Bengaluru: Rare double bone marrow transplant saves lives of two women patients

Bengaluru: BGS Gleneagles Global Hospital successfully performed two bone marrow transplants saving the lives of two women, who were battling with advanced stage multiple myeloma disease.

Shukriah Ali EzziAmer, a 46 year old woman from Yemen and Bhanumathi, a 56 year old from Bangalore presented to the hospital in a critical condition. After analysing their medical condition, the doctors prepared a detailed treatment plan, with 6 months of Induction chemotherapy and later performed autologous bone marrow transplantation.

A team of doctors comprising Dr Mangesh Kamath, Dr Rajeev Vijayakumar and Dr Neema Bhat conducted the transplant successfully.

EzziAmer, a housewife from Yemen visited BGS Gleneagles Global Hospital after she experienced severe backache, bone pain, low haemoglobin and fatigue and urinary tract infection. Doctors conducted a battery of tests, including comprehensive blood tests for diagnosing Myeloma, bone marrow biopsy and PET/CT scan.

The doctors came to a conclusion that EzziAmer was suffering from advanced stage multiple Myeloma and needed immediate medical intervention. After a thorough analysis of her health condition, the haemato-oncology team decided to conduct induction chemotherapy for six months and further performed autologous bone marrow transplantation to maintain disease remission.

Autologous bone marrow transplant is a medical non-surgical procedure, in which the affected patient's stem cells are removed from the body, before performing the high-dose chemotherapy treatment.

The stem cells are stored in a freezer, while the patient is undergoing high-dose chemotherapy after which the previously extracted stem cells are put back in the patient's body to make normal blood cells.

While preparing the treatment plan, EzziAmer underwent emotional stress apart from financial difficulties, which caused a major roadblock. After seeing her plight, the medical team decided to perform "day care BMT" under which the patient was admitted to the hospital only when required. The patient was admitted only during severe Neutropenia (abnormally low number of white blood cells (WBC) in the blood) and was discharged as soon as WBC counts recovered.

Dr Mangesh P Kamath, senior consultant medical oncologist, haemato-oncologist & BMT physician, BGS Gleneagles Global Hospital said, "The day care BMT is not usually done in India, due to fear of patients developing community acquired infections.

However, in this case, BMT was a unique experience to us as the patient had severe financial difficulties and her health condition was deteriorating each day. So, while treating EzziAmer, the BMT team was extra cautious, especially to avoid patients getting Covid-19 infection."

As she was responding well to induction chemotherapy, the haemato-oncology team fixed a date for the medical procedure, and admitted her on June 8. The team successfully performed an autologous bone marrow transplant and kept her under observation to examine her condition.

In the midst of treating EzziAmer, the haemato-oncology team was handling a similar challenge. Bhanumathi, a housewife from the city, was also facing similar problems. When she came to the hospital, she had weakness with fatigue in the bilateral lower limb, hip pain, low hemoglobin, and repeated upper respiratory tract infections.

Due to the severe back problem, before approaching the BGS Gleneagles Global Hospital she underwent neurosurgery to relieve spinal cord compression due to the tumour mass, however it didn't find any relief from pain. As her condition was more sensitive compared to EzziAmer, doctors conducted a battery of tests, including blood tests for diagnosing Myeloma, bone marrow biopsy and PET/CT scanning. Due to her medical history, onco-pathologist, evaluated the biopsied Paraspinal mass to get a clear picture of her spinal condition.

After evaluating her test results, the medical team learnt that she was also suffering from advanced stage multiple Myeloma and required immediate attention. The haemato-oncology team put her treatment plan and went ahead with six months induction chemotherapy. As Bhanumathi was showing positive response to chemotherapy, the medical experts decided to go ahead with autologous bone marrow transplantation.

Dr Rajeev Vijayakumar – senior consultant medical oncologist, haemato-oncologist & BMT physician, BGS Gleneagles Global Hospital, Bangalore says, "When Bhanumathi came to us, she was in grave pain and her spinal cord was severely affected. The timely intervention of our haemato-oncology team and the quick patient's treatment plans resulted in speedy recovery. This patient had multiple comorbidities, including asthma due to which we had to be careful in avoiding her from getting infected with any respiratory pathogens, including coronavirus."

Both the patients underwent comprehensive assessment for their disease status and were found to be Myeloma free currently. The patient from Yemen is back to her country and is currently on maintenance treatment and the second patient is asymptomatic.

Dr Neema Bhat, Senior Consultant, Pediatric Oncology, Haematology and BMT Physician at BGS Gleneagles Global Hospital says "Both patients underwent Comprehensive evaluation after bone marrow transplantation; the reports show that the both the patients are maintained in remission till date."

The "Day care BMT" is not usually done In India, due to fear of patients developing community acquired infections. However, in this case, BMT was a very unique experience to us, as the patient had severe financial difficulties and her health condition was deteriorating each day. So, while treating EzziAmer, the BMT team was extra cautious, especially to avoid patients getting COVID-19 infection

Dr Mangesh P. Kamath | Senior Consultant Medical Oncologist

When Bhanumathi came to us with her symptoms, she was in grave pain and her spinal cord was severely affected. The timely intervention of our haemato-oncology team and a swift treatment plan and action resulted in speedy recovery. The patient had multiple comorbidities including asthma due to which we had to be very careful in avoiding her from getting infected with any respiratory pathogens, including coronavirus

Dr Rajeev Vijayakumar | Senior Consultant Medical Oncologist

Both patients underwent comprehensive evaluation after bone marrow transplantation; the reports show that the both the patients are maintained in remission till date

Dr Neema Bhat | Senior Consultant, Pediatric Oncology