?Bone marrow transplant offers great hope: Expert

?Bone marrow transplantation today offers an alternative to life-long transfusion and chelation for patients with thalassemia major,? said Prof Mammen Chandy, head of haematology department, Christian Medical College (Vellore).

“Bone marrow transplantation today offers an alternative to life-long transfusion and chelation for patients with thalassemia major,” said Prof Mammen Chandy, head of haematology department, Christian Medical College (Vellore).

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He was delivering a lecture on ‘Bone Marrow Transplantation for Thalassemia’ on the second day of three-day Indo-US symposium on ‘Genetic Disorders: Focus on Hemoglobinopathies’ at Swatantrata Bhawan in Banaras Hindu University here on Monday.

“The first allogeneic bone marrow transplantation for thalassemia major was performed in Seattle in December 1981 and that patient is alive and well 25 years post transplant,” he said, adding, “in a country like India, the economic advantage of a bone marrow transplant for thalassemia is compelling because many families can manage a one-time investment of $15,000 but a life-long expenditure of $2000 a year for transfusion and chelation is a difficult proposition.”

“The team at Pesaro in Italy under the leadership of Prof Guido Lucarelli has since shown with 1003 patients that bone marrow transplantation is in fact a good alternative to transfusion and chelation for thalassemia with more than 85 percent even free survival in Class I and II patients,” he said.

“However, the procedure is associated with a significant risk of infection, regimen-related toxicity, graft versus host disease and relapse particularly in those patient who because of inadequate treatment and poor chelation have developed hepatomegaly and hepatic fibrosis,” he further said.

“Bone marrow transplantation today offers the possibility of good quality life without the burden of transfusion and chelation,” he said, adding, “the aim should be to treat the child optimally with adequate transfusion and chelation and perform the transplant early, preferably before the child is over 10 years old.”

Dr Sarita Agarwal of genetics department at Sanjay Gandhi Post Graduate Institute of Medical Sciences (Lucknow) delivered a lecture on ‘Genetic Modifiers of Thalassemia Phenotype’ while Dr Sharmila Chandra of Kolkata dwelt upon `Thalassemia Intermedia in India’.

Prof Nancy Olivieri of Toronto University (Canada) delivered a lecture on ‘Thalassemia Intermedia’ while Dr Punam Malik of Children’s Hospital Los Angeles dwelt upon ‘Genetic Basis of Beta Thalassemia and Gene Therapy’. Dr Lakshmanan Krishnamurti from University of Pittsburg Medical Center (USA) delivered a lecture on `Hematopoietic Cell Transplantation for Thalassemia’.