Logo of Phnom Penh Post newspaper Phnom Penh Post - Cambodian Thalassemia kids given new lives after Indian help

Cambodian Thalassemia kids given new lives after Indian help

Content image - Phnom Penh Post
Dr Sunil Bhat poses for a photograph with a Cambodian family he successfully treated. Photo supplied

Cambodian Thalassemia kids given new lives after Indian help

With Saturday having celebrated World Marrow Donor Day, Mazumdar Shaw Cancer Centre at Narayana Health City, one of the leading blood and marrow stem cell transplant units in India, highlights the alarming cases of two Cambodian sisters aged nine and 11 – their heroes being an 11-month-old sibling and a half-HLA matched father.

With a bone marrow transplant being the only cure for Thalassemia, it becomes very important to find a matching donor for such treatment.

“It is highly unlikely to find an unrelated donor for Cambodian descent patients as there is no Cambodian donor registry and number of Cambodian donors in other registries are almost negligible”, said c, the head of paediatric oncology, haematology and bone marrow transplants at Mazumdar Shaw Cancer Centre at Narayana Health City. “Chances of a match with other ethnic backgrounds is extremely low.”

It was a huge shock for the couple from Cambodia to have two consecutive children – both girls, suffering from Thalassemia – a potentially lethal disease. Both sisters were diagnosed with Thalassemia major – a disease that requires life-long blood transfusion every few weeks. “Most of the affected patients usually die in the second to fourth decade of life, ” Dr Bhat said.

Fortunately, almost eight years after the second child was born, the family was blessed with a baby boy who did not suffer from Thalassemia. The father, a doctor by profession, had made every possible effort to provide the best care to both his affected daughters.

However, it was getting difficult for him in Cambodia. Giving adequate, safe and effective blood transfusions and managing the complications of iron overload was becoming a challenge to the family. They learned that a bone marrow transplant would be the only cure for the condition.

They began their search for a centre with experience in paediatric bone marrow transplants. Their research led to Narayana Health City in Bengaluru and Dr Bhat, who has remarkable experience in treating complex cases of blood disorders in children. The centre is also known for its innovative techniques in Haplo identical (half-matched) bone marrow transplants.

Affirming that a bone marrow transplant (BMT) is the only cure for many life-threatening diseases, Dr Bhat said: “For more than 100 potentially life-threatening diseases, bone marrow transplant or blood stem cell transplant is the only cure.

‘Bad cells taken out’

These diseases range from cancers such as leukaemia, lymphoma, solid cancers to genetic disorders of blood forming cells and immune system like thalassemia major, sickle cell anaemia, severe immunodeficiency disorders.

With increasing number of haematological disorders, the number of patients requiring a blood stem cell transplant is also increasing. One of the major differences between bone marrow transplant and solid organ transplants like liver and kidney is that in BMT we need to match HLA of the patient and the donor.

The chance of a patient finding a matched donor within a family is only 25 per cent to 30 per cent – this leaves about 70 per cent of patients needing a BMT for the cure of their disease but don’t have a matching donor”.

The younger sister was fortunate her brother was a HLA match who could donate – but he was only 11 months old! Extracting marrow stem cells from a donor who is an infant was a clinical challenge.

The team at Narayana Health City came up with an innovative plan of taking the bone marrow from the donor at two different time points, around four to six weeks apart, in order to have adequate marrow for a transplant.

The transplant was performed in March this year making the 11-month-old infant the youngest donor to have donated bone marrow for his sister. The girl is now completely cured of Thalassemia.

However, her elder sister was not so lucky as she couldn’t get a fully matched donor. Therefore, her transplant was even more challenging. She did not have an HLA matched donor either in the family or anywhere in the world. The next possibility was a Haplo-identical transplant.

Doctors at Mazumdar Shaw Cancer Centre at Narayana Health City decided to use the stem cells of the father who was a half match with the elder daughter. A new technique was used in haplo (half matched) transplant as the donor stem cells were not fully matching the patient.

“Her bad cells were taken out in a procedure called TCR alpha-beta depletion and only the good cells were given to the patient”, explained Dr Bhat. “This avoids the risk of donor cells attacking the patient’s body.”

Although this technique helps in the above mentioned mechanism, it would delay the immune recovery, which would put them at risk of serious infections.

“To address this issue of slow immune recovery, CD45RA depletion is an additional technique recently introduced,” Dr Bhat said. “This helps us to give memory cells, which can fight infections in the patient.”

The transplant using this technique was performed on the elder girl in June this year and she is also now completely cured of her disease.

Narayana Health

MOST VIEWED

  • Investors’ $14.4M projects approved

    New investments from local and foreign sources continue to pour into Cambodia despite the Covid-19 pandemic remaining a lingering threat to regional and global economies. This comes as the Kingdom’s gross domestic product (GDP) is expected to contract between one and 2.9 per cent this

  • NagaWorld casinos set to reopen, schools to follow

    NAGACORP Ltd has requested that it be allowed to reopen its NagaWorld integrated resorts in Phnom Penh after the government recently approved casinos to operate again, provided they follow Covid-19 prevention measures set by the Ministry of Health. Mey Vann, the director-general of the Ministry

  • Rubber exports stretch 17%

    Cambodia exported 97,175 tonnes of natural rubber in the first five months of this year, surging 17 per cent compared to the same period last year as the Covid-19 pandemic stretches on, Ministry of Agriculture, Forestry and Fisheries official Khuong Phalla told The Post on Thursday. Phalla,

  • ASEM supports Kingdom’s proposal to postpone meeting amid Covid

    The 13th Asia-Europe Meeting (ASEM13) scheduled to be held in Cambodia in November has been postponed until mid-2021 due to the Covid-19 pandemic, a Ministry of Foreign Affairs and International Cooperation press statement released on Saturday said. The decision was made during a two-day meeting

  • Coffee maker roasted for producing fake product

    The Ministry of Interior’s Counter Counterfeit Committee will send a suspect to court on Monday after she allegedly roasted coffee mixed with soybeans and other ingredients, creating a product which could pose a high risk to consumers’ health. On the afternoon of July 2, the

  • Cash handout programme 80% complete

    Minister of Social Affairs, Veterans and Youth Rehabilitation Vong Soth confirmed on Thursday that the implementation of the Cash Transfer Programme For Poor and Vulnerable Households During Covid-19 had been implemented for more than 80% of the over 560,000 families. The programme was introduced one week ago.

  • Cambodia armed with money laundering laws

    Money laundering will now carry a penalty of up to five years in prison while those convicted of financing terrorists will be jailed for up to 20 years, according to new laws promulgated by King Norodom Sihamoni and seen by The Post on Thursday. Comprising nine

  • Where is Cambodia’s exit strategy that can save the economy?

    With the prospect of being slammed by a double whammy, the government is working on an economic recovery plan to deliver it from Covid-19 and the EU’s partial withdrawal of the Everything But Arms scheme in the next two to three years Cambodia is

  • Schools to be reopened in ‘three stages’

    With guidance from Prime Minister Hun Sen, the Ministry of Education, Youth and Sport, is in the process of reopening schools in three stages. But no timeline has been set, ministry spokesperson Ros Soveacha said on Thursday. Soveacha said the first stage will be to

  • Kingdom, UN discuss rights

    A year after Cambodia received 198 recommendations from UN member countries, the UN Office of the High Commissioner for Human Rights (OHCHR-Cambodia) met with the Cambodia Human Rights Committee (CHRC) to discuss following-up on the Kingdom’s third cycle of the Universal Periodic Review (UPR) and