Haemotologist Hospital

8/3/2019 Haemotologist Hospital

1/8

Suyash Hospital Private Limited

Hospital Name Suyash Hospital Private Limited

Address 5/1 Residency area,

City Indore

State Madhya Pradesh

Contact 0731-2493911 / 17

Website www.suyashhospital.in

Department1 Emergency

Department2 General

Department3 Gynecology

Department4 Hematology

Department5 Private

Department6 Radiology

Timing 24 Hours

Hospital/Clinic Hospital - Has admission (bed) facility

Contact Person Mr. Rajesh Malpani

Suyash hospital is a Indore based multi specialty hospital founded in the year 1992, situated in the heartof the city over 45000 square feet with ample space for parking and lush green garden. Its just 5 minutesdistance from the railway station and bus stand and 20 minutes from the airport. 24 hours Emergency &Trauma services are available. We have special laboratories equipped with state of the art infrastructureusing front line technologies for accurate diagnosis. Patient can choose from five categories ofaccommodation that comes with a wide range of patient friendly facilities.

Suyash Hospital Private Limited information

A.B. Road (opp M.G.M. Medical College), Indore-1, (M.P.) INDIAPh.: 0731-2493911 to 18, 4064911


2/8

Dr. Anil Singhvi in R.N.T. Marg, IndoreRate This Business

Category:

Hematologists

Address:

#108,Blood Line Clinic, Manas Bhavan

R.N.T. Marg

Indore -452001

Flag if incorrect

Landmark:

Tell us if you know

Phone:0731-2527081, 0731-4208761

Flag if incorrect

Mobile:

More Sign In|Join us|About Jivisha|Feedback

Haematologist

Clinic- Doctors Chamber

(6:00 PM - 8:00 PM)

34, Jaora Compound, in front of MY

Hospital,Indore (MP)Indore

Madhya Pradesh

Mobile: 09300004176,

Send mail | More

Home

About Me

Professional Summary

Beyond Profession

My Space

Dr. Manish NemaMBBS , MD , DM

Hematologist

Hemato-Oncologist

Registration # MP-0147

Add as a friend | Share your experience


3/8

Miscellaneous

Professional ExpertiseLeukemias

Lymphomas

Multiple Myeloma

Aplastic Anemias

Hemolytic anemias

MDS

Myeloproliferative disorder

Bleeding disorders

WBCs disorder

Thalassaemia

Sickle cell disease

BMT

Active Member

Join Date: Jan 2005

Location: lucknow, india.

Posts: 79

Bone Marrow Transplant (BMT) - Information from Dr.Mammen Chandy (Head, CMC,Vellore)

hi every1 ,this is from my doctor Dr. Mammen Chandy .

CHRISTIAN MEDICAL COLLEGE, VELLORE - 632 004.DEPARTMENT OF HEMATOLOGY

BONE MARROW TRANSPLANTATION FOR THALASSAEMIA

Patients with beta-thalassaemia major who are transfusiondependent can be considered for bone marrow transplant (BMT) atCMCH. We do not transplant patients with sickle cell anaemia orother forms of thalassaemia (HbE Thalassaemia, ThalassaemiaIntermedia, etc) in our department at present.

PATIENTWe prefer to take up patients who are two years old for bonemarrow transplant for thalassaemia.

CONTRAINDICATIONSPatients with the following problems cannot be taken fortransplant -


4/8

HIV positiveAcute HepatitisSevere cardiac dysfunction related to iron overload

DONORThe donor must be a HLA A, B, DR matched brother or sister. Inrare cases it is possible to find a match from one of the parents orother relations (cousins). HLA typing is done from blood takenfrom a vein in the usual way. The donor must at least two,preferably three years old. The donor and patient need not havethe same blood group. A sibling who has thalassaemia minor canserve as the donor if HLA matched with the patient HLA typing canbe done at any good laboratory in your area but all results have tobe rechecked in our Hospital bef ore transplant.

HLA typing can be done in CMCH by prior appointment and for thisyou need to write to us with the name, age and sex of the patientand all available brothers and sisters. We usually do the AB typing

first for the patient and all the siblings and then do DR typing onlyfor the patient and any AB matching brother or sister.

If an appointment is given for HLA typing on a particular date, weexpect you to keep the appointment and come as scheduled. If forany reason you are not able to come you must inform us by e-mail/fax/telegram at least 7 days in advance.

COLLECTION OF BLOOD FOR AUTOLOGOUS TRANSFUSIONIn general we would like to avoid transfusion of blood obtainedfrom a third party to the donor during the bone marrow harvest.Hence we collect blood from the donor on two or three occasions 2- 3 weeks prior to the harvest and keep this for transfusion to the

donor during the harvest.

ADMISSIONThe donor is admitted at the time of starting the conditioning forthe patient (one week before transplant). We are usually able todischarge the donor 2 to 3 days after the bone marrow harvest.

BONE MARROW HARVESTThis is the term used for the procedure of taking the marrow from

the donor for the transplant. This is done under generalanaesthesia. The marrow is sucked out of the hip bones using aneedle and there is no 'operation' or incision. The risk to the donoris minimal and related to the general anaesthesia (1 in 25,000).There is no long term problem or side effect to the donor and theharvest is similar to donating blood.

PATIENTThe patient and the donor will first have a full evaluation by the


5/8

transplant doctors in Vellore. If we are satisfied that thetransplant can be done and that the HLA is matching and that thedonor and patient are fit then we will discuss all the problemsrelating to the transplant with the parents. We will then give you atentative date for the transplant and correspond with youregarding the actual date and time for transplantation. The patientis usually admitted 2 weeks prior to the actual date of transplantinto a single room in the private ward.

