Bone-marrow transplant in Bangladesh

Doctors conducting first bone-marrow transplant in Bangladesh will start pushing back stem cells of a blood cancer patient on Monday at Dhaka Medical College and Hospital.

“It will take two to three weeks to complete the process,” the first-ever bone marrow transplant centre in-charge Prof MA Khan told bdnews24.com.

He said they had started destroying cancer cells of the patient with “high-dose chemotherapy” on Saturday before starting pushing back his own cells, collected earlier, from Monday.

The centre was inaugurated on Oct 20 last year at the ninth floor of the new DMCH building, which was remodelled, with the help of the Boston’s Massachusetts General Hospital (MGH).

MGH trained up its nurses and doctors while the government spent about Tk 200million for the whole project.

Authorities have earlier shifted dates of starting the first process to, what Prof Khan said, take “foolproof” measures.

The 52-year-old patient from a northern Rangpur district has been suffering from multiple myeloma, a kind of blood cancer.

Doctors call his transplant procedure ‘autologous’ in which one’s own bone marrow is used to fight the disease.

But since the patient’s bone marrow is already diseased, doctors clean them by killing cancer cells before they are transplanted back into the patient.

First chemotherapy is given to reduce cancer cells in the body as much as possible. Then doctors collect and store bone marrow cells.

After high-dose chemotherapy or radiation treatments, the stems cells are put back in the patient’s body to regenerate normal blood cells.

“We took all measures so that nothing goes wrong in the first case,” Prof Khan said.

He said doctors and nurses had to undergo extensive training before starting the first case.

Earlier, soon after opening the centre, he said they would be able to start the transplant process within a week, but later shifted dates.

Initially the hospital selected 10 patients suffering from cancer – multiple myeloma and lymphoma— and six of them were being prepared for the first set of transplants.

But Prof Khan on Saturday confirmed that they would start with only one patient.

In bone marrow transplantation, doctors replace damaged or destroyed bone marrow – the soft and spongy tissue inside bones – with healthy bone marrow stem cells to treat different types of blood cancer, certain genetic blood and immunity disorders like thalassemia, and severe aplastic anaemia.

There are no official data about people needing bone marrow transplants in Bangladesh but doctors say many go abroad for this replacement.

But the costs in Bangladesh will be less than one-third of what it costs outside.

DMCH officials earlier said for an autologous procedure the hospital will charge between Tk 0.5 million and 0.6 million while for the allogeneic in which bone marrow of siblings or donors are used would be between Tk 1 million and 1.5 million depending on patients.

The second procedure, allogeneic, is more critical and so Prof Khan expects to start it once the autologous procedure became successful.

The centre has five isolated cabins where five patients can be treated at a time. A patient will need to spend at least three weeks after the transplant, doctors say.

The centre will appeal to the affluent people to donate for the centre so that the facility can help poor and maintain standards.