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services and centres / centres of excellence / bone marrow transplant unit

Blood Cancer & Bone Marrow Transplant Centre

Overview of the Unit

This is a dedicated unit for all blood & bone marrow diseases including blood cancers where we provide a total comprehensive care package for diagnosis & treatment. This includes any type of bone marrow transplant: autologous, matched sibling, matched unrelated donor or haplo-identical transplant. We are also geared to provide care packages catering towards the physical & psychological wellbeing of the patient. 

We have both day care services & inward facilities including rooms that are fully equipped to minimise transmission of infection. These rooms have positive pressure and Hepa filtration. There is a 24-hr hotline for any type of support including emergencies & a fulltime specially trained dedicated nursing team and a multidisciplinary team of medical specialists to provide comprehensive care.

This is the only private hospital in the country that can provide in-house irradiated blood products, apheresis services, radiotherapy & PET scan facilities in order to provide all aspects of treatment required for blood and bone marrow cancers.

Blood Transfusions

A transfusion is putting blood or a component of it (red cells, platelets, plasma etc) into a person’s vein through an intravenous (IV) line.

Transfusions of blood and blood products may be given to a person who is losing blood or who can’t make enough blood cells.

People usually donate whole blood – blood taken right out of a vein through a needle. This whole blood may be called a unit or pint of blood, and equals about 450 ml. Blood has many parts (called components), and each one does a different job. Whole blood is usually separated into red blood cells, platelets, and plasma. Plasma can be further separated into clotting factors and certain proteins. This lets doctors give patients only what is needed. It also helps to get the most out of the donated blood.

We give blood transfusions to patients on an out patient basis. This is more convenient and less expensive to patients.

Types of Bone Marrow Transplants

  • Autologous - An autologous transplant is one which uses a person's own stem cells. These cells are collected in advance and reintroduced to the person at a later stage. This type of transplant is useful in patients with multiple myeloma, lymphoma, auto immune diseases, Multiple Sclerosis.
  • Allogeneic - In an allogeneic transplant, the patient receives bone marrow/stem cells from another person- usually a HLA compatible sibling or an unrelated donor. This type of transplant is used to correct severe inherited disorders such as thalassaemia, immune deficiencies, aplastic anaemia, MDS, and malignancies such as Leukaemia and Lymphoma. It involves a longer stay in the hospital (approximately 45 days)

Bone marrow and how blood cells are made 

Bone Marrow is the organ or 'factory' responsible to produce blood cells. It is in the core of long bones and the spongy center of flat bones such as the hip bones, ribs and skull. The earliest, most immature cells are called stem cells. Stem cells can divide to produce more stem cells or differentiate to produce red cells (RBC), white blood cells (WBC), or platelets. RBCs carry oxygen around the body, delivering it to all tissues. WBCs are the body's main defence against infection. Platelets are small sticky cells that prevent bruising and bleeding.

Once they are released from the marrow into the blood, platelets and WBC cells have only a short life span. RBCs live for about 3 months. Due to their limited life span all blood cells must be constantly renewed from the stem cell pool. Because of their ability to produce all types of blood cells on an on going basis, stem cells are the most important cells in bone marrow transplantation.

Most blood cancers, also called haematological malignancies, start in the bone marrow, which is where blood is produced. Blood cancers occur when abnormal blood cells start growing out of control, interrupting the function of normal blood cells, which fight off infection, transport oxygen to and from tissues and prevent bruising/bleeding.

Types of Blood Cancer

The main types of blood cancer are leukaemia, lymphoma and myeloma:

Leukaemia is a blood cancer that originates in the bone marrow. It occurs when the body creates too many abnormal white blood cells and interferes with the bone marrow’s ability to make normal blood cells.

Lymphoma is a cancer that develops in the lymphatic system from cells called lymphocytes, a type of white blood cell that helps the body fight infections. These can be either Hodgkin or non-Hodgkin lymphoma.

Multiple myeloma is a bone marrow cancer of plasma cells, a type of white blood cell made in the bone marrow.

What causes blood cancer?

Although the specific cause of blood cancer is unknown, various factors are associated with its onset. Some causes are:

  • Aging
  • Family history
  • Weak immune system
  • Certain infections
  • Exposure to certain drugs/chemicals/ radiation etc
  • Genetic defects

Some symptoms of Blood Cancers

  • Fever, chills
  • Persistent fatigue, weakness
  • Loss of appetite, nausea
  • Unexplained weight loss
  • Night sweats
  • Bone/joint pain
  • Abdominal discomfort
  • Headaches
  • Shortness of breath
  • Frequent infections
  • Itchy skin or skin rash
  • Swollen lymph nodes in the neck, underarms or groin
  • Bleeding and bruising

If a person is suspected to have a type of blood cancer, there are several tests that will typically be done. Some of the tests can rule out other conditions that can also cause similar symptoms as blood cancer, and other tests are used to determine the specific type of blood cancer.

