This is the story of a 16 year old girl from Kozhikode, Kerala, who was diagnosed with Acute Myeloid Leukaemia (AML). She was being treated at an advanced stage of the disease at Amrita Institute of Medical Sciences, Kochi. Leukaemia is a type of cancer affecting the blood and bone marrow, which produces our blood cells.

What is Acute Myeloid Leukaemia?

According to The Leukaemia Foundation of Australia[1], AML is a type of leukemia that results in the bone marrow producing abnormal white blood cells, red blood cells or platelets. White blood cells are what help our body fight disease and infection. However, in the case of AML, these cells crowd the marrow in such a way as to obstruct the production of normal red blood cells and platelet.

The 16 year old teenager suffering from AML had a relapse and the probability of her survival was very small. Dr. Neeraj Sidharthan, Head of the Stem Cells Transplant Unit at Amrita Institute of Medical Sciences, told The Times of India[2], as published in a May 2015 article, how they had desperately searched both the National Registry of Stem Cell samples, DATRI and the international Germany-based registry, DKMS, for a potential matching donor. There are over 70,000 stem cell samples in DATRI and none of them matched the patient.

The Treatment

The doctors had then suggested allogenic Stem Cells transplant, or the transfer of Stem Cells from a healthy person to save the girl. Usually, the donor cells come from either of the parents or a sibling, but in the present case, this could not happen. “This is perhaps one of the rarest transnational stem cell donation cases in the country,” remarked Dr. Sidharthan. Finally, the right sample was found from a 59 year old man from Germany, who consented to the donation.

The patient was promptly admitted to the Bone Marrow Transplant unit of the hospital for pre-procedure tests and other required treatments before the transfusion. As a precaution and because the donor was a person from a different continent and of the opposite gender, the girl was given chemotherapy drugs to prevent side effects.

The Stem Cells from the donor were airlifted from Dusseldorf and sent on to Cologne and then to Kochi via Abu Dhabi. The transfer of cells was professionally completed by a team of doctors under the charge of Dr. Sidharthan.

Following the successful Stem Cells transplant, there have been no reported side effects and the 16 year old visits the doctor regularly for checkups. Her platelet count is now normal.

This story of hope and survival is just one among many that Stem Cell Therapy has made possible.

[1] http://www.leukaemia.org.au/blood-cancers/leukaemias/acute-myeloid-leukaemia-aml

[2] http://timesofindia.indiatimes.com/india/Germans-stem-cells-give-Kerala-girl-new-lease-of-life/articleshow/47488132.cms

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As leukaemia strikes patients in India, doctors are considering cord blood transplants as a viable option to save patients.

Leukaemia is a disease in which the normal process of blood cell production changes. The bone marrow (the soft tissue inside bones) is a site where blood cells are made; all blood cells begin as stem cells in the marrow[1]. However, when a person develops leukaemia, the bone marrow starts producing too many immature/abnormal cells called lymphoblasts, which crowd out other healthy blood cells in the marrow, blood stream and the lymphatic system.

The lymphoblasts can travel to the rest of the body via the blood. While some leukaemias manifest themselves through visible signs that doctors can see, others develop slowly with symptoms that the patient will only be able to describe as ‘pain’ or ‘discomfort’.

The symptoms of leukaemia

The symptoms of leukaemia are many and diverse. Broadly, they have been identified as: fatigue, loss of appetite, loss of weight, recurring fever, anaemia, pale skin, dizziness, bleeding (in nose, gums, bloody vaginal discharge or bleeding between menstrual periods), cold sores and red sores on the skin, respiratory infections, boils around the anus, vomiting, headache, bone or joint pain, enlarged lymph nodes in neck, groin, underarms, abdominal discomfort or pain, bloated feeling in abdomen, cloudy or blurry vision, swollen testicles, etc. There may be other extremely painful symptoms of leukaemia like Leukocytoclastic Vasculitis (with sores on the extremities) and Sweet’s Syndrome (which is accompanied by high fever and painful boils on the body).[2]

Treating ALL and APL with cord blood

Traditionally, bone marrow transplants have been the preferred treatment option for acute leukaemia, but the process is fraught with delays and complications. The chances of the procedure being successful are high when the eligible recipient gets a marrow donor who matches for six HLAs (Human Leukocyte Antigens) – these antigens help the immune system recognise its own cells, hence the chances or rejection are lower.[3]

Many types of leukaemia remain untreatable. However, the Acute Promyelocytic Leukaemia (APL), which was first discovered in France in the 1950s, is now in the ambit of treatable leukaemia.[4] It has been found that adults with APL who need bone marrow transplants but do not have matching donors for important HLAs can undergo stem cell transplants using umbilical cord blood. The chances of success are much higher with one’s own cord blood.

Also, stem cell transplantation from cord blood does not cause any delays, since the appropriate blood units are procured within days. Also, the incidence of more people getting the transplant is higher with cord blood cells than with matching bone marrow.
[1] Leukaemia facts and types, The University of Texas MD Anderson Cancer Centre

[2] ‘Signs and symptoms of leukaemia’, Canadian Cancer Society

[3] Christensen, Damaris, ‘Umbilical Cord Blood Offers Another Option for Leukemia Patients’, Journal of the National Cancer Institute, Volume 97, Issue 4

[4] Kotiah, Sandy, ‘Acute Promyelocytic Leukemia’, emedicine.medscape.com

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