Transcript Meenakshi Mission Hospital, Madurai

Chief Minister's Comprehensive Health Insurance Scheme
NO MAN IS TOO POOR TO AFFORD WORLD CLASS CARE.
SUCCESS STORY OF BONE MARROW TRANSPLANTATION
Dr. Kasi Viswanathan,
Head Dept. Of Haematology & Bone marrow transplantation
Dept. Of Pediatric Oncology,
Meenakshi Mission Hospital & Research Centre, Madurai.
Haematopoietic stem cell
BONE MARROW HAS STEM CELLS
WHICH CONTINUOSLY PRODUCE
THE BLOOD CELLS
What is BMT ?
Its also known as Hematopoietic stem cell transplantation
• The process by which patients with damaged/defective
bone marrow is corrected.
• Done by intravenous infusion of
• autologous stem cells (SELF) or
• allogeneic stem cells (HEALTHY DONOR)
Lazarus HM. Autologous and allogeneic transplantation procedures for hematologic
malignancies. Manual of Clinical Hematology, 3rd edition 2002:399-409
There is a huge need for BMT in India
• USA
• POPULATION: 324 MILLION
• NO. TRANSPLANTS / YR: 19,000
• INDIA
• POPULATION : 1328 MILLION
• IF WE EXTRAPOLATE THIS DATA TO INDIAN POPULATION
• THE NO OF BMT’s NEEDED IN INDIA WILL BE: 77876
• THE REALITY IS : 1640
• THERE IS A HUGE NEED IN INDIA FOR BMT
08/23/16
Meenakshi Mission Hospital & Research Centre,
Madurai.
• We started our Bone Marrow Transplant Programme in
June 2014. - First BMT centre in southern Tamil Nadu.
• There is a huge need for bone marrow transplantation in
our country.
• The major problem we faced during BMT is the
affordability.
• We came to know that the CMCHIS is supporting BMT
for the socio-economically backward people.
• We applied for approving our centre for BMT and our
centre got approved.
• The First BMT under CMCHIS was done successfuly in May 2015.
• Totally we have done 40 BMTs
• 15 BMTs under CMCHIS.
• 14 are alive and cured;
• 1 patient died.
• Herewith presenting three of our success stories with the patients/ parents
testimonies.
Case 1
• Muthuparimala
Age: 15years; female.
Diagnosis: Acute Myeloid Leukemia
• Muthuparimala is the 15 year daughter of Mrs. Muniyammal. She was
diagnosed to have Acute Myeloid Leukemia in January 2016. The best
treatment for her would be Bone marrow transplant. Luckily she had a HLA
matched brother.
• Muthuparimala's father abandoned them at a very young age. Her mother works
as house maid to meet ends. The cost of transplant was beyond their
imagination. Her bone marrow transplant was entirely covered by the CMCHIS.
She is now more than 4 months from a successful Bone marrow transplant and
is doing well.
• Inspite of coming from a very poor background Muthuparimala, who is a bright
student and is academically inclined can now live her life cancer free, and
pursue her dreams.
Case 2
• Mahalakshmi
Age: 8years
Diagnosis: Fanconi Anemia
• Mahalakshmi is a 8 year daughter of a lorry driver Mr. Ravi Chandran and Home
maker Mrs. Revathi.
• She was diagnosed to have Fanconi Anemia, a genetic disorder that leads to
bone marrow failure, at 7 years.
• Without bone marrow transplant Fanconi Anemia is universally fatal.
• She had recurrent episodes of bleeding needing platelet transfusion and red
blood cell transfusions.
• She had a HLA matched normal younger brother. Successful bone marrow
transplant done under CMCHIS scheme. She is now more than 4 months from a
successful bone marrow transplant. She is cured of her illness.
Case 3
• Hari Sudhan
• Age: 4 years
• Diagnosis: Thalassemia Major
• Hari Sudhan is a 9 yr old boy. He was diagnosed to have Thalassemia Major at
7 months of age and was on monthly blood transfusion since then. The family
was shattered when they came know about his life long illness and cost of the
monthly blood transfusions was barely met by his father who is a daily wage
labourer.
• Inspite of regular treatment majority with Thalassemia would die in their thrid
decade due to cardiac and liver failure.The only curative option for Hari Sudhan
was Bone marrow transplant.
• He had a HLA matched older sibling. Because of the CMCHIS, Hari Sudhan is
now more than 8 months from a successful bone marrow transplant and is
transfusion independant. He will soon be going to school like any other child of
his age.
• ANOTHER MAJOR LIMITING FACTOR FOR BMT IS THE AVAILABILITY OF A
HLA MATCHED DONOR
• Only 30-40% of patients needing BMT will have a HLA identical sibling donor.
• The options in this situation are
• Haploidentical BMT
• Cord blood transplantation
• Matched unrelated donor BMT
• The catch is such transplants will cost 10-15 lakhs or even
more due to
• prolonged stay in hospital
• more treatment for immunosuppressive medications and Graft vs.
Host disease treatment.
• Cost of procuring the stem cells to be paid to the unrelated stem cell
donor registries.
OUR SUGGESTION
• TO ACCOMODATE SUCH TRANSPLANTS UNDER THE
CMCHIS SO THAT MORE PEOPLE ARE BENEFITTED
THANKS
TO OUR BELOVED
CHIEF MINISTER
FOR THIS MAJOR SUPPORT TO THE NEEDY PEOPLE.
"NO MAN IS TOO POOR TO AFFORD WORLD CLASS CARE"