and experienced oncologists and hematologists with medical degrees from top international institutes and establishments.
  • One can be sure to receive high-quality care and holistic care at a third of the price with the premier surgeons in India.
Success rate
  • The best bone marrow transplant hospitals in India, have a startling 60–90% success rate.
Cost of medication
  • Almost 90% of the medications that are sold in the US are also available in the country, but for a fraction of the price. This is a result of both the currency-exchange factor and the cheap manufacturing cost.

Turkey

Affordability:
  • The basic tenet that low-cost healthcare is of lower quality has been refuted by Turkey. A steady rise in global medical tourists to Turkey is evidence that the country now offers top-notch treatment facilities to overseas patients.
  • Without sacrificing care or quality, a patient can receive treatment at a quarter of the price charged in developed countries like the US or the UK.
Hospitals with Hospitality:
  • Over the past few years, Turkish hospitals have demonstrated notable progress in bone marrow reconstitution and engraftment.
  • Turkish hospitals and clinics actively market their partnerships and affiliations with esteemed organizations in the West.
  • Turkish hospitals typically feature a special section devoted to assisting international patients in every stage of the treatment to make the medical trip easy and hassle-free.
Qualified and Experienced Medical Team
  • A robust group of qualified, educated, and experienced surgeons in Turkey is also responsible for the country’s rising popularity as a destination for bone marrow transplants.
  • The excellent medical care and expertise of the trained and professional medical staff provided in hospitals in Turkey are credited with the notable success rate.
  • Haematologists in Turkey stay up to date with all the most recent developments in the field of oncology owing to their extensive experience working internationally.
Quality Oriented:
  • The Turkish Ministry of Health conducts routine inspections of bone marrow transplant hospitals to ensure their quality and adherence to global standards of care.
Informational Location and Accessibility:
  • Turkey is a country that can readily be reached from practically everywhere in the world due to its location between Europe, Asia, and the Middle East.

Thailand

Cost-effective:
  • With its first successful hematopoietic transplant in 1986, Thailand has come a long way. The medical tourism sector in Thailand is at an all-time high because of the continent’s expanding population, which is traversing the globe in quest of reasonably priced healthcare.
  • A bone marrow transplant costs 70% less in Thailand than it does in the US. Even in compared to European nations, the cost of therapy is far lower.
Less waiting time:
  • Another benefit of traveling to Thailand is that there is little to no wait time for medical care. The incredibly high waiting times in nations like the US, UK, or Canada might make it difficult to prevent or recover from sickness.
Board-certified doctors and medical providers
  • Bone marrow transplant surgeons frequently leave Thailand to practice medicine or pursue additional education in nations like the USA, Japan, or Germany. The method is more precise and accurate when the skills they possess are paired with Western experience. Higher BMT success rates follow as a result of this.
  • Thailand provides the most modern and secure operations carried out by only certified and accredited personnel due to the country’s high medical tourism rate.
  • Most of the medical practitioners are licensed by American medical societies or associations from more than two nations.
  • Thailand’s Medical Council, whose standards are comparable to those of the American Medical Association, which ensures professionalism (AMA).
Accreditation:
  • Thailand has 30 healthcare organizations accredited by Joint Commission International, the premier evaluator of international healthcare quality and safety, and is the world leader in the field.
Holistic & alternative treatment:
  • There are also a variety of complementary and alternative therapies available, including those from Eastern and western nationalities. The goal is to encourage overall health and harmonious body, mind, and spirit integration following surgery.

Spain

Organ donation:
  • For the past three decades, Spain has led the world in organ donation and pioneered the practice of bone marrow transplantation. The rise of this therapeutic method was highlighted by the Spanish National Transplant Organization’s revelation that the nation carried out more than 3000 hematopoietic stem cell transplants in 2019.
Infrastructure:
  • The infrastructure and facilities at bone marrow transplant institutions in Spain are exceptional.
  • These include modular BMT units, air handling units, automatic and selected control systems, cutting-edge research labs, and blood banks.
Robust medical system:
  • The country serves a perfect combination of quality care, excellent accommodation, and low-cost treatment options for patients.
  • There are more than 20 JCI-accredited hospitals spread throughout Spain, complemented by trained and qualified staff. International patients can avail themselves of various facilities like airport transfer, arranged accommodation, interpreter services, etc., provided by the hospitals.
  • The healthcare system in Spain is among the greatest in the world.
  • More than 804 hospitals and 160,981 beds make up Spain’s extensive healthcare system. For every 100,000 people, it provides more than 10,600 surgeries.
  • The hematologists here are considered one of the most professional in the world.
Accreditation:
  • Spain has 24 medical facilities that have been approved by the Joint Commission International (JCI), to ensure that patients and medical tourists receive the best care possible in the nation.
Cost-effective:
  • International medical tourists are drawn to this comprehensive and cost-effective healthcare system.

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