HICKMAN CATHETER INSERTIONUnder general or local anaesthesia a silicone rubber catheter(tube) is inserted into a vein in the neck and positioned near theright atrium of the heart. This tube will be used through out thetransplant period for giving all medicines and blood products.Nutrition is also given through this tube when the patient is notable to eat. The tube is removed after the transplant when all theproblems are over (2 months).

ADMISSION TO THE TRANSPLANT UNITThe patient is admitted to the transplant unit 7 to 10 days prior tothe transplant. The unit has HEPA filtered air to keep it sterile andthe patient remains in this room till the donor's cells have startedto grow and the blood count is satisfactory (usually 3 to 4 weeks).There is a nurse in constant attendance for each patient. Pressurecooked food is given and can be prepared by the family undersupervision by the nurse.

VISITORSWe allow one family member to go into the transplant room andbe with the patient for as long as is necessary depending on theage of the patient. There is a protocol for entry into the unit which

is supervised by nursing staff.

CONDITIONINGThis is term used for the treatment given to destroy the patient'sown bone marrow. A drug called Busulphan is given by mouth forfour days and cyclophosphamide by injection for four days. Somepatients may have vomiting during this treatment.

BONE MARROW TRANSPLANTThe marrow that is taken from the donor is put into a specialplastic bag (it looks just like blood) and this is given to the patientthrough the Hickman catheter like an ordinary blood transfusion.

ENGRAFTMENTIn two to three weeks time the mother cells (stem cells) from thedonor will, after settling in the bone marrow of the patient, startto produce blood cells and the blood count of the patient begins torise. This is known as engraftment. The patient can be transferredout of the transplant unit when the white cell count issatisfactory.


6/8

COMPLICATIONS

1. INFECTION :During the period after giving conditioning and beforeengraftment, the patient's white cells count is very low and thepatient is prone to bacterial and fungal infections. There is also ahigh risk of viral infections like herpes and CMV for about one yearpost transplant.

2. GRAFT FAILURE-REJECTION :In about 10 to 20% of patients, the donors bone marrow may failto engraft or be rejected some time later. Graft rejection canoccur many months after transplant and will result in the patientbecoming transfusion dependant again with relapse of thethalassaemia.

3. GRAFT VERSUS HOST DISEASE :Despite adequate HLA matching in some patients the donor's cellsdetect minor differences between the donor and patient and canattack the patient. This manifests as skin rash, jaundice, diarrhoeaand fever. This is controlled with cyclosporine and steroids. If it ismild it does not cause significant problems but severe graft versushost disease can be fatal. This complication is seen in 20 % ofchildren.

Haemorrhagic cystitis, veno occlusive disease and interstitialpneumonia are some of the other complications seen in the posttransplant period.

DISCHARGEWhen the blood counts are normal and if there are nocomplications the patient is discharged from the ward and stays inVellore for 3 - 4 weeks during which regular follow up is done inthe out-patient clinic every week. It is possible to rent a housenear the hospital for Rs.500/- to Rs.1,000/- per month for thewhole family to stay.

POST TRANSPLANT CAREThe total duration of stay for an uncomplicated transplant will beabout three months and for a patient who has complications thefamily may need to stay in Vellore for 6 months.

For one year post transplant the patient needs to be carefulregarding infection and it may be preferable not to send the childto school. Cyclosporine is continued for 6 months and thentapered. If there is no graft versus host disease or othercomplication, children who have had a successful transplant forthalassaemia may lead a normal life.

COST


7/8

We do not have a package cost for BMT in Vellore and patients arecharged individually according to what is required. So far the costhas ranged from 6 lakhs to 10 lakhs depending on thecomplications post transplant. We require an advance payment ofRs. 6 lakhs when the patient is admitted and the family shouldmake arrangements for another 1 - 2 lakhs in case there arecomplications. A weekly statement of costs is provided to thepatient and any balance will be refunded at the time of discharge.

RESULTSThe maximum number of bone marrow transplants forthalassaemia have been done by Professor Lucarelli at Pesaro in

Italy and he has shown that liver enlargement, liver fibrosis andpoor chelation are the main factors which effect the outcome ofBMT in thalassaemia. In patients who do not have any of theserisk factors BMT is successful in 95 % of patients. However inpatients who have all three factors transplant is associated withmorbidity (failure or death) in 40% of patients.

It is reasonable to expect the following results for bone marrowtransplantation in thalassaemia -

60% - 80% complete cure with good quality of life10% - 20% relapse of the thalassaemia10% - 20% death due to transplant related complications.

When a family decides on bone marrow transplantation theseresults have to be kept in mind and compared with what can beachieved with transfusion and chelation.

The transplant unit in Vellore till June 2003 has transplanted over350 patients, more than 150 of whom had thalassaemia major.For any further information regarding bone marrowtransplantation you may contact one of the following :

Dr. Mammen Chandy MD, FRACP, FRCPA Address :Professor and Head. Department of Haematology

Dr. Alok Srivastava MD, FRACP, FRCPA Christian Medical CollegeProfessor. Vellore - 632004, Tamil Nadu, IndiaDr. Vikram Mathews MD, DM Tel : +91-416-2222102/2223603Reader. Ext. : 2352/2472/2169/2890/2891Dr.Biju George MD, DM Fax : +91-416-2232035/2232054Reader. e-mail : [email protected] Files

mohak.txt (9.5 KB, 12 views)


8/8

Last edited by solankyno1; February 13th, 2005 at 03:28 PM.. Reason:Change the title of post.

Documents

Haemotologist Hospital