A bone marrow transplant is an extremely complex procedure that involves careful planning and consideration. However, for many patients, it is a life-saving procedure when conducted on time and as needed. Stem cell transplant or hematopoietic cell transplantation (HCT) is the other term for bone marrow transplantation.
In this procedure, the specialists replace the damaged bone marrow cells in the body of the patient with healthy cells. The healthy cells may come from the patient’s own body (autologous stem cell transplant) or a donor (allogeneic stem cells transplant).
Bone marrow transplant procedure involves a team of specialists, which includes hematologists, radiologists, oncologists, laboratory technicians, and other staff members. A majority of hospitals around the world that offer this treatment have dedicated bone marrow transplant departments or units with specialized equipment and state-of-the-art machinery.
Because of the complexities of bone marrow transplant, it often becomes difficult to determine the exact cost of the procedure. Overall, this procedure is quite expensive as it involves the use of special techniques, equipment, and manpower.
Additionally, it provides a detailed breakdown of the costs that a patient is expected to bear during their course of treatment and the factors that affect the total cost of treatment.
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When is Bone Marrow Transplant Conducted?
Bone marrow is a soft tissue present in the center of the bones. It is responsible for producing all types of blood cells in the body. It is absolutely essential for the maintenance of the body’s lymphatic system.
Certain medical conditions can affect the functioning of the bone marrow and reduce its effectiveness. This can, in turn, lead to a range of complications and warrant the need for an immediate intervention.
Some of the medical conditions and diseases that affect the bone marrow include leukemia, sickle cell anemia, thalassemia, and lymphoma. High-intensity chemotherapy for certain forms of cancers can also damage the healthy bone marrow. In such cases as well, bone marrow transplant becomes a necessity.
The following are some of the conditions that the specialists treat with the help of bone marrow transplantation:
- Multiple Myelomas
- Thalassemia
- Acute Myelogenous Leukemia
- Acute Lymphoblastic Leukemia
- Chronic Lymphocytic Leukemia
- Hodgkin’s Lymphoma
- Non-Hodgkin’s Lymphoma
- Severe Aplastic Anemia
- Severely Combined Immunodeficiency Syndrome
- Sickle Cell Disease
- Krabbe Disease
Depending on the type of condition that one is suffering from, the doctors may conduct autologous or allogeneic stem cell transplants.
Factors Affecting the Cost of Bone Marrow Transplantation
Types and Costs of Stem Cell Transplants
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Stem cell transplantation or bone marrow transplantation is a highly complicated and technical procedure that involves a lot of skills and effort. In the case of autologous stem cells transplant, healthy bone marrow is retrieved from the body of the patient and later used for transplantation when needed. In an allogeneic transplant, the healthy bone marrow is derived from a matching donor or an unrelated donor.
Then there is something called haploidentical stem cell transplantation, It involves taking the healthy stem cells from a donor that is only half-matched. It is only suitable for patients who do not have an HLA-identical sibling donor.
The cost associated with each type of stem cell transplant is different. This is because the doctors use different techniques, preservation methods, and tests in each case. The following are some of the factors that control the cost of bone marrow transplantation around the world.
Type of Condition
The type of medical condition or ailment that an individual has is one of the biggest factors that control the cost of bone marrow transplantation. Each of the conditions affecting the bone marrow cells is treated differently and each patient has a different treatment plan. For example, bone marrow destruction in the case of aplastic anemia patient is treated differently from a patient who has had his or her bone marrow destroyed as due to chemotherapy.
Type of Transplantation
Autologous stem cells transplant costs far less than allogeneic stem cells transplant. Further, the allogeneic transplant from a related donor costs less than an allogeneic transplant from an unrelated donor. Because in the latter case, a donor is searched through the Bone Marrow Registry of that particular country. This costs extra. Lastly, haploidentical allogeneic stem cells transplant costs a lot more because there are a number of tests involved and also, this procedure is much more complicated.
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Pre-procedure Tests
Bone marrow transplantation often involves a series and rounds of HLA-typing tests with all siblings in the case of allogeneic transplantation. Additionally, the work-up of the patient and the donor costs extra. This is not the same in the case of autologous transplantation. In this case, only the patient is thoroughly evaluated and investigations are carried out before taking the healthy bone marrow cells.
Chemotherapy Cost: In certain cases such as leukemia, the patient is given a few cycles of chemotherapy before the bone marrow transplantation. The chemotherapy regimen increases the total cost of treatment for that particular condition.
Type of Hospital
The cost of bone marrow transplantation varies by hospital type and location. Whether you choose specialized transplant hospitals, centre, or multispecialty hospital, the total expense will differ. Additionally, costs can vary significantly between countries
Age of the Patient
Age of the patient is another factor that drives the total cost of bone marrow transplantation. The cost is usually higher in the case of a pediatric patient or those who are aged less than 20. This is because they require more care and tests and also, the total duration of hospitalization is greater in their case.
Monitoring Required
The total hospital stay also affects the cost of bone marrow transplantation. Sometimes, the total duration of hospitalization gets extended for additional monitoring in the case of pediatric patients. Some of the reasons responsible for an extra or extended hospital stay include monitoring for graft-versus-host disease, the need for ventilator support or intensive care, and the presence of a bacterial, fungal, or viral infection.
Other Factors:
- The expertise of the specialist
- Hospital fees
- Room charges
- Laboratory charges
- Cost of the donor (in case of an unrelated donor)
- Investigations cost
- Expenses associated with recovery
- Follow-up costs
Bone Marrow Transplantation Cost Itemized Breakdown
Pre-surgery Costs |
Surgery Cost |
Post-surgery Costs |
- Physical examination
- All investigations
- HLA typing
- Blood tests
- Chemotherapy (if applicable)
- Donor fees (if applicable)
- Medications
- Pre-operative preparation
- Documentation
|
- Surgery team fees
- Anesthesia charges
- OT charges
- Other consumables and medicines
- Laboratory charges
|
- Medications cost
- Other special consumables
- Any additional service availed
- Any other consultation
- Complications management
- Unanticipated care
- Follow-up cost
|
Tests Conducted Before Bone Marrow Transplantation
- Pulmonary function tests
- HLA (human leukocyte antigen) typing (for allogeneic cases)
- 24-hour urine examination
- Chest X-ray
- Sinus X-ray
- Echocardiogram
- Psychiatric evaluation
- Cardiac evaluation
- PET, CT, and MRI scans
- Blood work-up
- Infectious disease profiling
Cost of Accommodation, Food, and Local Travel
Patients who travel from abroad to a particular country for treatment have to bear the additional cost of hotel accommodation, local traveling, and food. This additional cost on top of the treatment cost depends on individual preferences. For example, a patient may decide to stay in a 3-star, 4-star or 5-star accommodation and prefer to eat exquisite cuisine during his or her stay. The cost increases with an increase in the level of luxury that a patient looks to have.
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