Stem cell transplant for scleroderma treatment in India

Last Modified: December 2, 2019  |   Created on: September 6, 2019
Stem Cell Treatment

Autologous hematopoietic stem cell transplantation (AHSCT) is a safe and effective treatment modality in cases of severe scleroderma. This technique has shown significant improvement in skin sclerosis and stabilization of functions of internal organs. 

Evidence from clinical studies suggest that AHSCT can be a real disease-modifying treatment for systemic sclerosis with better long-term survival in comparison with other conventional treatment (like intravenous cyclophosphamide). 

Scleroderma

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Cost of Stem cell treatment for Scleroderma in India

The cost of autologous hematopoietic stem cell transplantation for scleroderma treatment in India starts from USD 18,000 onwards. For more precise cost-estimates from various hospitals, you can send us your medical reports and we will revert at the soonest.

The overall stem cell treatment cost in India is comparatively lower than western countries, but with an equally good success rate.

What is scleroderma?

Scleroderma, or systemic sclerosis, is a chronic skin disease characterized by hardening and tightening of skin. It is generally classified as one of the autoimmune rheumatic diseases and involves an abnormal growth of connective tissue called collagen that supports the skin and internal organs.

The term “Scleroderma” is formed by two Greek words: “sclero” which means hard, and “derma” which means the skin. The hardening of the skin is one of the most visible indications of the disease but it may also damage the blood vessels and internal organs like the heart, lungs, and kidneys. The manifestation of disease vary from patient-to-patient depending on the type of scleroderma.

What are the types of scleroderma?

Mainly, there are two types of scleroderma:

1. Localized scleroderma: It is a more common form of the disease and mainly affects the skin, usually in just a few places. It appears as waxy patches or streaks on the skin. This less severe form may go away or stop progressing without treatment

There are further two kinds of localized scleroderma:

  • a. Morphea: This causes hard, discoloured patches of varying sizes and shapes on the skin.
  • b. Linear: This involves the formation of lines or streaks of thickened skin on the arms, legs, or face. It is known as en coup de sabre if a long crease forms on the head or neck. Linear localized scleroderma involves deeper layers of the skin and the surface layers, and at times even affect the movement of the joints. It usually develops in childhood and affects the growth of limbs in children

2. Systemic scleroderma: It is also known as generalized scleroderma. This is a more severe form and involves various body parts or systems. It is also of two kinds:

  • a. Limited scleroderma: It starts slowly, affecting the skin of the face, hands, and feet. It can then damage internal organs like the lungs, intestines, or esophagus. The tissues of the affected organs become hard and fibrous, making them function less efficiently. Sometimes, it can affect the heart and increase blood pressure in the lungs.

It is also referred to as CREST syndrome which stands for.

  • Calcinosis
  • Raynaud Phenomenon
  • Esophageal dysfunction
  • Sclerodactyly
  • Telangiectasia
  • b. Diffuse scleroderma: This form manifests quickly and affects the skin on the middle part of the body, thighs, upper arms, hands, and feet. It also involves damage to internal organs and cause problems like kidney failure, restriction of digestive and pulmonary functions. This type of scleroderma can become life-threatening. 

How can Lyfboat assist you getting Stem Cell Transplant for Scleroderma Treatment in India?

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Lyfboat is a free advisory platform; we do not charge any fees from patients. In fact, we negotiate the price that Indian hospitals offer. In some cases we are able to reduce the cost by negotiating upto 20% of what Hospitals generally offer. We advise the best treatment from the top hospital/surgeon at best price.

What are the causes of scleroderma?

The exact cause of scleroderma is still not known. Scleroderma results from overproduction and accumulation of collagen in certain body parts. A lot of research is being conducted by scientists all over the world to determine the exact cause of this disease.

Certain risk factors are known to increase the likelihood of developing scleroderma. A combination of these factors, including immune system related problems, genetics and environmental triggers play an important role in the manifestation of the disease.

What are the symptoms of scleroderma?

