In the last year, 47 persons, including 29 children, underwent bone marrow transplantation (BMT) at the Rajiv Gandhi Government General Hospital (RGGGH). Doctors at the Department of Haematology, while measuring the transplant outcomes, have logged more than 90% success rate in treating these patients.
Aruna Rajendran, Haemato Oncologist and Bone Marrow Transplant Physician, Madras Medical College/RGGGH, said that 75 patients have undergone BMTs since the inception of the unit in 2018. “We had about four to 10 patients a year. In the last one year, the number has increased nearly four or five fold,” she said.
E. Theranirajan, dean, RGGGH, said in the initial years, not a single case of paediatric BMT was done. Infrastructure and manpower were put in place that led to more patients benefiting from the treatment.
Bone marrow transplantation is covered under the Chief Minister’s Comprehensive Health Insurance Scheme, he said.
Dr. Aruna said that most of the patients had inherited bone marrow failure syndrome (Fanconi Anaemia). “This is dominant in children. Of the 27 children, at least 10 were in this disease category. They have a tendency to develop bone marrow failure by seven to eight years of age. This is a chronic disease and the cost of care is high,” she said. The youngest patient so far has been a one-and-a-half-year-old child who underwent autologous transplant for neuroblastoma.
In adults, acute myeloid leukemia is the dominant cause while there are cases of relapsed leukemias too.
The unit performs all categories of BMTs — autologous, allogeneic matched related and unrelated donors and haploidentical transplants.
“We have done all categories of transplants in the last year; more allogeneic matched related and matched unrelated transplants. Patients, who seek treatment in the government sector, include those below the poverty line and those who have to undergo complex transplants but cannot afford the cost in the private sector,” she said.
Until a year ago, haploidentical transplants were not done in government facilities, she said. “Haploidentical BMTs are complex transplants and cost around ₹50 lakh to ₹75 lakh in the private sector based on the complications encountered. Patients are pumped with lots of drugs, including immunosuppressants, and need to stay in hospital for one to three months,” she said.
In fact, four patients have undergone sequential transplants so far. This is when the body rejects the graft from a donor and the patient undergoes a second transplant from another donor.
“One of the four patients came to us for the second transplant from a private hospital,” she said.
Stem cell registries DATRI and DKMS were working with the RGGGH team in supporting these patients’ BMTs, she said.
“DKMS Germany and German stem cell donors have been supporting the government sector by donating stem cells and giving cost concessions,” she said.
She said that people were worried about outcomes in the government facilities. “Our success rate is 93%,” she said.
Dr. Theranirajan said: “This is high-end treatment and is available for the poor and needy patients in the government sector. We have had excellent outcomes. In future, expansion of the facility is needed as the demand is high, including among patients from middle-class families.”
