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Patient's own stem cells used to cure cancer

Malathy Iyer, TNN 27 July 2009, 01:30am IST

MUMBAI: For 15 years, Rakesh Singh (name changed) went about his high-pressure job as a

senior engineer in a central government firm with a transplanted kidney.

Daily, he would pop immuno-suppressant pills to prevent his body from rejecting the donated organ. Then, about 18 months ago, he was struck by an "explosive" form of cancer called multiple myeloma — big boils erupted across and within his body, impairing his ability to sign and speak.

Singh's disease put doctors in the city's Jaslok Hospital in a bind about what line of treatment to follow: reducing the immuno-suppressants to let his body fight the cancer cells could have led to a possible rejection of the kidney.

It was then decided to give him a second transplant — of the bone marrow this time — with his own stem cells. Today, Singh is cancer-free and a medical marvel of sorts.

It has been a month since the 49-year-old underwent a PET (positron emission tomography) scan that categorically showed that he had no more cancer cells in his body. He has been breathing easy since then, but the doctors who treated him over 18 months have got a tad busier: they have a big announcement to make to the world.

Papers are being written, archives are being rechecked and old-timers being consulted before the doctors submit their claim to Nephrology Dialysis Transplant, a European journal.

"Singh is the first kidney transplant patient in the world to undergo a stem cell transplant to beat multiple myeloma (a cancer of the plasma cell) after ablative chemotherapy," say nephrologist Dr Madan Bahadur, hematologist Dr Sameer Shah and oncologist Dr Ganpati Bhat.

KEM Hospital's head of nephrology department, Dr V Hase, says, "The Jaslok patient’s case is of great academic interest. Firstly, it is rare for a kidney transplant patient to develop multiple myeloma. Secondly, no transplant patient in India has undergone a stem cell transplant as a rescue mission against cancer.’’

Dr Hase adds that renal failure is a known complication of multiple myeloma. ‘‘So, in the western world, multiple myeloma patients would undergo stem cell transplant first and a renal transplant later,’’ he says. ‘‘But in the Mumbai case, the opposite has happened.’’

As for the man who underwent the Rs 19-lakh rescue, ‘‘life in the last 18 months has been a struggle for survival’’. He smiles as he recalls the difficulty he had in signing papers.