The signs and symptoms of scleroderma vary depending on the parts of the body that are affected by it. Other than thickening of the skin, other symptoms of scleroderma are:

  • Appearance of red spots on enlarged red blood vessels on the hands, face and around nail beds (telangiectasias)
  • Excessive deposition of calcium in the skin (calcinosis)
  • Raynaud’s phenomenon – fingers or toes turn red, white, or blue in response to cold temperatures.
  • Swelling on the hands and feet
  • Rigidity/stiffness in joints
  • Tightening of facial skin
  • Ulcers on the fingertips and toes
  • Persistent cough and breathlessness
  • Sjögren’s syndrome – dry eyes and mouth
  • Problems of digestive and gastrointestinal tract like constipation, diarrhea, heartburn (acid reflux), nausea, etc.
  • Weight loss and fatigue

Scleroderma can also affect the functions of organs like the heart, lungs or kidneys to varying degrees.

How is scleroderma diagnosed?

The diagnostic process may require consultation with rheumatologists (arthritis specialists), and/or dermatologists (skin specialists), require blood studies and other specialized tests depending upon which organs are affected.

Diagnosis of scleroderma can be tricky as the disease affects different organs and the symptoms can resemble those of other diseases. The diagnostic process usually involves:

  • Evaluating the patient’s full medical history
  • Imaging tests: X-rays and CT scans are done to look for abnormalities in the lung while ultrasound and MRI can be used for soft tissue assessment. Thermography is used to detect temperature differences in skin between the lesion and normal tissue.
  • Blood tests: To check for elevated levels of immune factors, called antinuclear antibodies. This test may not be a definitive indicator for scleroderma as these antibodies are also formed in other autoimmune diseases such as lupus.
  • An endoscopy might be performed to check for damage to the esophagus and the intestines.

How common is scleroderma?

It’s estimated that approximately 300,000 people in America have scleroderma, with one third of these having the systemic form of scleroderma.

Scleroderma can develop in people of every age group from infants to elderly, but most frequently it occurs between the ages of 25 to 55. Systemic scleroderma is more common in adults while the localized scleroderma is more prevalent in children. The disease affects more females than males, in a ratio of about 4-to-1.

What treatment methods are available for scleroderma?

Presently, there is no definitive cure for scleroderma, but treatment is available to manage the symptoms of the disease. A combination of medications, occupational therapy and lifestyle changes are used to control the scleroderma symptoms and prevent complications.

Non-steroidal and steroidal drugs for given to manage gastrointestinal problems like heartburn and other conditions like high blood pressure, selling and pain in the joints. Physical and occupational therapy is also included in order to improve the mobility and strength of the muscles as well as to manage pain.

Surgery is usually the last option of treatment of scleroderma related complications. Surgical intervention includes amputation (to remove the fingertip tissue that have died due to Raynaud’s disease) and lung transplant in severe cases.

Stem cell transplant for scleroderma treatment

Stem cells are the mother cells that have the potential to develop into many types of cells in the body. These cells have the unique ability to repair and replace the damaged cells of the body. Stem cell transplant is aimed at arresting the faulty immune process and reset the immune system to restore its natural function. There are various kinds of stem cells that are used in therapeutic modalities. Hematopoietic stem cells (HSCs) are a type of tissue-specific stem cells that are used for the treatment of systemic sclerosis. The goal of HSCT in scleroderma treatment is to arrest fibrotic process and reverse the immune malfunction that is causing the symptoms. 

In this procedure, chemotherapy treatment or irradiation is used to ameliorate the problematic immune cells, and then replaced it with a new healthy batch of immune cells to restore the normal functions of the immune system. 

Autologous HSCT (using the patient’s own stem cells) is preferred over allogeneic HSCT (stem cells from a different person – donor) due to lack of rejection and reduced risk of mortality. 

What is the success rate of stem cell transplantation for scleroderma?

Autologous Hematopoietic stem cell transplant (AHSCT) for scleroderma treatment success rate is around 70%.

The overall improvements after AHSCT therapy in scleroderma patients: 

  • Long-term event-free survival, i.e. without serious lung, kidney or heart complications
  • Improvement of skin and pulmonary functions
  • Prevent worsening of damage to organs
  • Reduce dependency on immune suppressing medication

What are the steps involved in AHSCT procedure?

