The Hematology Department looks after people with problems in their blood.

This includes leukemia, some forms of anemia (like Sickle Cell) and congenital (from birth) diseases like thalassaemia and hemophilia.

roblems seen include

Thalassaemia ! a genetic problem with the blood "one marrow failure syndromes such as aplastic anemia. "lood cancers such as leukemias, lymphomas (cancer affecting lymph nodes) and multiple myeloma. Diet for cancer patients# http#$$www.scribd.com$doc$%&'&()*%*$cancer!diet "leeding disorders like hemophilia and platelet related disorders.

+bout "one ,arrow Transplant - ",T

",T takes cells from inside the bones from a healthy person and gi.es them to the person who is sick. The bone marrow is where the white blood cells, /"C and platelets are made. "one marrow transplants are done for people with leukemia, thalassaemia, myeloma and aplastic anemia. http#$$www.scribd.com$doc$%)01%'())$",T!/eferral!2uidelines!3456!&0%(

7nauguration of "one ,arrow Transplant by admabhushan (8ate) 9.".2rant, with rof /eu.en :r from Hadassah 4ni.ersity and ,r "omi "hote(C.6.: /uby Hall Clinic) and Director Dr ;i<ay /amanan. http#$$www.isracast.com$article.asp=>7D?%&0%@t?7srael!7ndia!3oint!Cancer!/esearch

Treating the disease

Airst, the bad bone marrow that has caused the disease, like leukaemia, must be killed$destroyed to get rid of the bad cells. This is done with radiotherapy (=ray treatment) or large doses of chemotherapy (drugs).

2etting new cells - from relati.es

Then the transplant can start. "one ,arrow Transplants come from a li.ing person who is called the donor, this is often a relati.e - a small operation takes some cells from inside the healthy personBs bones to gi.e to the sick person. This is an allogenic transplant. The good donor cells are gi.en to the patient though a needle in the arm - <ust like a blood transfusion.

2etting new cells - from the patient

Some transplants take the patients own cells - this is an autologous transplant. This is done if there is no relati.e with blood like the patients blood (no match). Airst the patient has chemotherapy to get rid lots of the bad cells causing the leukaemia. Chen in remission the good healthy cells grow /emission is when there are no bad leukaemia cells left. 2rowth factor is gi.en to help the cells multiply so there are enough for the transplant. 2ood cells that are .ery young can be separated from the rest of the cells. These stem cells are so young that they ha.e not yet grown into the different types leukocytes, lymphocytes etc Chen the white blood count is high enough the patient has blood taken. This is a bit like donating blood but the blood goes into a cell separation

machine. Here the stem cells are taken out (separated). "ut the rest of the cells are put back in the patient. 7t <ust takes &!1 hours. +utologous transplants are done mainly for patients with multiple myeloma. 7t mobiliDes peripheral blood stem cells.

"one ,arrow Transplant in /uby Hall Clinic

The department started its ",T program in &00). Hematology does about %* autologous @ 10 allogenic bone marrow transplants $ stem cell transplants (SCT) a year. There are special rooms for the patients. The rooms stop them from getting infections when the transplants are done. The transplants are done for leukemia, lymphoma, some marrow failure problems and genetic disorders. "one marrow failure is when the marrow stops making blood cells. 2enetic problems are things like thalassaemia. "etween &00) and &0%1, o.er %*E allogenic and about 1) autologous SCT ha.e been done.

Hemophilia
Hemophilia is a genetic disease mainly in boys. There is a gene that does not make the clotting factor properly. So, the boys bleed .ery easily from .ery small accidents. They also bleed into muscles and <oints eg knees and elbows. Treatment# The clotting factors can be in<ected into patients to stop the problem. "ut the factors are .ery e=pensi.e and in 7ndia most people cannot afford them. Care is gi.en for all these problems for patients with hemophilia. The hematologists look after the blood problem. They also work with the :rthopedic surgeons and physical medicine and rehabilitation doctors for the muscle and <oint problems. The muscle and <oint bleeds cause pain and stop people using their arms and legs properly. Ce ha.e done comple= <oint surgeries and coronary artery bypass surgery.

Thalassemia
Thalassemia is a genetic disease. The child is born with a gene that makes bad hemoglobin. atients start getting problems as a child. ",T is used to treat Thalassemia and )' transplants ha.e been done so far with a success rate of '0F e.en though most of the patients are in Class 77 or 777. Ce ha.e done first successful unrelated cord blood stem cell transplant, Combined(cord and bone marrow), Haploidentical transplant(from mother with half match). http#$$francais.insception.com$node$(1( http#$$www.cure&children.org$news$madurai!bangalore!<aipur!pune!and!delhi

:ur data is part of prestigious 6",T and C7",T/ international sur.ey. http#$$www.scribd.com$doc$%G('(%(G($7nternational!Sur.ey!of!transplant!for!sickle!cell! disease Ce ha.e facility to in house. anel /eacti.e +ntibodies and mi=ed lymphocyte crossmatch testing

Ce ha.e inhouse H8+ testing and are in process of getting cell sorter. These facilities are a.ailable under leadership of Dr 5ita ,unshi. :ur centre has done pioneering research on Hydro=yurea and Cheatgrass in Thalassaemia.

http#$$www.scribd.com$doc$&0(GG(1&($4se!of!Hydro=yurea!Cith!Cheatgrass!in! Thalassaemia!,a<or

,olecular 2enetics and +ntenatal Diagnosis

7n most patients and carriers with thalassaemia a test is done that finds the gene causing the problem. + carrier is someone who has the abnormal gene but it does not cause any problems. The test is done by looking at the patients D5+ (chromosomes). The department can also gi.e an antenatal diagnosis. This means that when a lady is only ' weeks pregnant they can look at the baby. They test to see if the baby has the abnormal gene that would gi.e the child thalassaemia. Ce are working in association with 4ni.ersity of diagnosis. une for setting centre for genetic

Ainancial +7D for atients

The department tries to get money to support for patients who find it difficult to pay their medical bills. This is mainly for the patients on the general ward. +round 1*0!*00 patients are gi.en financial assistance e.ery year. The money comes from the rime ministerHs fund, Chief ministerHs fund, charitable trusts and philanthropic indi.iduals who want to help others.

Some of the 7n.estigations @ rocedures done at Hematology 4nit are#

"one ,arrow Transplantation 7mmunophenotyping Cytogenetics Stress Cytogenetics +pheresis Cryopreser.ation