Who can be taken up for HSCT ?
Patients with MS having a Relapsing-Remitting course, Secondary Progressive (SPMS), Primary Progressive (PPMS) or Progressive Relapsing (PRMS).
Patients must have a Karnofsky Performance Status above 70% and a EDSS score of 6.5 or below. Age between 18 and 65 years.
Patients with EDSS above 6.5
Patients with an EDSS score between 6 and 7 may be accepted for HSCT in India after a thorough neurological evaluation.
We invite patients having a high EDSS score to come to Artemis Hospital, India and go through the Pre-testing Program to decide their eligibility for HSCT.
HSCT India Treatment Package Cost
At Our JCI-USA Quality Accredited Hospital in India, we have a comprehensive Medical Evaluation and HSCT Treatment Package that offers great Value for Money.
Medical And Hospital Accommodation Package
HSCT Treatment Package – 33,000 US Dollars (Thirty Thousand Six Hundred US Dollars).
Package Cost Includes –
- Cost of all Tests including MRI and Consultations for Pre-HSCT Medical Evaluation on in-patient basis.
After arrival at New Delhi Airport the patient is received by an Artemis Hospital Executive and accommodated at a private room at the hospital where the attendant is also staying with the patient. During the first 4 days tests and consultations are done. The patient and attendant are staying in a Triple Hepa Filtered room at the BMT Isolation Ward.
- HSCT patients are admitted to hospital straight from the Airport and discharged straight to Airport.
- HSCT Treatment Cost – Duration of 33 days for stay of both patient and attendant in Hospital room equipped with HEPA Filter with Triple Level Air Filtration for high level of infection control. Click here to see Day wise protocol
HSCT Inclusion criteria:
- Patients with MS having a relapsing-remitting course (other forms could also be considered: Secondary progressive (SPMS), primary progressive (PPMS) or progressive relapsing (PRMS)).
- Patients must have a Karnofsky Performance Status above 70% and an EDSS score of 6 or below.
- Patients with an EDSS score between 6 and 7 may be accepted after neurological evaluation. The patients should be accompanied by an ENGLISH SPEAKING attendant who is fully capable of transferring the patient on and off the taxi, to and from the toilet, etc.
- If a medical condition appears in the pre-transplant evaluations performed by our Specialists that impede the patient from getting the transplant, the patient will be refunded minus the expenditure done up to that point of time. This may include cost of hospital stay and the evaluations performed.
- The patient has to be able to travel to and remain in India during a 33 days period, accompanied by a caregiver/ attendant.
- We recommend discontinuing Immune Modulation or Suppression Treatments 3 months before the transplant (can vary).
- Once patients show to comply with the inclusion criteria they will be officially added to the waiting list.
- As soon as openings are available patients will receive proposal dates.
- Patients must bring one ENGLISH SPEAKING attendant to stay with them during the treatment. Only one attendant is allowed to stay at the hospital with the patient at any given time.
- Treatment must be fully paid 30 days prior to the date of the scheduled treatment.
|Day 0||Arrival at New Delhi Airport. – Admit in Artemis Hospital room||Airport Pick up by Hospital|
|Day 1||Appointment with Hematologist, Neurologist and Review of Medical History||Consultation & Tests|
|Day 2||Medical Evaluation Tests. Blood tests. LFT and RFT Viral Screening.||Medical Tests|
|Day 3||Continue Medical Evaluation Tests DTPA, HRCT Etc.||Medical Tests|
|Day 4||Continue Medical Evaluation Tests PFT, X- RAY Chest etc.||Medical Tests|
|Day 5||Counseling with Neurologist and Haematologist. Review of all test reports.||Medical Tests Review|
|Day 6||Multidisciplinary Clinical Meeting to approve HSCT, Obtain Consent.||HSCT Final Approval|
|Day 7||GCSF initiated.||Stem cell mobilization|
|Day 8||GCSF 5 mic/kg/day once a day and Methyl Pred 1 mg/kg||CBC/Stem cell mobilization|
|Day 9||GCSF 5 mic/kg/day once a day||CBC/Stem cell mobilization|
|Day 10||GCSF 5 mic/kg/day once a day||CBC/Stem Cell Harvest depending on the CD34 count|
|Day 11||GCSF 5 mic/kg/day once a day & Harvest of Stem Cells||CBC/Stem cell mobilization|
|Day 12||Cyclophophamide 50 mg/kg||Chemotherapy|
|Day 13||Cyclophophamide 50 mg/kg + ATG 2.5 mg/kg (Thymoglobulin)||Chemotherapy|
|Day 14||Cyclophophamide 50 mg/kg + ATG 2,5 mg/kg (Thymoglobulin)||Chemotherapy|
|Day 15||Cyclophophamide 50 mg/kg + ATG 2,5 mg/kg (Thymoglobulin)||Chemotherapy|
|Day 17||Stem Cell Infusion||Stem Cell Infusion|
|Day 18-30||Supportive Care – Management of Febrile Neutropenia; Recovery of counts and supportive care||Recovery Phase|
|Day 30-33||Discharge from hospital depending on recovery status and departure back to patient’s home country.||Recovery Phase|
Note 1 : Cost of Stay beyond Day 33 at the hospital may cost about 300 US Dollars per day and is payable extra.
Note 2 : In rare cases (2-3%) the Stem Cells yield may be difficult to obtain and those patients may need additional treatment for mobilization of Stem Cells – Injection Plerixafor. Additional cost of about 2000 US Dollars may have to be paid extra by such patients.
Echo = Echocardiography is a sonogram to create images of the heart
MRI = Magnetic resonance imaging is a test that uses a magnetic field and pulses of radio wave energy to make images of inside the body.
PFT = Pulmonary Function Test = Spirometry = Test that measures how well the lungs function and bring oxygen to the rest of the body.
DTPA = Renal scan that involves the use of radioactive material to examine the kidneys and assess their function.
HRCT = High-Resolution Computed Tomography is a technique to image various lung pathologies.
VEP = Visual evoked potentials are produced by exposing the eye to a reversible checkerboard pattern or strobe light flash, help to detect vision impairment caused by optic nerve damage, particularly from multiple sclerosis.
BERA = Bera is an objective way of eliciting brain stem potentials in response to audiological click stimuli. These waves are recorded by electrodes placed over the scalp.
Note 1: After consultations with Head Hematologist and Neurologist if required more medical tests can be added to above if advised.
Note 2: After the Pre-HSCT Tests and Consulations are done, each patient’s case is reviewed by a Multidisciplinary Team and then the patient is taken up for HSCT.