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Dr. Suresh H Advani

How Bone Marrow Transplant is saving lives in India - 22nd March 2019

A girl is wheeled across a busy corridor of a hospital. Her parents said that she had been feeling tired and unwell for several days, with rashes all over his body, and had fainted at the front of the house in the morning while leaving for school. The doctors put her into the emergency ward and run some blood tests. They soon find that she has severe case pancytopenia, which means the drastic reduction of all three cell lines: Hemoglobin (Hb), white blood cells (WBCs) and platelets. 

Her evaluation reveals a related rare disorder of the bone marrow, called severe aplastic anemia (SAA), that occurs due to near complete dysfunction of the entire hematopoietic functioning, which involves Hb, WBC, and platelets. If left untreated, patients like her rapidly deteriorate and die either due to the severe thrombocytopenia, which means low platelet, related massive bleeding, or severe opportunistic infections, such as fungal, bacterial or viral, due to their extremely low blood counts.

And moreover, patients like her remain transfusion dependent till any definitive therapy. Luckily, none of that happened and she lives today as she underwent a procedure called a bone marrow transplant (BMT). 

Diseases like leukemias, severe aplastic anemia, lymphomas, multiple myeloma, immune deficiency disorders, and some solid-tumor cancers require bone marrow transplant. The number of patients seeking bone marrow transplant in India has increased over the last five years. Nearly 2000 transplants, with more than 1000 allogeneic, are being performed annually across seventy-five centers as per Indian Stem Cell Transplant Registry (ISCTR) 2017 report.

Bone marrow transplants are complicated procedures, involving the replacement of the entire blood system in an affected person through guided chemotherapy and afterward, substituting it with a healthy donor hematopoietic stem cells. It is these donor's stem cells that ultimately replenish the patient's blood system over time. 

The reported success rate of transplants from India has been from 20% in uncontrolled blood cancers to 70% to 80% in young, fit patients with aplastic anemia. But all this would have been probably impossible without the efforts of a certain man in a wheelchair. 

Doctor Suresh Advani is known to be the first oncologist in India to have successfully done a bone-marrow transplant. He transplanted bone marrow into a nine-year-old girl who was down with myeloid leukemia, with her brother acting as a donor. 

Doctor Advani was also a part of clinical trials to help children with lymphoblastic leukemia, conducting on 1,200 patients, and his trials helped raise success rates in treatment from 20% to 70%. He is regarded as a healer and is considered a role model by many doctors across the country.