Happy to be home after successful bone marrow transplant
It is a joyous reunion in Colombo, with three-year-old Yenuli exchanging many hi-fives with Dr. Sachin Suresh Jadhav from India. Even though she is oblivious to the life-saving role played by Dr. Jadhav, her mother, father and grandparents are only too aware of how their lives may have changed without the doctor’s intervention.
The family’s saga of illness had begun on May 1, last year, with Yenuli’s mother, L.R. Shanaki Sakuntala, 34, coming down with a cold and a fever.
As any young mother would do, Shanaki from Kegalle continued with her routine of looking after her daughter and working at a private insurance company. The fever, though, did not leave her.
“Adu wuna, wedi vuna,” says Shanaki, explaining that the fever would fall and rise. She also lost her appetite. A danger signal came when her gums started bleeding and at the end of May a full blood count “was not good”.
“My platelets and red blood cells were low but the white blood cells were high,” she says.
Admission to Kurunegala Hospital gave a clear indication what was wrong with her. Her blood picture showed that leukaemia (blood cancer) was coursing through her body and she was then referred to Consultant Oncologist Dr. Jayantha Balawardana at the National Cancer Hospital at Maharagama.
Shanaki had been struck by Acute Myeloid Leukaemia (AML).
The family was in shock. Hale and hearty had been Shanaki, having done sports and also been a cadet while in school. Husband, H.N.D. Kodikaragoda, whom she affectionately calls ‘Thaththi’, however, was not ready to give up on Shanaki, for he had heard of a cure for AML through a bone marrow transplant. But her blood counts were too low.
Such bone marrow transplants were being done succesfully, their research revealed, at BGS Global Hospitals in Bangalore, India, part of the Global Hospitals Group. When they informed Dr. Balawardana about their decision to seek a bone marrow transplant there, he had taken the responsibility of bringing Shanaki’s counts to a certain level so that she could undertake the journey.
The arrangements with regard to Shanaki’s treatment had been facilitated by Forte International Pvt. Ltd., under the guidance of Chairman M.F.A. Riyas.
After one and a half months at the Cancer Hospital and the first cycle of chemotherapy at the Kurunegala Hospital, she was given the green light to travel and it was on July 7 that she and her husband flew to Bangalore, while her mother and father looked after Yenuli who was only two then, back at home.
More chemotherapy followed at BGS Global Hospitals with a high-dose on August 12 and the bone marrow transplant scheduled for August 20.
Recalling the effects of the high dose of chemotherapy, Shanaki says her hair fell off and her nails turned black. She also looked really old.
For Shanaki, bone marrow donors were not an issue. The middle sister between an aiya and a malli, both her siblings were a match. As her aiya and malli were working in Qatar, the match had been performed by collecting cells onto cotton swabs from inside their cheeks.
It was her aiya who came to Bangalore 15 days before her transplant as her donor, MediScene learns.
Describing in detail how this allogeneic bone marrow transplant took place, she says that her aiya underwent a course of injections after which she was administered his stem cells through a Hickman line fixed below her neck.
While her brother returned to his job in Qatar after a week, Shanaki was at BGS Global Hospitals for three months for testing whether the donor cells had taken root in her system. Initially, the donor cells were 60% to 40% of hers but gradually rose to 80% and then 90%, proof that the bone marrow transplant was a success.
On November 28, Shanaki returned to Sri Lanka, looking like her former self – a young and pretty woman of 33.
She still has to have weekly blood tests which include liver and kidney functioning to ensure that all is well within her body, but now Shanaki plans ahead.
Explaining that her husband was like a rock who stood by her filling her with positive thoughts, Shanaki is also ever-grateful to her relatives, friends and colleagues who were supportive throughout. “My mother is still engaging in religious activities such as Bodhi pooja,” she says with emotion.
Getting back to work soon is Shanaki’s next target, while ensuring that her little girl gets the best education possible.
| Indian specialist’s views on life-saving BMT Solid tumours, leukaemia and lymphoma are being cured through bone marrow transplantation (BMT), says the Chief of Haematology and BMT, BGS Global Hospitals, Bangalore, Dr. Sachin Jadhav who was in Colombo recently. Describing the process, he says that the first step is to find a donor for such patients as Shanaki who need BMT. Once tests including HLA (human leukocyte antigen or tissue) typing have been performed to find a match, a thorough check of both the donor and the recipient is carried out. While the donor should be healthy, the patient needs to be fit for such a procedure. “We admitted Shanaki and gave her chemo for five days to destroy her bone marrow. This is the time there are major side-effects such as the white blood cell count decreasing, bringing down her immunity as well as her platelet count dropping which could lead to bleeding. A patient can also get mucosal ulcers and loose motions,” says Dr. Jadhav who has performed 450 such transplants, stressing that the main risk is infection. The donor, meanwhile, is administered injections for five days to increase his stem cells. Thereafter, the donor’s stem cells are collected from his blood using an apheresis machine and these stem cells are infused intravenously to the patient’s blood, it is learnt. The next two to three weeks are the “most dangerous”, according to Dr. Jadhav, until the new bone marrow develops and begins producing white blood cells, platelets and red blood cells. The main risks bone marrow recipients face are: Graft Versus Host Disease which needs to be treated with immuno-suppressants. An infection when the patient’s immunity is low. Recurrence of cancer which is a low risk. The success rate of BMT could vary from 30% to 90% depending on the patients and the disease, with an average success rate of about 60-70%. There is only a 5% risk of the donor marrow being rejected, according to this BMT Specialist. Blood tests are carried out on Day 28 and Day 100 to check out chimerism, he says, explaining that this is to ensure that 100% of the new cells produced by the patient belong to the donor’s stem cells. “Shanaki is fine and we are thrilled to see her back with her family,” says Dr. Jadhav, describing his short reunion with them in Colombo as “fantastic”.
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