Syngeneic (BMT) in India

  • Syngeneic Bone Marrow Transplant (BMT) is a specialized procedure where the bone marroww is transplanted from a genetically identical twin.
  • This type of transplant is particularly relevant in cases of certain hematological disorders, such as leukemias, lymphomas, and other bone marroww failure syndromes.
  • In syngeneic BMT, the donor and recipient are identical twins, meaning there is a perfect match in tissue type, minimizing the risk of graft-versus-host disease (GVHD).

Types of Syngeneic (BMT) in Pediatrics

1.Full-Matched Syngeneic BMT

  • Description: Conducted between identical twins, ensuring perfect genetic match.

2. Reduced Intensity Conditioning (RIC) BMT

  • Description: In some cases, especially for older or less fit children, a less aggressive conditioning regimen is used to reduce toxicity.
  • Application: This approach may be utilized to make the procedure safer for patients who may not tolerate standard conditioning.

Causes and Risk Factors

  • Hematological Malignancies.
  • Bone Marrow Failure Syndromes.
  • Genetic Disorders.
  • Genetic Factors
  • Environmental Factors

Symptoms

1. Common Symptoms:

  • Fatigue: Persistent tiredness due to anemia or low blood cell counts.
  • Fever: Unexplained fevers can indicate infection or the presence of malignancy.
  • Weight Loss: Unintentional weight loss can occur with malignancies or bone marroww disorders.

2. Hematological Symptoms

  • Anemia Symptoms:Weakness, pallor, and shortness of breath due to low red blood cell counts.
  • Thrombocytopenia Symptoms:Easy bruising, bleeding gums, or petechiae (small red spots) from low platelet counts.
  • Leukopenia Symptoms:Increased susceptibility to infections due to low white blood cell counts.

Diagnosis

1. Clinical Evaluation

  • Medical History: A comprehensive history of the child’s symptoms, family history of blood disorders, and any previous treatments.
  • Physical Examination: Checking for signs of anemia (pallor, fatigue), lymphadenopathy (swollen lymph nodes), hepatosplenomegaly (enlarged liver and spleen), and other relevant physical findings.

2. Blood Tests:

  • Complete Blood Count (CBC): To assess levels of red blood cells, white blood cells, and platelets. Abnormalities may indicate conditions like leukemia or aplastic anemia.
  • Peripheral Blood Smear: Examination of blood cells under a microscope to identify abnormal cells, such as leukemic blasts.
  • Bone Marrow Aspiration and Biopsy: Essential for diagnosing many hematological disorders. This involves taking a sample of bone marroww to analyze the cellularity, presence of abnormal cells, and other characteristics.

3. Imaging Studies:

  • X-rays, Ultrasound, or CT Scans: To evaluate for any masses (like lymphadenopathy) or organ enlargement (liver, spleen) that may suggest malignancy.

Treatment Options

1. Chemotherapy:

  • Regular follow-up visits to monitor for late effects of the transplant, which may include growth and development issues, endocrine problems, and psychosocial support.

2.  Radiation Therapy:

  • In some cases, total body irradiation (TBI) may be included to further prepare the body for transplant, particularly in cases of leukemia.

3.  Bone Marrow Harvesting:

  • The identical twin donor undergoes a procedure to collect bone marroww, typically done under general anesthesia. This usually involves aspiration from the iliac crest (hip bone).

Current Research and Developments

  • Innovations in transplant techniques and protocols .
  • Role of immunotherapy and new treatment modalities .
  • Ongoing research and clinical trials in pediatric BMT

Conclusion

  • Syngeneic BMT is a valuable treatment option for pediatric patients with certain hematological conditions.
  • The combination of reduced risks and high success rates makes it a preferred choice when an identical twin is available.
  • Continuous advancements in transplant techniques and supportive care are crucial for improving outcomes in these young patients.
  • Early referral to specialized centers can enhance the likelihood of successful treatment.

Departments

Related Hospitals

Indraprastha Apollo Hospitals (Jasola, Delhi)

Max Super Specialty Hospital Gurgaon

Artemis Hospital (Gurgaon)

Jaypee Hospital Noida Delhi NCR India

Narayana Superspecialty Hospital Gurgaon

W Pratiksha Hospital (Gurgaon)

Pushpawati Singhania Hospital & Research Institute