Blood tests

There are several blood tests that may be run to diagnose blood cancer and rule out other conditions.

Lymph node biopsy

Some blood cancers require a lymph node biopsy to confirm the diagnosis. A biopsy is a procedure in which a sample of tissue is removed from the body for examination under the microscope. In a lymph node biopsy, a lymph node or a part of one is removed through a surgical procedure. In some cases, a biopsy sample can be taken with a needle, however, the results are typically more conclusive with an open (surgical) biopsy.

Bone marrow aspiration and biopsy

Blood cancers often affect both the blood and the bone marrow, and a bone marrow aspiration and biopsy are generally needed to diagnose blood cancer. The bone marrow aspiration and biopsy are samples of bone marrow that are taken usually from the hip (pelvic) bone. The aspiration uses a hollow needle to remove some of the liquid bone marrow. Although a local anaesthetic (pain relief) is used, some patients experience discomfort for a brief time when the marrow is removed. The bone marrow biopsy (trephine biopsy) is done at the same time to remove a small core of bone containing marrow. Patients usually feel pressure and a tugging sensation during this procedure. It is important to remember that the bone marrow does not have nerves that carry “pain” sensation, therefore it is unlikely to feel “pain” during the procedure, what the patient may experience is a sensation of “pressure”.

Spinal tap

A spinal tap, also known as a spinal fluid test or lumbar puncture, is a procedure to collect a sample of the cerebrospinal fluid – the fluid that surrounds the brain and spinal cord and acts as a cushion. The fluid is collected from the lumbar region of the back while the patient typically lies on their side with their knees pulled up to their chest. A spinal tap may be performed to see if blood cancer has spread to the cerebrospinal fluid.

Imaging tests

Imaging tests are a variety of assessments that use medical equipment to create pictures of the body. There are several different imaging tests that may be used during diagnosis or staging of blood cancer, including:

  • A chest x-ray takes an image of the chest, lungs, heart, large arteries, ribs, and diaphragm, and it may be used if a doctor suspects a lung infection, heart failure or malignancy in the chest etc
  • A computed tomography (CT) scan uses special equipment to make cross-sectional views of the inside of the body and may be used to see if blood cancer has spread to specific organs, such as the liver, spleen or lymph nodes
  • A magnetic resonance image (MRI) uses powerful magnets and radio waves to generate pictures of the internal structures of the body and may be used to examine the brain or spinal cord
  • PET Scan is an imaging test that helps reveal how your tissues and organs are functioning and how extensively the cancer has spread.
  • Ultrasound uses high-frequency sound waves to produce an image. Ultrasound can be useful in viewing lymph nodes or potentially enlarged organs in the abdomen, like the kidneys, liver, or spleen

Treatment for blood cancer depends on the type of cancer, your age, how far the cancer has progressed, where the cancer has spread. Some common blood cancer treatments include:

Chemotherapy: Chemotherapy uses anticancer drugs to interfere with and stop the growth of cancer cells in the body. Chemotherapy for blood cancer sometimes involves giving several drugs together in a set regimen. This treatment may also be given before a stem cell transplant.

Immunotherapy: Treatment targeting specific cells of the immune system that are cancerous.

Radiation therapy: Radiation therapy may be used to destroy cancer cells or to relieve pain or discomfort. It may also be given before a stem cell transplant.

Stem cell transplantation: A stem cell transplant infuses healthy blood-forming stem cells into the body. Stem cells may be collected from the bone marrow, circulating blood and umbilical cord blood.

*Asiri Health is the ONLY group of hospitals in the private sector in Sri Lanka that has all the above diagnostic and treatment modalities in house.


 
Bone Marrow Transplant (Haematopoietic Stem Cell Transplant)

Bone Marrow Transplant (Haematopoietic Stem Cell Transplant)

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Bone Marrow Transplant for Children

Bone Marrow Transplant for Children

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Pre-Transplant Tests & Procedures

Pre-Transplant Tests & Procedures

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What You Can Expect during Bone Marrow Transplant

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Diet & Nutrition after Discharge from Hospital

Diet & Nutrition after Discharge from Hospital

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Direct Hotline: +94 76 625 8941

Email: chlbmt@asiri.lk

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