When Bone Marrow Fails Your Near Ones Must Come to Your Rescue: Story of Haploidentical Bone Marrow
When kidney fails we look for a new kidney. In the meantime, the patient can be kept well and alive with dialysis. The donor is often a family member with same blood group. However, when bone marrow fails, the world crumbles in front of us. This condition is called APLASTIC ANEMIA. Bone marrow produces millions of cells every minute to keep us alive. There are no artificial means to substitute these cells. Only donated blood and platelets are available to salvage these patients. And yet there is no substitute for white blood cells which are our main and only defense against infections. To replace an empty bone marrow with normal healthy cells from a donor would seem to be a logical treatment for this condition. This process is called a BONE MARROW TRANSPLANTATION (BMT).Cells of each individual carries its own signature in the form of HLA antigens and BMT is not possible without a complete HLA antigen match. There is only one in four chance of finding a match within a family and one in a million chance of finding a match amongst the normal population. The Europeans have circumvented this problem by creating registries of over 10 million volunteer donors which provides 90% chance of finding HLA MATCHED VOLUNTEER DONORS for such patients. Indians rarely find a complete match from such foreign registries. Most of the patients suffering from Aplastic Anemia die from infection or bleeding due to lack of HLA MATCHED DONORS.More importantly the cost of procuring the blood or marrow products alone, from Europe or USA ranges from 10,000-30,000 USD. Similar transplants can be performed from UNRELATED CORD BLOOD UNITS at a similar cost, but the procedure is more challenging.
The saying that €nature is the mother of all inventions' is not without reason. HLA antigens are inherited as a set from each of the parents. A mother nurtures a baby in her womb for 9 months without rejecting it even though HLA antigens inherited by the baby from the father should cause a rejection. This is nature's example of development of tolerance and thus, a child and the mother are natural donors for each other in most cases even though they are only half matched in their HLA antigens. Based on the pioneering work by doctors from Italy, BMT from a half matched (HAPLOIDENTICAL) donor from the family was developed. Yet, it was challenging and often not reproducible. The researchers from Johns Hopkins and FHCRC, Seattle innovated yet another way of carrying out Haploidentical BMT which was more reproducible.
Unfortunately, Aplastic Anemia is a disease more common in developing countries in Asia and Haploidentical BMT has not been widely carried out for this disorder in the Western countries. Even when attempted in Aplastic Anemia, Haploidentical BMT has been a failure more often than not. We have developed a successful method of carryingout Haploidentical BMT in Aplastic Anemia. We have carried out over 10 such transplants in patients with Aplastic Anemia. Our research in this field has been acclaimed internationally and been followed elsewhere. The cost for such transplants is not more expensive than Matched Family Donor BMT.
Due to lack of awareness, thousands of patients with Aplastic Anemia die across the country. Most are children and young adults. Haploidentical BMT as we have shown can make a difference to these unfortunate children. Its time the patients and the treating doctors, both are aware of this possibility and help in our endeavour.
The saying that €nature is the mother of all inventions' is not without reason. HLA antigens are inherited as a set from each of the parents. A mother nurtures a baby in her womb for 9 months without rejecting it even though HLA antigens inherited by the baby from the father should cause a rejection. This is nature's example of development of tolerance and thus, a child and the mother are natural donors for each other in most cases even though they are only half matched in their HLA antigens. Based on the pioneering work by doctors from Italy, BMT from a half matched (HAPLOIDENTICAL) donor from the family was developed. Yet, it was challenging and often not reproducible. The researchers from Johns Hopkins and FHCRC, Seattle innovated yet another way of carrying out Haploidentical BMT which was more reproducible.
Unfortunately, Aplastic Anemia is a disease more common in developing countries in Asia and Haploidentical BMT has not been widely carried out for this disorder in the Western countries. Even when attempted in Aplastic Anemia, Haploidentical BMT has been a failure more often than not. We have developed a successful method of carryingout Haploidentical BMT in Aplastic Anemia. We have carried out over 10 such transplants in patients with Aplastic Anemia. Our research in this field has been acclaimed internationally and been followed elsewhere. The cost for such transplants is not more expensive than Matched Family Donor BMT.
Due to lack of awareness, thousands of patients with Aplastic Anemia die across the country. Most are children and young adults. Haploidentical BMT as we have shown can make a difference to these unfortunate children. Its time the patients and the treating doctors, both are aware of this possibility and help in our endeavour.
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