BMT Vs CBT Vs SCT

Dear All,

For the last couple of years my son has been transfusing every 6 to 8 months, and doctors are strongly encouraging us to seriously think about BMT. So we undergone a journey of IVF/PGD and thank God my wife is not pregnant with a matched sibling and due date is mid July. We have already made arrangements for cord blood banking as well.

Our doctors recommended a couple of hospitals in India (Apollo and CMC) so i started communicating with them to put a plan forward.

Still i am confused about the difference between BMT, CBT and SCT. what is the difference and which one applies in our case. Most of the doctors are mentioning only BMT even after i explain our situation as i did above.

I would like to get your thoughts and experience please.

Thanks,

Technically, a BMT requires bone marrow be drawn from the donor, but these days it is far more likely to use stem cells drawn from the blood, SCT. Cord blood isn't used often, as the supply of stem cells may not be enough for success.

Thanks Andy for your feedback.

Does this mean that stem cells extracted from sibling's umbilical cord blood may not be sufficient, and more stem cells are required to be extracted from the donor?

I wonder why would the doctor consider BMT when transfusion has just happened once in last 6 months?
Best of luck

I am sorry BabyRiya, transfusion is taking place every 6 to 8 weeks (not months)

Fahed,

If there are not enough stem cells in the cord blood, they may opt to use only the stem cells extracted from the donor's veins.

Thanks Andy for your feedback,

I have been in touch with some doctors in India and a couple of them advised to wait until the sibling is 10 KG or 2 years old (whichever comes first) to extract more stem cells as this would increase the success rate of the stem cells transplant.

Dear Friends,

Alhamdulillah i have been blesses with a new baby after IVF/PGD and he is thal minor and full matching to his thal major brother.

Now i need to make up my mind on when/where and how to conduct the BMT.

My biggest concerns after success rate are fertility and cost.

Any advice from you friends is much appreciated.

Can a BMT be done in the country where you live?

Hi Andy,

I live in UAE and BMT is not available over here.

Where would you potentially have it done?

I have been recommended to go to Apollo Chennai India, as Dr Revathy Raj have been known for her successful BMTs.

At the same time i am considering to give novelty treatment a shot and try Dr. Ramanan as a last option before BMT.

Dear Friends,

I came to know that Apollo Chennai India only apply full conditioning Chemotherapy which impacts fertility.

I know that they are applying low intensity chemo with half matched donors in John Hopkins hospital USA.

My son has a full matched donor. Isn't it possible to apply low intensity chemo? Do you recommend any hospital/doctor (taking budget into consideration) where low intensity chemo is used?

If using cord blood you usually need to combine more then one sample to have a good enough cell count. Two donors means higher chance of GVHD

My sons doctor always uses bone marrow and not peripheral blood because peripheral blood stem cells carry a higher risk for GVHD though survival rate is similar
Please see:
https://www.ncbi.nlm.nih.gov/pubmed/24748537