COST OF HEMATOPOIETIC STEM CELL TRANSPLANTATION IN INDIA

Hematopoietic stem cell transplantation (HSCT) is the definite cure for many hematological diseases. With the increasing indications for HSCT and its relatively low cost in Indian subcontinent, an increasing number of patients are opting for this procedure. We retrospectively analyzed the cost of one hundred sixty two HSCTs done at our center in the last three years. The median cost of autologous transplant was INR 7,52,294 (USD, $12,500) (range INR 6,19,850-14,17,212) and the median cost of allogenic transplant was INR 10,74,881 ($18,000) (range INR 6,49,944-23,82,227). The cost of HSCT is cheaper here compared to that in developed countries and success rates are nearly equivalent. The major factors contributing to the cost are related to the complications post-transplant mainly infections and graft versus host disease, which are also the reasons for the increased stay in the hospital

Are we missing out something in donor notification?

Background: Donor notification is an integral part of any blood collection facility. But regarding DAT positive donors there are no standard guidelines to notify them or to refer them to any clinician. Aim of this study was to suggest possible ways to manage DAT positive donors. Material and Methods: This was a retrospective study extended over past 5 years from 2013-2017 in a tertiary care health center. All whole blood donations were tested for ABO Rh, irregular antibody, HIV, HBV, HCV, SYPHILIS, and Malaria parasite. At the time of blood request if crossmatch came incomnpatible and antibody screen was negative we do DAT of the unit and if it comes positive then DAT work up was done. Result: Of total 55,310 donations, Twenty-two (0.04%) donors were DAT positive. From DAT positive donors, in 72% of cases IgG alone was responsible for DAT positivity of the unit, and in 18% of cases, involved IgG was subtyped as I gG1/IgG3. Conclusion: With the evidence of a significantly increased risk of cancer, especially hematologic malignancies, among blood donors with a positive DAT, donor notification is suggested. There should be a standardized protocol across the country about donor notification to avoid confusion and variations seen in different blood collection facilities