Dr. Kasi Viswanathan, Head Dept. Of Haematology & Bone marrow transplantation Dept. Of Pediatric Oncology, Meenakshi Mission Hospital & Research Centre, Madurai. Chief Minister's Comprehensive Health Insurance Scheme NO MAN IS TOO POOR TO AFFORD WORLD CLASS CARE. SUCCESS STORY OF BONE MARROW TRANSPLANTATION

BONE MARROW HAS STEM CELLS WHICH CONTINUOSLY PRODUCE THE BLOOD CELLS Haematopoietic stem cell

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, 3 rd edition 2002:

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: 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 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 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 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 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"