The Hyderabad- based multi-speciality tertiary care center, Global Hospitals recently performed haploidentical stem cell transplant on an eight years old child suffering from acute leukaemia.
The patient had to undergo immediate transplantation due to the relapse of his acute leukaemia. Haplo or half-matched transplant was the only option in which the father was found to be a compatible match as a haplo donor.
The team of experts at Global Hospitals performed the pre-tests required for the transplant. The patient was admitted in special rooms fitted with high-efficiency particulate air (HEPA) filters for transplantation. He received a very high dose of chemotherapy to destroy the diseased bone marrow. The donor received a few injections before stem cells were removed by apheresis procedure. The child was infused with these stem cells on the transplant day. The team noted that the white blood cell (WBC) counts plunged to below 100 for several days and infections were controlled by using higher antibiotics.
He was provided extensive support with blood transfusions, nutrients along with pain killers to keep his pain under control. After twelve days of infusing stem cells, the child’s own new cells were developed back and he started recovering.
A haploidentical transplant is a type of allogeneic transplant. It uses healthy, blood-forming cells from a half-matched donor to replace the unhealthy ones. The donor is typically a family member.
For allogeneic transplants, the doctor tests the patient’s blood to find out their human leukocyte antigen (HLA) type. HLA is a protein or marker found on most cells in one’s body. Doctors then look for a donor or umbilical cord blood that closely matches the patient’s HLA.
Unfortunately, a lot of patients who require bone marrow transplant usually do not have a completely HLA matched donor, as there are only 25% of chances that one finds a sibling matched donor. In this case, a haploidentical transplant may be an option. This is a type of allogeneic transplant where the donor matches exactly half of the patient’s HLA.
The lead physician Dr Niranjan Rathod, Head of Dept, Hematology & BMT, Global Hospitals was trained in this type of transplant procedure from Fred Hutchinson Cancer Research Centre, Seattle, USA, under the guidance of Dr Prof. O’Donnell.
“There is a high risk (in this procedure) because of chances of graft failure and graft versus host disease (GvHD), however, these transplants offer a great option to the patients in urgent need of transplants,” he said.
Graft versus host disease (GvHD) is a condition that might occur after an allogeneic transplant. In GvHD, the donated bone marrow or peripheral blood stem cells view the recipient’s body as foreign, and the donated cells/bone marrow attack the body.