MOHAN Foundation, in collaboration with NATCO, organized an online masterclass titled “Beyond Solid Organ Transplantation: Understanding Bone Marrow Transplantation (BMT)”, on June 20, 2026, for NATCO and MOHAN Foundation members. Ms. Hemal Kanvinde, Quality Assurance Officer welcomed the participants and introduced the speaker, Dr. Divya Bansal, Consultant and Cluster Head of Hematology-Oncology and Bone Marrow Transplant at Manipal Hospital, Delhi. Dr. Bansal is a Pediatrician with a DM in Clinical Hematology from AIIMS New Delhi and prior experience at Imperial College London, with special interest in hemoglobinopathies, coagulation disorders, aplastic anaemia, and hematological malignancies.

Dr. Bansal began by clarifying that the more accurate term for the procedure is Hematopoietic Stem Cell Transplantation (HSCT), since stem cells are now sourced from peripheral blood and cord blood in addition to bone marrow. HSCT works by infusing healthy stem cells to replace diseased marrow, enable high-dose chemotherapy, restore the immune system, or, in cancers, help destroy tumor cells.

She distinguished between autologous transplants, where patients receive their own stored cells, and allogeneic transplants, which use an HLA-matched donor and carry a risk of Graft-versus-Host Disease (GvHD). On stem cell sources, she noted that peripheral blood is the most common choice in India due to faster engraftment, while cord blood is generally viable only for children, and private cord blood banking offers little benefit to the individual donor.

Comparing HSCT with solid organ transplantation, Dr. Bansal explained that HSCT requires no major surgery and that immunosuppression can often be stopped once the donor’s immune system takes over, unlike the lifelong suppression needed after organ transplants. She added that rejection in HSCT is bidirectional, as either the body can reject the donor cells or the donor cells can attack the body, whereas organ rejection runs only one way.

On donor safety and regulation, she reassured participants that HSCT donors face no long-term risk, since stem cells replenish within 72 hours. HSCT is governed by ICMR and CDSCO guidelines, with strict anonymity maintained between unrelated donors and recipients, and registries such as Datri and DKMS help source matched donors, at a legitimate cost of roughly 9–10 lakhs domestically and 25–45 lakhs internationally, covering workup, harvest, and transport.

Dr. Bansal walked participants through the clinical journey, starting with an HLA-matched sibling as the first choice of donor, which carries roughly a 25 percent chance of compatibility, before turning to matched unrelated or haploidentical donors if needed. After conditioning chemotherapy, cells are infused intravenously, with neutrophils typically recovering within 12–25 days and success tracked through chimerism testing. She also detailed key complications, including early toxicities, infections, and GvHD, noting the paradox that while GvHD is risky, it also helps eliminate residual cancer cells.

She emphasized that transplant coordinators play a vital role across the entire process, from donor workup and financial counselling to supporting families through the prolonged isolation period and guiding patients on post-transplant precautions.

During the Q&A, Dr. Bansal clarified that HSCT cannot currently treat kidney, muscle, or nerve disorders, and that cadaveric donors are not required since living donors face no permanent loss. She noted that emerging therapies like CAR-T and CRISPR may reduce reliance on BMT in the future, but it remains a vital option today, with younger patients and deeper remission offering the best outcomes; transplants are now possible for patients up to 75–80 years old using reduced intensity conditioning. She added that HSCT is currently not covered under Ayushman Bharat due to its cost and specialized nature.

Nearly 60 participants joined the masterclass, which gave transplant coordinators a clearer understanding of HSCT and reinforced their central role in guiding patients and families through this complex journey of care.