When a 10-year-old has cancer, the boy’s family and doctors obviously have to do everything under the sun to find a cure for him. That is what parents and doctors of Vikram (name changed) of Madurai did. The hunt was on to find a 100 per cent matching donor, and when that failed, they found one that was a half match.
Vikram got a bone marrow transplant with a 50 per cent match from his mother. He survives to tell the tale today, speaking over a surgical mask.
According to his doctors, he is the ‘first ever recipient of the first ever Haploidentical transplant in the country”.
The most challenging aspect of bone marrow transplants, believe it or not, is finding matching donors.
A 100 per cent match is ideal, but at least 80 per cent is needed before the doctors take a risk transplanting the stem cells. Without robust donor registries within the Indian subcontinent and genetic pool, the chances of finding a donor are rather slim.
“His sister failed to be an appropriate matching donor, but his mother was a 50 per cent match. We decided to go ahead and perform a Replete T Cell Haploidentical transplant,” says Chezhian Subash, haemato oncologist, MIOT Institute of Haematology, Haemato-Oncology and Bone Marrow transplant.
The chances of rejection, naturally, are much higher. “This is why we need to take care of the patient extremely well post procedure. The body is being tweaked not to reject the donor stem cells by suppressing the natural immune system. So while he waits for the donor cells to grow in him, we have to be careful that he does not pick up infections,” explains Prithvi Mohandas, MIOT Hospitals. Post procedure, the patient is given a special combination of immuno suppressant drugs so that his body does not reject the organ, Joydeep Chakrabartty, also with the MIOT Institute of Haematology.
Dr. Prithvi added that the procedure can be performed for between Rs. 10-15 lakh at MIOT. “It makes a bone marrow transplant accessible to a large number of people who otherwise could not afford it. More importantly, a 50 per cent donor match, usually possible with parents, opens up possibilities for patients with a number of blood-related disorders.
The Institute was launched formally by British Prime Minister’s Trade Envoy Kenneth Clarke. The occasion also served to facilitate the signing of a memorandum of understanding between MIOT and Whittington Hospital, London, on an ante natal screening programme for Thalassemia.
Nick Harper, representing the UK hospital, said India had about 10 per cent of people with Thalassemia, at a very conservative estimate.
Not detecting the condition before or at birth could have disastrous consequences for families and impose a huge health burden on the country, he said.
The screening programme will hope to evolve a model that could then be replicated in Tamil Nadu, and India.
Mr. Clarke said the association between these two institutions would be of mutual benefit to the nations. Both countries were interested in providing the highest possible quality of care to the widest possible population, he added.
Mike Nithavrianakis, British Deputy High Commissioner, said the Indo British Health Initiative, set up 18 months ago, was an effort to take advantage of the incredible links between both nations, and create a platform for healthcare professionals and trade bodies from India and the UK to meet together and exchange ideas.