A hospital in Chennai has created history by successfully conducting a unrelated bone marrow transplant in an eight-year-old Ugandan boy using the cord blood cells from an American donor, at a fraction of what the procedure would cost internationally.
Howard Kafeero from Uganda suffered from Fanconi anaemia (FA), a genetic disease that could have been fatal. Seven months ago, he was brought to the Apollo Specialty Hospital here.
The doctors successfully networked an unrelated but compatible American donor whose cord blood matched Howard's needs and carried out the bone marrow transplant that saved the boy's life. Doctors say that Howard is now almost 100 percent normal.
Revathi Raj, senior consultant for Paediatric Haematology at the Apollo Hospital said: "It was tough. Usually, related family members are apt donors, but the boy had none. Left with no alternative, we persevered for several months and succeeded.
"The predominant and life-threatening aspect of Fanconi anaemia is bone marrow failure. It is this condition that we have corrected. Now, Howard's blood count is normal, 100 days after the treatment."
For Howard's mother, Sarah Kafeero, a school teacher, it was a tense wait even after the hospital registered with the US-based National Marrow Donor Programme (NMDP) in January, found a donor in April and did the transfusion soon afterwards. The Kafeeros had already lost Howard's sibling to the disease, 12 years ago.
"Doctors, whom I trusted, did treat my son very well, but it is god who healed him," Sarah said.
Howard showed the first symptoms of the disease when he was five. After frequent blood transfusions, Sarah decided to find out whether the disorder could be completely cured. Before long, she found out that a trip to the US was out of the question due to the prohibitive cost. When friends suggested Chennai as an alternative, Sarah rushed here.
Howard is now eager to return home and rejoin the rest of the family in Kampala.
"Now I can go back home and play with my brother. That is something I miss here," Howard said with a broad grin.
The success of this case means that patients needing blood and bone marrow transplants from unrelated donors have a new hope and a new destination for the cure.
It is the first time that an unrelated transplant of stem cells and bone marrow for patients with advanced leukaemia and bone marrow failure has been done in India. A host of reasons contributed to the delay in the procedure being made available in the country.
Jose Easow, the senior consultant for medical oncology-haematology at the Apollo Hospital, said that high-resolution special blood tests for matching human antigen leukocytes between donor and recipient - called HLA typing - was absent in India.
"On that count it was risky to go ahead with a stem cell transplant from an unrelated donor on the basis of a low-resolution HLA typing report. It was a gamble because we knew that there was only a 30 percent chance of locating a compatible family donor whose stem cells could be used for treating some advanced conditions. Now, it is no longer necessary to go abroad for such treatment," Easow said.
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