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SRINAGAR: The stem cell donor was from Poland. Donor identification and bone marrow transportation were facilitated by a German organisation. The transplant was carried out by doctors at Sher-i-Kashmir Institute of Medical Sciences (SKIMS) in Srinagar.This international medical collaboration has saved the life of a three-year-old Kashmir boy suffering from Hemophagocytic Lymphohistiocytosis (HLH), a rare hyperinflammatory condition in which the body’s immune system attacks its own organs and healthy blood cells. Characterised by excessive immune activation, HLH can be genetic or acquired, and is life-threatening if untreated. Hematopoietic stem cell transplant (also known as a bone marrow transplant) is the only definitive, curative treatment for familial HLH.“A matched donor was identified through an international bone marrow donor network facilitated by the Germany-based DKMS registry. Stem cells collected from a donor in Poland were transported to SKIMS, where the transplant was performed a few days ago. The transportation costs were borne by the German organisation,” SKIMS director Prof. M Ashraf Ganie said Tuesday.“This is a major development not only for SKIMS, but also for the country. Only a few centres in India perform matched unrelated donor (MUD) transplants and this is the first such procedure at our institute,” he added.It was about two years ago that the boy’s father, a resident of Safapora in Ganderbal district, brought him to SKIMS, where he was diagnosed with HLH. Having lost his daughter to the same disease three years ago, the father was alarmed when the boy, after remaining healthy for about 12 months, showed similar symptoms — weakness, weight loss, thrombocytopenia (abnormally low blood platelets count) and hepatosplenomegaly (enlargement of liver and spleen).After the HLH diagnosis, the father approached Dr Reshma Roshan, associate professor at SKIMS. Dr Reshma, along with Prof Sajad Ahmad Geelani, head of clinical haematology dept, and Dr Afaq Ahmad Khan, who were part of the treatment team, said the child did not have a matched donor within the family. Fortunately, a donor was arranged, “enabling us to carry out MUD transplant”, they said. The patient was stable and healthy, and his investigations were normal, the doctors said, adding that the child was discharged Tuesday and would now remain on outpatient follow-up.Prof. Geelani said bone marrow transplant donors are usually siblings who have a full HLA match. “Another option is haploidentical or half-matched transplant from a parent, while MUD transplant is performed when a suitable donor is identified through international registries,” he said.“The chances of complications are lower with a matched sibling donor compared with haploidentical or MUD transplants,” he added. The doctor said donation of bone marrow stem cells is generally safe and doesn’t cause any harm to the donor.“I am happy that my child has recovered,” said the grateful father. He appealed for the opening of a donor registration facility at SKIMS and said he would be the first person to register.Prof. Ganie said there was a need to raise awareness about stem cell donations and urged people to register as potential donors. “If more people register and their (human leukocyte antigen) HLA profiles are included in donor registries, they could potentially save the lives of patients in need of stem cell transplants,” the SKIMS director said.
