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bone marrow transplantation

Q: My son (6 months old) has been detected Thalasaemia major. He is undergoing blood transfusion. I have come to know that this disease can be cured by doing a bone marrow transplantation,. I read an article on the DOCTOR NDTV regarding this.My queries are follwoing 1.What is Bone marrow transplantation? How is it done? 2. What should be the age of the donor 3. What should be the age of the receiving child. 4. what is the risk factor of the donor 5. What is the risk factor of the receiver 6. Which are the hospitals and where are these operations performed. 7. What do you mean by HLA matched DONOR? 8. What is the procedure to get a donor of this kind?

A:1. Bone marrow Transplant is the method by whichthe marrow from a brother or sister matched at the HLAlocus is put into the boy of the patient after burningthe marrow of the patient with the help of medicinesnto create space for the marrow from the donor. 2. The donor should be old enough to donate the marrowand ideally should be years or older. The decision totake the marrow from a child will depend on theinstitution which is doing the transplant. 3. The ideal age for doing transplant in a child ofthalassemia is 4-5 years 4. The risk is of the risk of anaesthesia which ispractically negligible 5. The risk to the recipient is of acute toxicity andcomplications in the form of infections and bleeding.Then there is the risk of Acute rejection or of Chronic Graft versus host disease. The risk of deathin a well preserved child is about 10% 6. The centre which has the maximum experience of doing transplants in Thalassemics in India is CMC vellore 7. HLA are the loci by which individuals cells can beidentified and before we undergo a transplant one hasto identify what are the distinguishing features of ones cells and thenmatch it with the features of thedonors cells 8. The proceedure is to get the HLA identification of allthe members of the family of the patient which meansfirst relatives of the patient. It is done by drawing blood from all the members and the results are available in 2 weeks time.

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