Autologous BMT (or AHSCT) is a multistep process, containing following basic steps

  1. Mobilization and harvesting of stem cells: In this step, bone marrow stem cells are collected from peripheral blood. For this, a combination of drugs are given to the patient in order to promote movement of stem cells from the bone marrow to the bloodstream. This is known as mobilization. After this, cells are collected through a process called apheresis. In this, the blood is extracted from the patient’s arm through a needle which is sent to a machine where the stem cells are then sorted out. The remaining blood cells are sent back into the body. The harvested cells are then frozen using cryopreservation method until the time of reinfusion.
  2. Conditioning: Also known as conditioning chemotherapy. A short course of chemotherapy is administered to destroy the defective immune system (known as myeloablation). Myeloablative AHSCT method is a more stringent type of treatment which involves administration of total body irradiation (TBI) for complete removal of bone marrow.
  3. Transplantation: For Stem cell transplantation, the frozen stem cells are thawed and reinfused them back into the patient’s body. It only takes a few hours to perform and the process is like blood infusion. The stem cells are then expected to move to the bone marrow and produce new blood cells. This may take upto 10-30 days and the immune system is very low during this time. 

Risks and side effects of HSCT

  • Possible complications due the intense AHSCT-related immunosuppression: opportunistic infections, urinary tract infections, neutropenic fever and viral reactivation 
  • Autoimmune conditions like autoimmune thyroiditis may develop
  • Side effects of chemotherapy: fatigue, weakness and a temporary loss of appetite

Frequently Asked Questions (FAQs)

Q. Who is the best candidate for bone marrow transplant for scleroderma?

The patients who might benefit most from AHSCT are those with a rapid progressive and diffuse skin sclerosis, mild initial organ damage and persistent high levels of disease activity. 

Q. Is scleroderma hereditary?

Scleroderma is not directly inherited but research indicate that genetic predisposition is a risk factor for the disease. This means people with a family history of rheumatic diseases may have slightly more chances of getting scleroderma.

Q. How serious can scleroderma become?

Scleroderma is a chronic disease with a very wide range of symptoms that range from very mild to life threatening. The severity of the disease will depend on which parts of the body are affected and the level of their damage. A mild case can progressively become serious if not treated properly or timely. So, it becomes critical that you look for highly qualified and skilled doctor for your treatment and prevent chance for irreversible damage.

Q. Can scleroderma be transmitted from one person to another?

No, scleroderma is not contagious, infectious or cancerous condition.

Vanshika Rawat

Written By Vanshika Rawat

Vanshika Rawat is an experienced content developer. She is well-versed and knowledgeable in topics of science and medicine, and has worked under brilliant scientist during her higher education. She has obtained her degrees in Masters and Bachelors in Science - Microbiology (with Hons. ) from renowned institutions - Panjab University and University of Delhi.
Dr. Surbhi Suden

Verified By Dr. Surbhi Suden

Dr. Surbhi Suden is one of the founders of Lyfboat and a doctor with a renowned name in the Medical tourism industry. She has been working with international patients since 2008 and is a deeply committed professional with a long term vision of transforming the current healthcare scenarios.

Best Hospitals for Stem cell transplant for scleroderma treatment in India

Hospitals in India are world renowned medical facilities with high-tech infrastructure and the latest medical equipment. These hospitals maintain a high standard of safety and hygiene to ensure that the patients receive top-class treatment and services. The top hospitals in Delhi, Gurgaon, Bangalore, Chennai and other cities have accreditations from international and national organizations like Joint Commission International (JCI) and National Accreditation Board for Hospitals and Healthcare Providers (NABH) for the quality of services. Stem cell transplant is a complex procedure which requires stringent environment and first-rated facilities for best clinical outcomes. The best bone marrow transplant hospitals in India have specialized units for the procedure and equipped with the finest instruments and devices.

Best Bone Marrow transplant Doctors in India

Indian doctors are widely known for their skills and expertise in various specialties, including advanced techniques like stem cell transplantation. The best hematologists in India are qualified experts in procedure like Autologous Hematopoietic stem cell transplantation. 

Their vast medical experience and proficiency in performing bone marrow transplant procedures makes them highly sought after on a global level. The best bone marrow transplant doctors in India are associated with the top-tier hospitals and have treated numerous patients with BMT. 

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