Premier cancer care institute of the Northeast, Dr B Borooah Cancer Institute (BBCI), a unit of Mumbai’s Tata Memorial Hospital, has achieved yet another milestone in modern treatment.

The Guwahati-based healthcare institute, a grant-in-aid establishment under the Department of Atomic Energy, has achieved a significant medical breakthrough by performing the first matched unrelated donor (MUD) allogeneic stem cell transplant in the Northeast.

The process involves the use of stem cells from a donor outside the patient's family and represents a significant medical breakthrough in the region. Doctors recently performed a transplant on a 19-year-old patient. He is now cured and has been discharged from the hospital.

Stem cell transplants are crucial in the treatment of haematological disorders, including leukaemia. However, one of the biggest challenges is ensuring human leukocyte antigen (HLA) matching between the donor and the recipient. Doctors and researchers have noted that there is only a 25 per cent chance of an HLA-match between one's siblings, making it even more difficult to find a suitable donor outside the family.

The patient receiving full-body irradiaton

The diverse ethnic groups and communities in the Northeast compound this challenge, making it quite difficult to find donors.

"The patient was a 19-year-old young boy with relapsed and refractory cancer. His family did not have a suitable donor. For him, other donors outside the registry-based family were the only viable option for long-term survival." Associate Professor of Adult Haematology and Lead physician of the BMT (bone marrow transplant) unit, Dr Asif Iqbal said.

The BBCI started searching for donors across the country since June through the DATRI Blood Stem Cell Donor Registry, one of India's largest registries. By July, a potential donor was identified.

Once the donor was confirmed, a complicated process began -- verification typing, infectious disease testing, donor medical approval, cryopreservation approval, and so on. The stem cells had to be transported across several states from the donor, who was located in Ludhiana. At that time, the patient had no other residual disease (MRD). This made it easier to transplant.

The Rs 18.5 lakh process was made possible by a distant relative of the donor. The hospital authorities were alert in advance as the donor's cells had to be brought across several states. The hospital authorities also collected the patients' own stem cells for autotransfusion, just in case the transfusion failed.

Doctors performing stem cell procedure on patient

"Due to a lack of awareness, the number of stem cell donors in the North East is very low. That boy was very lucky, but we need more donors to help such patients," Dr Iqbal said.

Dr Iqbal said, "Meticulous care had to be taken while transporting the life-saving stem cells from Ludhiana, Punjab and across states, which required perfect coordination between donor agencies, airport authorities, government departments, the apheresis centre in Ludhiana and BBCI transplant unit."

The stem cells arrived safely and were transplanted immediately, although the ABO blood groups did not match. The patient underwent a full-dose total body irradiation (TBI)-based conditioning regimen, which reflected the better substitutability of BBCI. The TBI itself is an accomplishment of the institute. It was carried out under the supervision of Dr Kaushik Kataki, Assistant Professor of Radiation Oncology. The lung shield necessary for this procedure was manufactured locally at BBCI.

Dr Asif Iqbal said the achievement reflected the dedication of the hospital’s various departments -- Transfusion Medicine, Hemato-pathology, Microbiology, Radiation Oncology and BMT Nursing Staff – who did it with great precision and dedication.

Dr Asif Iqbal with the patient

Dr Iqbal has initiated special steps to make 'stem cell donation' more popular. He said he would launch an awareness campaign in the state in January. “There are more than 200 tribal communities in the Northeast, and there is a lack of awareness among them. When they are diagnosed with cancer, they have to approach organisations like BKMS to find stem cell donors from elsewhere,” he told Awaz-The Voice.

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He said there is no precedent for stem cell donation in the entire North East. "The human body contains 5 litres of bone marrow, and if one person donates just 150 millilitres, a person who loses bone marrow due to cancer can gain a fresh lease of life. Everyone has a golden opportunity to become a warrior against cancer by donating stem cells as easily as donating blood," he added.