Haplo-identical Bone Marrow Transplantation

Aug. 25, 2014 - PRLog -- A 25 year old IT professional was struck with Hodgkin’s Disease which is one of the most curable cancers arising from lymph glands. He was treated with standard chemotherapy and the disease went away only to reappear a few months later. This time he received local radiation and Autologous Bone Marrow Transplantation (BMT). However, the response was short-lived and the cancer sprung its ugly head within 6 months.

The young man and his distraught family went from one centre to another. Various forms of chemotherapy and a new drug called Brentuximab were suggested to him by the experts. However, the drug Brentuximab had to be imported and each cycle of treatment would have costed about 5 lakhs. Some had suggested an Allogeneic BMT but his only brother was fully mismatched with him and this option was no longer a consideration.

While searching for other treatment options, patient visited Dharamshila Hospital’s website. He was inspired to know that he can go for “Half Matched or Haploidentical Transplantation”. He was thrilled to find out that Dharamshila Hospital is the first and only cancer hospital of India, which has built BMT unit, as per International standards Class 1000 for clean rooms. Availability of clean rooms ensures minimizing bacterial, fungal and viral infections to which most immunosuppressed patients are prone to.

Inspite of being discouraged by most centres to go for Haploidentical transplantation, he took the challenge. He enrolled himself in the Haploidentical BMT programme being carried out by Dr.Suparno Chakrabarti and Dr.Sarita Jaiswal for last 3 years.

As expected, his parents were half matched donors. On further investigations, Dr.Sarita Jaiswal identified a unique population of white blood cells in the father, which could kill the tumour cells of the patient, without causing any adverse reaction. These unique cells are called “KIR ligand mismatched NK Cells (Natural Killer cells)”. These cells were analysed and were found very effective in killing tumour cells in the test tube.

Patient was admitted at Dharamshila Hospital under Dr.Sarita Jaiswal, who had been trained in transplants involving such cells manipulations at Italy and USA. Since, patient had already received a lot of intensive chemotherapy and local radiation; there was no question of giving him additional chemotherapy.

In addition to Immunosuppressive drugs, patient received a small dose of “Total Body Irradiation” by Dr.Kanika Sharma, Radiation oncologists. This was followed by transfusion of his father’s half matched stem cells. After 7 days, his father’s white blood cells were again collected; special KIR ligand mismatched natural killer cells were separated from the white cells and infused into the patient.

The stem cells from the father started growing in the patient after 2 weeks. He is free of all bacterial and viral infections since then. The blood and bone marrow of the patient were regularly analysed and it showed that the cells from the father which were supposed to be killing the tumour without causing any reaction in the patient, were growing in number.

Sixty days after the BMT, a PET scan was done to see the state of the cancer. To everyone’s joy and surprise, it had disappeared completely.

Few such cases have been reported worldwide and this is the first time Indian doctors have used innovation, science and technology to cure such a refractory cancer. Dr Sarita Jaiswal had seen some very impressive results with Haploidentical BMT using cell manipulation, but to replicate the procedure in its entirety would cost 40 lakhs at least. Hence, Dr Sarita innovated this unique way of carrying out the Half matched BMT at a low cost and administer selective cells at the right time which help in hitting the tumour as well as fighting infections.

Several such Haploidentical BMT using this unique and innovative technology are being carried out by Dr Sarita Jaiswal at Dharamshila BMT Centre. Dr Sarita says that it is not just about giving the special cells but understanding the science behind it and applying it in the right context in the correct way.

According to Dr.Suparno Chakrabarti, any patient who needs Bone Marrow Transplantation and does not have fully HLA matched donor can opt for Haploidentical Transplantation. With the right choice of donor (Parent, Sibling, Children / one can get cured of otherwise refractory blood or lymph gland cancers.