Best Hospitals for Hematopoietic Stem Cell Transplantation (HSCT) in Bengaluru, India

Haematopoietic Stem Cell Transplantation (HSCT) is the infusion of pluripotent haematopoietic progenitor cells — sourced from bone marrow, peripheral blood, or umbilical cord blood — into a conditioned recipient with the goal of restoring normal haematopoiesis and, in allogeneic settings, inducing a graft-versus-tumour (GVT) immune effect. The procedure is broadly classified as autologous (patient's own stem cells re-infused after myeloablative chemotherapy) or allogeneic (donor cells from a matched sibling, matched unrelated donor, haploidentical relative, or cord blood unit). The physiological impact is profound: conditioning regimens such as BuCy (busulfan + cyclophosphamide), FluBu (fludarabine + busulfan), or TBI-based protocols ablate the recipient's marrow, rendering them profoundly immunosuppressed and pancytopenic for 2–6 weeks before donor engraftment restores marrow function.

• ELIGIBLE CONDITIONS (Malignant): Acute Myeloid Leukaemia (AML) in CR1/CR2, Acute Lymphoblastic Leukaemia (ALL) in CR1 (high-risk) or CR2, Chronic Myeloid Leukaemia (CML) in accelerated/blast phase or TKI-refractory, Myelodysplastic Syndromes (MDS) with IPSS-R intermediate or higher, Hodgkin and Non-Hodgkin Lymphoma (relapsed/refractory or high-risk), Multiple Myeloma (autologous HSCT as consolidation post-induction), Myelofibrosis (allogeneic HSCT for DIPSS+ intermediate-2 or high risk)
• ELIGIBLE CONDITIONS (Non-Malignant): Severe Aplastic Anaemia (SAA), Thalassaemia Major (Lucarelli Class I–III), Sickle Cell Disease with major organ complications, SCID and primary immunodeficiencies, Fanconi Anaemia, Wiskott-Aldrich Syndrome, Hurler Syndrome and selected lysosomal storage disorders, POEMS syndrome
• ELIGIBLE CONDITIONS (Autoimmune — Investigational/Specialist Centres): Refractory Multiple Sclerosis (MS), Systemic Sclerosis, Crohn's Disease (autologous HSCT under EBMT guidelines)
• REQUIRED PRE-TRANSPLANT DIAGNOSTICS: Bone marrow biopsy and trephine with cytogenetics (karyotype, FISH), molecular profiling (NGS panel for FLT3, NPM1, IDH1/2, TP53, ASXL1), HLA typing (high-resolution 10/10 allele-level for patient and donor), PET-CT scan (for lymphoma patients to confirm complete remission pre-transplant), ECHO (left ventricular ejection fraction must typically be ≥ 45%), Pulmonary Function Tests (DLCO ≥ 50% predicted), Creatinine clearance (GFR ≥ 40–60 mL/min depending on regimen), Liver function and bilirubin (Child-Pugh scoring), CMV/EBV/HSV/VZV/HBV/HCV/HIV serology for patient and donor, HCT-CI comorbidity scoring, Dental clearance and ENT evaluation, Fertility counselling and sperm/oocyte cryopreservation discussion
• CONTRAINDICATIONS (Absolute or Relative): LVEF < 40% or uncontrolled cardiac failure, Severe hepatic dysfunction (bilirubin > 3× ULN, cirrhosis), Active uncontrolled systemic infection at time of conditioning, Active solid organ malignancy (other than indication), ECOG performance status ≥ 3 for myeloablative regimens (RIC may be considered in selected patients), Active psychiatric illness precluding informed consent or treatment compliance, Lack of suitable donor (for allogeneic) — though haploidentical and cord blood programmes have significantly reduced this barrier

AUTOLOGOUS HSCT (Auto-SCT):

In autologous HSCT, the patient's own peripheral blood stem cells (PBSCs) are mobilised using G-CSF (filgrastim or plerixafor + G-CSF for poor mobilisers), collected by large-volume leukapheresis (targeting ≥ 2–4 × 10⁶ CD34+ cells/kg), cryopreserved in DMSO, and re-infused after high-dose chemotherapy conditioning. Standard conditioning regimens include BEAM (carmustine, etoposide, cytarabine, melphalan) for lymphomas and Melphalan 200 mg/m² (Mel200) for multiple myeloma. Auto-HSCT carries no GVHD risk and has faster immune reconstitution but no GVT effect, carrying a higher relapse risk for AML. Tandem autologous transplants (two sequential auto-HSCTs) are used in high-risk myeloma at specialist centres.

ALLOGENEIC HSCT (Allo-SCT) — MATCHED SIBLING DONOR (MSD):

MSD allo-HSCT remains the gold standard for most haematological malignancies. The donor undergoes G-CSF mobilisation (peripheral blood stem cell collection is now preferred over surgical bone marrow harvest in most adult programmes due to faster engraftment). The graft contains T-cells that mediate GVT effect. GVHD prophylaxis typically uses tacrolimus + methotrexate (short course) or tacrolimus + sirolimus. Myeloablative conditioning (BuCy4, TBI 12 Gy + cyclophosphamide) is standard for fit patients < 55 years. RIC (FluBu2 or Flu-Mel) is used for older or comorbid patients.

PHASE 1 — INITIAL ASSESSMENT & GAF HEALTHCARE CASE REVIEW (Weeks -12 to -8 before transplant):

• Patient submits medical records to GAF Healthcare (bone marrow biopsy reports, molecular panels, HLA typing, imaging, echocardiogram, PFTs, complete blood count, metabolic panel)
• GAF Healthcare's medical team conducts a structured case review and presents the case to shortlisted transplant centres in India or UAE
• Written transplant plan (conditioning regimen, donor strategy, estimated timeline, cost estimate) received from the centre within 5–7 business days
• e-Medical Visa (India) or UAE entry visa application initiated with GAF Healthcare's immigration support team

PHASE 2 — PRE-TRANSPLANT WORKUP IN COUNTRY (Days -30 to -14):