When Hope And Age Are Not On Your Side; Have Faitha Fairy Tale Of Haploidentical (half Matched) Bmt-www.777vk.com

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Leukemia-Lymphoma-Cancer Myelofibrosis is a disease of the elderly worldwide. The bone marrow dries up and spleen enlarges vigorously to make up for it. The only cure lies in allogeneic Bone marrow transplantation. But the downside is that the patients are usually old (>60 years) and rejection is very high, even with fully matched family donor. A 65 year old lawyer from Lucknow was suffering from Myelofibrosis for 3 years. He was reasonably well with oral medicines and an occasional blood transfusion. His sister who was 67 years old at the time of his diagnosis was HLA- matched with the patient. However, the patient was not keen on a transplant as his kids were still in college and he knew that even with matched family donor BMT, the chances of .plications are 10-30%. Since end of 2013, he started getting more anemic and his blood counts started plummeting. He started feeling tired most of the day and the spleen started growing rapidly and reached the size of a baseball in 3 months. His hematologist felt that it is high time he had a BMT or else he would have only a few months to survive. He was referred to Dr Suparno Chakrabarti and Dr Sarita Jaiswal at Dharamshila BMT Centre for an allogeneic BMT. They assessed the patient and found that not only was the bone marrow drying up; the residual cells were turning to leukemia. This is called ACCELERATED PHASE OF MYELOFIBROSIS. This is indeed a very difficult situation. No one in this condition has known to survive even after BMT. To top it the donor was found to have some heart problems. The doctors at Dharamshila sadly informed the patient and his family that there is not a lot of hope and he has a few months to survive with blood transfusions. The patient and his family went around a few hospitals in the country but all pulled their shutters down. Dejected and disappointed, the family was planning their trip back to the home city. On their way back, the patient stopped by at Dharamshila Hospital and asked Dr Chakrabarti one last time, you are in this field for 25 years, and can you not do something for me. Dr Chakrabarti looked at Dr Sarita Jaiswal and asked if she had any thoughts. They have been carrying out BMT from half matched (HAPLOIDENTICAL) donor for last 3 years, but this was a tough call. There was no such transplant performed successfully in the past in End Stage of Myelofibrosis which is turning to leukemia. Dr Sarita Jaiswal was recently back from her long stint of training in Haploidentical BMT in Italy and USA. She had initiated an innovative way of carrying out Haploidentical BMT in patients with advanced blood cancers. They informed the patient and his family about the nature of the procedure and emphasised that this is an experimental procedure. The family clutched on to it like the last straw. Dr Jaiswal started working on the procedure on the patient and Dr Chakrabarti kept on explaining that the chances of success are very slim. But the grit and determination of the patient, his wife, children and the brothers and sisters took them aback. They expressed unflinching faith on the team. He was admitted behind the closed doors of the BMT unit at Dharamshila Hospital in August, 2014. Dr Sarita Jaiswal innovated a new way of conditioning (pretransplant treatment) this patient to reduce the spleen size with the help of Dr Kanika Sharma from the Department of Radiation Oncology. Such treatment has been carried out only once before. But the infrastructure and expertise of the Radiation doctors, physicists and technicians were second to none. This was executed to perfection. On the night he received his first chemotherapy for conditioning, the patient developed a serious heart problem as well. The family was again called to sit down with the doctors. They were asked if they want to abort the procedure, but the answer was no. Dr Sarita Jaiswal doggedly went ahead while the patients life hung in a balance. He underwent Half Matched transplantation from his daughter and the rest is history. He started growing his daughters cells after 15 days and was discharged a month later. The patient braved many ups and downs over the next 6 months with his wife and family strongly by his side. It has been 9 months since the transplant; the disease has disappeared .pletely and the patient is ready to start a new innings. The family and the patient says that this was possible because of the dedication and devotion of Dr Sarita Jaiswal and her team, but Dr Sarita Jaiswal herself attributes the success to the unfettered faith of the patient and his wife on the team and the single minded will to get cured. In India, patients who are above the age of 50 years are rarely offered a BMT, even if they have a matched family donor. In USA and Europe, patients up to the age of 75 years and beyond are offered BMT from a donor. Why this difference? With economic developments, the population of those above the age of 60 years is on the increase. But, somehow in India, the elderly population are not given the same chance as the younger patients for a curative treatment. Dr Chakrabarti is firmly of the opinion that age is only a number. If the .ans in the body are working well and the mind is young, older patients do as well with a curative procedure such as BMT. The case highlighted here illustrates the point. Dr Sarita Jaiswal had presented the data on HAPLOIDENTICAL BMT on February 2015 at San Diego where the largest BMT conference of the world was held. She said 41 patients have undergone Haploidentical BMT since Dr Suparno Chakrbarti started this program in 2011. It is not just the numbers, but the amount of innovative research that has gone in to make HAPLOIDENTICAL BMT a successful procedure in a country like India, surprised the western audience. How often do the doctors say that BMT from a Haploidentical family donor is a high risk procedure and doing so in a 65 year old is a sacrilege! Our patient and his family smilingly disagree. About the Author: 相关的主题文章: