Sawai Man Singh Hospital here has successfully conducted the first-ever bone marrow transplant in Rajasthan, treating a 45-year-old patient diagnosed with lymph node cancer which re-surfaced after chemotherapy, and giving him a new lease of life through a highly complicated stem cell transfer technique.
The operation was carried out at the Birla Cancer Centre in S.M.S. Hospital’s Medical Oncology Division in September-end after collecting stem cells from the blood circulation system of Sukhvinder Singh, a resident of Gurdaspur in Punjab, who was suffering from relapsed Hodgkin’s lymphoma that damaged his bone marrow.
Prof. Hemant Malhotra, head of the Medical Oncology Division, told The Hindu that the lymph node cancer was diagnosed in Sukhvinder in August 1998 and it re-appeared in June 2004 despite a prolonged chemotherapy treatment. It stopped formation of blood cells in his body.
Bone marrow stem cells in the human body turn into red blood cells, white blood cells and platelets to help the body stay healthy. If the bone marrow is attacked by a disease such as leukaemia or cancer, it can no longer make normal blood cells.
The autologous stem cell transplant – involving relocation of cells from the patient’s own blood – was performed after administering growth factors for ten days to Sukhvinder to expand the blood-forming cell pool and mobilise the cells from bone marrow to peripheral blood. The growth factor is a protein which stimulates the growth of new stem cells that spill over into the blood.
Dr. Malhotra said the blood stem cells were then collected from the patient’s circulation system by a stem cell separator machine for four consecutive days. The blood removed from a vein was passed through the machine which separated the stem cells and returned the remaining blood through a central venous catheter.
These stem cells were stored at the Cancer Centre at 4 degrees Celsius after their count was found satisfactory. Thereafter Sukhvinder was given high-dose chemotherapy for four days to destroy the diseased cells in his bone marrow and the rest of his body.
The collected and stored blood forming stem cells were infused into Sukhvinder’s body on September 20 to enable them to take over the job of making new blood cells. The patient was shifted to the bacteria-free high-efficiency particulate air (HEPA) filter room and treated for complications such as jaundice and infection.
In addition to antibiotics and anti-fungal drugs for treatment of infection, Sukhvinder was also given transfusions of blood cells and platelets until his body began producing its own. He received two units of blood and nine bags of single donor platelets.
After the RBC and WBC count recovered in his blood, Sukhvinder was taken out of the bone marrow transplant unit on October 13 and he would be fit to go home soon, said Dr. Malhotra.
The operation at S.M.S. Hospital, the biggest government hospital in the State, entailed an expenditure of Rs.3 lakh against an average cost of Rs.5 lakh to 7 lakh in the very few hospitals in the country where the bone marrow transplant is conducted.
The Birla Cancer Centre plans to do a few more autologous stem cells transplants before starting allogeneic transplants in which the stem cells are taken from another person. The donor may be a relative or a complete stranger, but his immune system markers should closely match the patient’s.
Dr. Malhotra said the Birla Cancer Centre – built earlier this year at a cost of Rs.1.30 crore under the Union Government’s National Cancer Control Programme – would undertake two transplant operations every month once the programme starts running at its full capacity.
