Bone marrow transplant holds hope for kids with severe sickle cell

bone marrow transplantation

Nagpur: Muskan and Rohit are playful and appear normal like any other kids of their age under 10 years. Both indulge in mischief, running around the corridor as their parents anxiously wait outside a doctor’s cabin. Muskan and Rohit are severe sickle patients from birth. Despite being on high doses of hydroxyurea, they fall sick anytime leaving them hospitalized at least once a month.

“Bone marrow transplant (BMT) is the only option for such severe sickle cell patients”, said Dr Dipty Jain, nodal officer for sickle cell in Nagpur.
Their siblings are the prospective donors for BMT and need to undergo a human leukocyte antigen (HLA) typing test. A select group of 10 severe sickle cell patients were, probably for the first time in the region, introduced to HLA typing tests at an upcoming private hospital in the city.

Dr Jain facilitated the free of cost collection of HLA, which carries information about the genetic makeup of the human body. Once the HLA matches, doctors will perform BMT in Delhi in the coming days. “Many patients die as they are not aware of the BMT option and the due process. Their parents belong to rural areas and have poor economic backgrounds,” said Dr Jain.

Dr Gaurav Kharya, the senior consultant for paediatric haemato-oncology, immunology at Apollo Centre for BMT & Cellular Therapy, performed the HLA tests at the upcoming Arihant Multispeciality Hospital in the city.
Dr Kharya has performed 105 BMT for sickle cell patients in the age group 10 months to 32 years.

“BMT success rate in sickle cell disease depends on the age of the recipient, how much damage the disease has caused, and the donor. Overall, the success rate is 80 to 95%. If an under 10-year-old patient gets a full genetic match donor, then such kid will have a high success rate,” said Dr Kharya.

In case of a mismatch, a modified technique developed by Dr Kharya will be used. “We have developed a safe modified technique at our Delhi centre. It involves preparing the recipient 6 to 8 weeks before the transplant. Apollo protocols for BMT have been published exclusively for sickle cell,” he said.

Dr Kharya said the burden of sickle cell is huge. “We decided to select patients who are less than 10 years old, having uncontrolled symptoms despite medication and have severe problems,” he said.

The HLA test results will come in around 6 weeks. “The samples have been sent to Germany. In the next phase, if we get 100% matching pairs, we will initiate a campaign to get sponsorship for BMT,” said Dr Kharya.