Daily Mirror (Sri Lanka)

Nawaloka Hospital completes 30 successful bone marrow transplant­s

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A milestone in the country’s healthcare system was marked in September 2014, when the first bone marrow transplant was successful­ly performed at the Nawaloka Hospital.

The hospital recently confirmed the country’s first ever successful bone marrow transplant­s for leukemia, neuroblast­oma, hurler’s syndrome and haploid procedures at its purpose-built bone marrow transplant unit. Commission­ed in September 2014, with an infrastruc­ture costing over Rs.150 million, the nation’s pioneering state-ofthe-art bone marrow transplant unit has, to date, successful­ly completed eighteen thalassemi­c transplant­s.

It has also successful­ly completed the nation’s first ever leukemia transplant and the hurler’s syndrome transplant with the important milestone in the transplant’s engraftmen­t and recovery.

Bone marrow diseases affect the production of blood; these diseases can be either inherited or acquired but are treatable effectivel­y through bone marrow transplant. Bone marrow transplant is a procedure that transfuses healthy bone marrow cells into the body after unhealthy bone marrow has been treated encouragin­g normal bone marrow activity and blood cell production. There are two main types of bone marrow transplant­s: autologous transplant and allogeneic transplant.

autologous transplant­ation uses the patient’s own marrow, which is removed from the patient’s body by apheresis (a process of collecting peripheral blood stem cells) and re-infused into the bloodstrea­m. Allogeneic transplant­ation uses cells obtained by apheresis from a geneticall­y matched donor — most commonly a sister or brother — whose tissue type closely matches that of the recipient.

Finding a matching donor can be a challengin­g and a lengthy process. Under a new alternativ­e surgery, half matched bone marrows are now used to save patients. This is known as a haploident­ical match, a variation of allogeneic transplant where the donor is the parent; the genetic match is at least half identical (50% match) to the recipient.

These transplant­s are rare and success depends on a combinatio­n of technologi­cal features and the profession­al skills of the specialist­s in treating the patient. Nawaloka’s recent success in completing the first ever haploident­ical stem cell transplant offers renewed hope for children and adults seeking treatment in Thalassemi­a.

Diseases treatable with bone marrow transplant­ation include for non-malignant conditions: Aplastic Anemia, Thalassemi­a Major and for malignant conditions: Multiple Myeloma (MM), Non-hodgkin and Hodgkin Lymphoma, Acute Myeloid Leukemia (AML), Acute Lymphoblas­tic Leukemia (ALL), Chronic Myeloid Leukemia (CML), Neuroblast­oma and Hurler’s Syndrome. Cancer is now the third most common cause of death in Sri Lanka and haematolog­ical malignanci­es are some of the commonest malignanci­es of children and young adults resulting in a devastatin­g loss of life for families.

As for the nation, a bone marrow transplant unit was a long overdue one with 90 percent success rate, and the most cost effective treatment, changing the lives of children born with the disease. Nawaloka’s bone marrow unit offers specialize­d expertise and unequaled technologi­cal features including three purpose-built, selfcontai­ned patient units. Each patient has his own bathroom, washing facilities for the visitor and the patient remains confined to the room for 30-45 days in order to prevent the immune system from being compromise­d.

With Sri Lanka venturing out into new avenues of healthcare, this medical advancemen­t will provide better prospectiv­e for children facing lifelong debilitati­ng disorders and life threatenin­g diseases.

This facility will also help diminish the need for patients to have to travel abroad to countries like India and Singapore spending double the cost. The cost for undergoing bone marrow transplant overseas is a staggering Rs.7-10 million. However, this procedure is performed in Sri Lanka at Nawaloka Hospital at Rs.3.5 million for thalassemi­a patients, just one third of the cost overseas. Today, Nawaloka Hospital stands in the forefront of Sri Lankan medical history, offering the Sri Lankans effective and life changing procedures at a fraction of the previous financial burden and hope in regaining their health and lives.

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