An ex-colleague called me one morning to tell me that his 14-year-old son had been recently diagnosed with a type of Blood Cancer called Acute Lymphocytic Leukemia (ALL). The family was devastated. What started as a fever and ear infection ultimately turned out to be cancer. I could well feel his desperation and need for reassurance as chemotherapy had already been started for the boy, but the doctors did not have much hope.
In one of the leading Cancer Units that I am engaged with in Bengaluru, a 4-year-old boy was diagnosed to have a plastic anaemia – a type of anaemia where the body’s bone marrow does not produce enough blood cells. It is known to be a serious condition that can cause uncontrolled bleeding and render the person at a high risk of catching infections.
A 19-year old boy from Djibouti developed a swelling on the right side of his neck. Investigations revealed that he had Hodgkin’s Lymphoma – a cancer of the immune system that cripples one’s ability to fight off infections. He underwent 6 cycles of chemotherapy and was in remission for about two years. Investigations done after 2 years revealed that the cancer had returned – he had a relapse of Hodgkin’s Lymphoma.
As you can see from the cases that I have described, these are extremely difficult and trying times for the parents and the family. The diagnosis of cancer in a child comes as the first shock. Seeing the child go through chemotherapy and its various side effects is something very difficult for parents to take. And the third thing that keeps haunting the parents is the chance that the cancer can relapse.
In such patients, I understand that bone marrow transplant can offer a ray of hope – a better chance of survival, and a chance to lead a normal life. When a patient undergoes chemotherapy to destroy the cancer cells in cases like the ones described above, the healthy cells in the bone marrow also get destroyed. Bone marrow performs the vital function of producing blood cells. Without adequate blood cells in the blood an individual can end up with a host of complications – survival itself is doubtful.
With bone marrow transplant, new cells called stem cells are introduced into the blood – these settle in the marrow and start producing blood cells. But where do these stem cells come from? It can come from the same person or from another person. When the same person’s stem cells are transplanted back, it is called autologous bone marrow transplant. If a donor’s stem cells are transplanted into a patient, it is called allogenic bone marrow transplant.
The whole process is not as simple as it sounds. For a patient, in case of autologous transplant, it involves first harvesting stem cells from the bone marrow & storage, followed by intense chemotherapy to destroy the cancer and then transplanting the stored stem cells back into the body. If the patient’s own stem cells cannot be used, the family will have to look for a donor. It is usually siblings who turn out to be perfect donor matches for stem cells. Therefore, for a parent, it is a situation where both children have to be put through the process of transplant. Parents with a single child will have to look outside for a matching donor by registering themselves in national registries.
The success of a bone marrow transplant depends on a lot of factors. BMT can fail in some cases. This usually leads to death. Recovery from BMT can take over a year and the patient has to be very careful during this period. Even a small infection could set back the whole healing process by a couple of months.
Although BMT carries its own set of risks, the outcome is comparatively more favourable when it comes to children and young adults. Parents, particularly, pin their hopes on the doctors and the hospital for this one chance that might help their child lead a fairly normal life after an ordeal with cancer. In this present day and age of medical intervention we can hope that BMT gives children this chance. It is imperative to do in-depth research while selecting the Cancer Centre which must have a team of experienced Specialists, a creditable history of successful transplants done and survival rates published, the proper hospital infrastructure including dedicated BMT ICUs for treating such patients with the latest technology, a transparent pricing policy besides an entire team of Caregivers and Patient Services Team. Notwithstanding every possible criteria met, there are no guarantees and success will always vary from case to case.
Disclaimer: The views and opinions expressed in this article are the personal views of the author and do not necessarily reflect the official policy or position of any governmental/other agency. Patient names have been changed to protect their identity. This article contains facts that have been obtained from reliable sources, but may be subject to change with time. The author will not be responsible in any way for the comments given by reader/s.