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Apollo Cancer Institute, Hyderabad gives a new lease of life to three patients with rare and complex blood disorders through bone marrow transplantation

Date: 7 Jun 17

Apollo Cancer Institute, Hyderabad has accomplished a rare distinction of successfully treating three patients with acute blood cancer ailments, who were in a precarious condition when they came to the hospital. These patients were suffering from rare Bone Marrow Stem Cell Disorders of Paroxysmal Nocturnal Haemoglobinuria (PNH) - a bone marrow stem cell disease, which leads to rapid destruction of red cells; Biphenotypic Acute Leukemia - a rare type of Blood cancer with less than 8% survival rate and Aplastic Anaemia - a disease of Bone marrow, which curtails blood cells production. The matching stem cell donor for one of the patients was from Germany as no such donor was available here.

Briefing the media about the stupendous accomplishment, Dr Padmaja Lokireddy, Consultant Haemato - oncology and Stem cell Transplant, Apollo Cancer Institute; Mr Y Subramaniam, CEO and Dr Ravindra Babu, Medical Superintendent, Apollo Hospitals, Hyderabad said that stem cell transplant is cure for many blood disorders; Apollo Cancer Institute is one of the few Centers in the country with the necessary expertise and is geared to provide succour to such patients.

Mr Biswajit Saha, a 37 year old farmer hailing from Assam, was suffering from rare bone marrow stem cell disorder called PNH (Paroxysmal Nocturnal Haemoglobinuria), which occurs in 1 amongst a 10 lakh population. He was suffering with Anaemia, red coloured urine due to breakage of his red blood cells for the last two years. Such patients develop blood clots in the main blood vessels and if left untreated can develop life threatening heart and lung problems. Mr. Saha was transfused with blood at regular intervals, at times, 3 units a week. His visits to several doctors couldn't get him relief and was mostly misdiagnosed and treated for a liver ailment. His condition deteriorated over time as he had developed lung and heart problems and was breathless on minimal exertion. That's when he approached Apollo Cancer Institute, Hyderabad and our diagnosis identified it as PNH. The option available for Mr. Saha was an antibody treatment called Eculizumab(solaris), to be taken every week for lifetime. This medication is not available currently in India and is also way beyond his means, costing Rs 8 lakhs per week. Hence, the second-best treatment option was bone marrow transplant. He has undergone the first known PNH transplant in India four months ago, with the bone marrow donated by his brother. He has since recovered fully and is going about with his daily routine, in his village. Since the transplant he has not needed any blood transfusion and his lung and heart functions reverted to normal.

A thirty-one-year-old, mother of two, Mrs Kavitha, was diagnosed with Biphenotypic Acute Leukemia, a lethal ailment with two different types of blood cancers - acute Myeloid and Acute Lymphoid Leukemia, manifesting simultaneously. She had 98% disease in the bone marrow, in the chest and abdomen, cancer cells were detected even in the brain. The survival rate of patients with this type of leukemia was a dismal 8%. The initial dose of chemotherapy proved futile as the disease in her was virulent and had to take recourse to administering two other aggressive types of chemotherapy to gain control over it. However, the permanent cure was to perform a Bone marrow transplant on her. The strong dosage of chemotherapy took a serious toll on her condition and she had to be infused with nutritional support through her veins daily, to improve her weight and prepare her for a Transplant. The next seemingly insurmountable challenge we had on our hand was not finding a matching donor from amongst her family members and our attempt to locate a full match for her in the Indian, German and American registries proved in vain. We had to compromise with a donor of a different blood group with 90% match from Bangalore. The Transplant performed with all the associated challenges was of very high risk and extremely complex. Subsequent to the transplant, she contracted Cytomegalovirus virus infection which she fought through and has now crossed 100 days which is a giant milestone in the transplant process. Her blood test reveals 99% of Donor DNA type which gives reassurance that her Leukemia is cured.

The third patient, Mrs Prathima, a 32 year old lady was diagnosed with Aplastic anaemia three years ago and had very low platelet count and anaemia. Such patients are highly susceptible to infections and need regular blood and platelet transfusion. The initial option of Horse serum (ATG) treatment did not have long lasting success. The only chance of cure for her was bone marrow Transplantation, for which she came to Apollo Cancer Institute, Hyderabad. She didn't have a matching family donor but our search for a full 100% matching donor helped locate one in Germany. We had donor stem cells collected and airlifted fresh within 24 hours from there. Since her transplant, she had not had any major complications and didn't need any platelet transfusions.

Dr Padmaja Lokireddy said "It's a moment of immense fulfilment for me and the entire team at Apollo Cancer Institute, Hyderabad, for successfully treating patients with three complex and rare blood cancer ailments needing bone marrow transplantation. The outcome being on par with the best international institutions, gives us the impetus to take on bigger challenges and be the centre of excellence for treating complex blood cancer ailments in this part of the world".

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