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First stem cell transplant at Jaffna Hospital
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As Saman Kumari goes back to her family after life-saving procedure,
this hospital becomes the third in SL to set up a state BMT Unit
By Kumudini Hettiarachchi
Housewife and mother of two, Saman Kumari (38), is very happy to be back with her family in the village of Iluppelessa, Padiyapelella, around 60km from Kandy town.
She has not come home with a few material possessions from West Asia to help her husband, a causal telecommunication employee, keep the home fires burning, but from Jaffna with a new lease of life, having overcome “ata-midulu wala cancer ekak (bone marrow cancer)”.
Kumari is the flag-bearer for the Jaffna Teaching Hospital (TH) which embarked on the life-saving procedure of the first autologous stem cell transplant on June 6. Stem cells are healthy blood-forming cells found in most parts of the body including the bone marrow.
The team which worked in tandem to make the autologous stem cell transplant a reality
Jaffna TH is the third centre in Sri Lanka to venture into this treatment pathway. While the first was the National Cancer Institute (Apeksha Hospital), Maharagama, in 2016, the second was the Lady Ridgeway Hospital (LRH) for Children, Colombo, in 2020.
Dr. T. Sathiyamoorthy
To the query by the Sunday Times, on the need for this procedure in the northern town of Jaffna, Consultant Transfusion Physician Dr. Nilmini Hettiarachchi said that there was a Cancer Unit at the Tellippalai Base Hospital with Consultant Oncologists at the helm. Those with blood cancers were checked out by the Consultant Haemato-Oncologist Dr. Nilupuli Gunarathne and then referred to Maharagama for treatment and management including stem cell transplantation.
Kumari says how the waiting list at Maharagama is very long and she was due for the procedure only in April 2025.
It is to ease the trouble of travel and stay in far-away Colombo for patients that Dr. Hettiarachchi and Dr. Gunarathne, with the unstinting support of Jaffna TH Director Dr. T. Sathiyamoorthy, Deputy Director Dr. C.S. Jamunananda and Consultant-colleagues, took measures amid numerous challenges to launch Jaffna’s Bone Marrow Transplant (BMT) Unit.
Dr. Nilmini Hettiarachchi
“This is the first step to help needy patients through stem cell transplants, with immense support from the Health Ministry,” said Dr. Sathiyamoorthy, reiterating that now that the green-light has been given, the ministry would pave the way to expand these services and take it to greater heights.
Dr. Hettiarachchi delves into the challenges they faced including a lack of staff for the BMT Unit. While currently, it has three who are temporary Medical Officers (MOs), three more would help to take the service forward. This is while, if there were two more nursing officers, in addition to the three already in place, the BMT Unit would be able to perform this procedure on a minimum of two to three patients per month.
Another need is a Consultant Nutritionist, which they overcame in the case of Kumari by constantly calling Apeksha Hospital’s Dr. Sajitha Mallawaarachchi who was ever-willing to help.
Paying tribute to Swami Dr. Mohanathas of the Sannithi Murugan Temple who generously donated Rs. 525,000 for the purchase of the expensive chemotherapy and stem cell mobilization medicines needed for the first two patients, Dr. Hettiarachchi says that they are not available in the hospital pharmacy. (The second patient was due to undergo stem cell transplantation this week.)
Dr. Nilupuli Gunarathne
“We need to get down these medicines on an individual basis per patient after approval from the National Medicines Regulatory Authority (NMRA). This we were able to do with the donor funds but it is a major limiting factor in the continuation of this service,” she pointed out.
However, she is quick to underscore that most of the other costly drugs including intravenous antibiotics, anti-fungals, anti-virals, parenteral feeds and all expensive investigations needed almost daily, were provided by the Jaffna TH, a testament to how the state health system is a boon to the humble and needy.
Describing how they took much pain to ensure world standards for the BMT Unit, she says that they gave Kumari growth factor (granulocyte colony stimulating factor) for four to five days to increase her stem cells, while she was in remission. The first stem cell harvest was on Day 5 (June 4) after the growth factor was administered. Then the patient underwent high chemotherapy ablation to rid her body of the diseased stem cells, followed by isolation to prevent her catching an infection, flushing out of chemotherapy and infusion of her own earlier-harvested stem cells.
Dr. Kavitha Indranath
Dr. Hettiarachchi re-lives the nail-biting tension as Kumari’s white blood cell count plummeted to zero, as expected, but leaving her extremely vulnerable to infection. “Usually Day 6 and 7 are bad,” she said.
The Jaffna TH’s hope and plans are to continue autologous stem cell transplants without disruption and also launch allogeneic stem cell transplants, using donor stem cells.
The setting up of the Sri Lanka Stem Cell Donor Registry this year due to the untiring efforts of the National Blood Transfusion Service would help allogeneic stem cell transplants, is Dr. Hettiarachchi’s belief.
Dr. Hettiarachchi is very appreciative of Consultant Haematologist Dr. Thaneshwari Sooriyakumar; Consultant Clinical Oncologist Dr. Kavitha Indranath; Consultant Microbiologist Dr. Rajanthi Ramachandran; Kandy’s Consultant Haemato-Oncologist Dr. Nilupuli Gunarathne; BMT Unit’s MOs Dr. S. Shanmugapriya & Dr. C. Capilraj; Resident House Officer (RHO) Dr. K. Shobana; Nursing Staff Master-in-Charge M. Sureshnesan and Nursing Officers E.G.U.K. Ellegama, B.A.S.K. Ariyarathne, W.G.M.C.J. Kumarasinghe & W.M.M.K. Wijesinghe; Health Assistant P. Thursuya; and trained volunteer J. Vijenthiny, for their efforts towards this cause.
Kumari who was discharged on Tuesday (June 25) having been in hospital since May 30 says that her children are happy that amma gedara avilla nisa.
The whole family “pin denawa” (showering blessings) on the medical team which has pulled Kumari back from the brink of death.
Saman Kumari happy to be back home with her family
| Lend a helping handAny generous donors who wish to support this newly-opened BMT Unit, may send their contributions to: Jaffna General Hospital Development Association; Commercial Bank – Jaffna; Account Number: 1060012154. | |
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