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Challenges versus Success rate of Haploidentical Bone Marrow Transplantation at Dharamshila BMT Centre

Knowing very well, the trauma of patients and their families, who have failed to find a fully HLA matched donor, for Allogeneic Bone Marrow Transplantation (BMT), Dharamshila Hospital And Research Centre, pioneered a comprehensive Haploidentical [half matched family donors (Parents/ children / sibling)] BMT. This program was started with the right mix of experience, expertise and infrastructure. We have performed 46 Haploidentical BMT in the last 21 months and 39 patients are disease free i.e. a survival rate of 84% which is comparable to the best global institutions doing Haploidentical BMT.

However, sometimes, despite our best efforts, conscientious and specialist medical care, it is impossible to save the lives of each and every patient, who walks through our doors. Sometimes, the disease is simply not treatable or the patients come to us at such an advanced stage of disease that current medical research and care cannot compete with cancer or the complications that arise out of the desperate attempt to cure the disease. We have lost 7 such lives in the last 18 months, despite unrelenting and often heroic attempts by the team to save these lives. We share the grief and the inconsolable loss with all the families. Most of these families are in touch with us and appreciate our efforts. Many of them have helped subsequent patients in similar situations, with financial aid and moral support.

We salute their courage, fortitude and generosity.

Unfortunately, a couple of such families have resorted to malicious campaigning. We are happy to reach out to all those who have any query in good faith. Our BMT doctors spend all their waking hours in the hospital and are role models for selfless service considering patient above the self. Any death is painful and it hurts the treating team and the entire staff as much, as it does to the family. Such allegations hurt even more when we know that the entire team have treated these patients as their own family member, actively raised funds for these patients and have provided huge financial subsidies on the treatment.

We can state with complete conviction that there has been no medical negligence on our part and we are happy to reach out to anyone who has even got an iota of doubt on this. No hospital would have attempted to treat these patients, as they were extremely difficult to cure. We have shared the details of treatment given to couple of patients who died, with National and International experts, who have applauded our efforts as ‘heroic’ and ‘miraculous’.

We have a long way to go and we have only begun our journey. Prof E D Thomas who pioneered bone marrow transplantation in the late 1960s and later won a Nobel Prize in Medicine in 1990 was accused of experimenting when he treated patients with end-stage leukemia and 90% of them died. His 10% success rate gave birth to Bone Marrow Transplantation. BMT Physicians all over the world are striving to improve the outcome. We have taken up the challenge to establish HAPLOIDENTICAL BMT as a viable and life-saving procedure for those lacking a matched family donor. The hard work and relentless basic and clinical research of our doctors is reflected in improvement of survival of such patients from 20% in 2011 to 84% in 2015. The international figures for survival in such patients with high risk blood cancers are less than 50%. It remains to be seen, whether we can maintain the improved outcomes or the law of averages would catch up. Haploidentical BMT is progressively becoming the treatment of choice for patients without a matched family donor. Our doctors have made a small but significant contribution to this progress. Their research is accepted internationally and their innovations in this field have made the institution and the country proud.

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