Mumbai: Sion Hospital to expand bone marrow unit

Current BMT facility at Sion Hospital. Pic/By Special Arrangement

The Lokmanya Tilak Municipal Medical College and General Hospital (LTMGH) at Sion completed 104 bone marrow transplants (BMT) in their paediatric ward as of March 31. However, considering the increasing number of patients on the waiting list, the hospital has planned to expand its BMT treatment facilities. It is the first civic hospital to have introduced this facility for children in 2015.

"Our first patient was a 15-year-old boy who was diagnosed with aplastic anemia. His bone marrow was not producing red blood cells, white blood cells, and platelets. 10 years on, after the transplant, today he is married and has a healthy child," said Dr Sujata Sharma, in-charge, division of paediatric hematology, department of paediatrics, Sion Hospital.

"We have received all permissions from the Brihanmumbai Municipal Corporation (BMC), and the construction works will begin within a few weeks. The expanded facility will be started on the second floor of Eknath Gaikwad Urban Health Centre located in Dharavi as the current building of Sion Hospital faces space constraints. This new ward will have five BMT beds and a four-bedded step-down room. The step-down rooms have HEPA filtration and are like ICU rooms for those undergoing the transplant," informed Dr Sharma.

As per the hospital authorities, this new project will be funded entirely by the NGO MKH Foundation, which has been working towards thalassemia eradication across the country. The NGO is expected to spend approximately Rs 18 to Rs 20 crore for the project.

In a recent BMT case, a 6-month-old girl child with primary immunodeficiency (T cell migration defect), a mutation in the ARPC1B gene, was transplanted successfully. "Only three to five cases are reported in the literature. Patients of primary immunodeficiency get admitted with recurrent life threatening infections and are likely to die of infection if not transplanted early in life," informed Dr Sharma.

Current facility

The hospital currently has only one BMT bed and four step-down rooms. At one particular time, the hospital can conduct BMT of just one patient, and each patient needs at least one month to 45 days for the process, after which they are shifted to these step-down rooms.

"Considering a month's time required for the treatment, ideally nearly 120 patients could have been treated so far. However, sometimes complications arise, and the patients are required to occupy the room for more than 45 days. This apart, other issues such as maintenance works restrict admissions of the patients, too. Also, we could not treat patients during the COVID-19 period," explained Dr Sharma.

While there are at least seven to eight patients on the waiting list at one particular time, nearly one or two patients are added per week, which are emergency cases. These further delays treatment access to those already on the list.

"Once we expand, we can conduct at least four to five BMTs simultaneously against just one that we do now," said Dr Radnyi Mande, consultant, Paediatric haematology, oncology division, department of Paediatrics, LTMGH.

Transplants done at Sion Hospital

Total transplants completed 104
Severe aplastic anemia 36
Thalassemia 35
Malignancy 21
Inborn errors of immunity 07
Fanconi Anemia 3
Sickle Cell Anemia 1
P K Deficiency 1

Cost difference

While at BMC-run hospitals, each transplant costs '10 to '12 lakh; the costs go up to '25 to '40 lakh per transplant at a private hospital.

Need for bone marrow transplants

"Above-mentioned diseases are of marrow cells. And thus, replacing the bone marrow with healthy HLA-matched marrow stem cells is the only permanent cure for it," mentioned Dr Sharma. CEO of Wadia Hospitals, Dr Minnie Bodhanwala, explained, "Bone marrow transplant can be either autologous (using the patient's own cells) for solid tumours like neuroblastoma or allogeneic (from a donor). Allogeneic bone marrow transplant is done to treat a variety of conditions, primarily blood-related cancers like leukaemia, non-cancerous blood disorders like aplastic anaemia, thalassemia, immunodeficiencies like severe combined immunodeficiency, Wiskott-Aldrich syndrome, and certain metabolic disorders."