Unrelated donor bone marrow transplantation in 3 year old with Acute Myeloid Leukemia

Vinod Gunasekaran

Happy to share this new milestone,

A 3 year old child with AML was refractory to 2 cycles of intense induction chemotherapy. He received a 3rd course of salvage chemotherapy and the disease was controlled. There were no full matched family members for BMT.

Search done in DATRI stem cell registry (based in Chennai) identified a 10/10 full matched voluntary donor, 33-year-aged Male, based in Kerala. Donor was counselled, evaluated to be medically fit.

Child was admitted in Kauvery 10 days before the donor’s convenient date of stem cell donation. Child received myeloablative doses of chemotherapy here.

In parallel, donor received S/C G-CSF injections in Kerala followed which stem cells were collected by apheresis there. Stem cells were transported by road to Trichy, and infused to the patient on the same day at midnight (16/05/2024).

Patient recovered post-BMT and discharged. One month later, he had a prolonged re-admission for upper gut GVHD and CMV reactivation, which was controlled by immunosuppression + Ganciclovir & discharged.

Currently child is well on low dose tapering steroid and Cyclosporine and has crossed 100 days post BMT.

Our centre got approved by the Stem Cell registry recently and we have started doing now (2 so far).

Regarding norms:

  • For a donor, the process is simple. No surgery. Just a few subcutaneous injections and an apheresis procedure. Hence, any healthy person can volunteer to be a stem cell donor and register him / her in a registry.
  • ⁠India has few approved registries of which DATRI (Chennai) is the largest with > 5 lakh registered donors in their database.
  • ⁠Volunteers’ buccal swabs will be collected and HLA typed & a database is generated. This database is linked worldwide with all international registries.
  • ⁠If we send any patient’s HLA report, the registry with search for their software and list of available donors (local/international) will be available in few minutes.

Acknowledgment

Thanks to Kauvery Hospital Management for continuously supporting such complex treatments & the experts in various fields – 24×7 Pediatric support, PICU, Paed Gastro, Paed Nephro, Hematology, Radiology, Laboratory and especially BMT Nursing for their invaluable contribution.

Dr. Vinod Gunasekaran - Paediatric Haematologist & Oncologist in Trichy

Dr. Vinod Gunasekaran
Consultant-Paediatric Haemato Oncology

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