By ; Bakinam Khaled
Baby Rita, a month-old baby girl, born out of a consanguineous wedlock was diagnosed in initial months of life with progressive pallor and poor gaze fixation. Without wasting time, the family approached Apollo Hospital, where she received supportive care which included regular blood and platelet transfusions. In addition, parents were counselled about the diagnosis and possible curative option and subsequently referred to Dr. Gaurav Kharya, Clinical Lead, Center for Bone Marrow Transplant and Cellular Therapy, and Senior Consultant, Pediatric Hematology, Oncology and Immunology. On evaluating her further, Dr Gaurav confirmed the diagnosis of Osteopetrosis. As she was the only child, HLA (human leucocyte antigen) typing (genetic matching) for patient and parents was undertaken and both parents were found to have haploidentical (half HLA match) with the patient. As such, an unrelated donor search was initiated but no suitable donor was identified.
To avoid wasting time, Dr Gaurav counselled the parents and suggested to move ahead with T cell depleted haploidentical Bone Marrow Transplant (BMT) using mother as the donor. However, the patient’s BMT course was complicated due to chemotherapy drugs. Fortunately, her new bone marrow started working around day +12. After a vigorous treatment plan, the patient was successfully discharged around day +21 post BMT. Currently, the baby is 9 months old post BMT and is in excellent condition with normal functioning bone marrow and much improved CNS (central nervous system) status. Dr. Gaurav shed light on the above incident and other latest trends and developments in bone marrow transplant during the 2nd Emirates Pediatric Hematology and Oncology Conference, that was held at Bab Al Qasr Hotel in Abu Dhabi recently. Dr. Gaurav Kharya had joined other renowned speakers from the UAE and the United States who shared their expertise during the conference.
The event was held to underscore the importance of early detection and diagnosis of common hematological and oncological problems in children as well as tackle the management of hematological and oncological problems by general pediatricians. It took place at a time when the estimated hematological abnormalities in children in the UAE now stand at 8 percent, although no clear cut estimates are available. During his talk, Dr. Kharya also discussed the differences between Bone Marrow Transplant & Cellular Therapy and provided insights on disease prevalent in UAE which can be cured by BMT, including primary immune deficiency disorders, hemoglobinopathies, marrow failure syndromes or leukemias/blood cancers. Dr. Kharya has a vast experience in transplanting children with various blood disorders, benign or malignant, and immunological diseases. Boasting 10 years of professional experience, Dr. Kharya has done close to 800 transplants for various diseases along with his team members. He is credited for performing the first haploidentical bone marrow transplant for sickle cell disease in India. He also did the first invitro TCR alpha beta CD 19 depleted haploidentical BMT in a five-month-old baby suffering from severe combined immunodeficiency. The patient is one of the youngest children to receive a bone marrow transplant in India. A bone marrow transplant, or a stem cell transplant, is used to treat different kinds of cancer such as leukemia and multiple myeloma as well as other blood disorders. Dr. Kharya has partnered with non-government organisations to provide financial and social support to children who need a bone marrow transplant and treatments for cancer and immunological disease. This is in line with his belief that access to treatments should still be available to families despite having no sufficient funds.