Not less than a miracle at SSGCH, Miraj

A 19-year-old young boy had a serious blood cancer (ALL) 3 years back. He was treated in one of the metro cities for 2 years. After completing his treatment, his disease recurred. When he went to see his treating doctor again, he was advised to take supportive treatment at his home town as there was no option for curing him now. He was from Sangli district and so he decided to have one visit at our hospital.

When we saw him, he was having frank disease in his blood. He was on treatment with some oral medications to which he was not responding. His elder brother was determined to save him. We took this case as a challenge and decided to give him the best possible treatment available in the world. He was from a poor family background, so the responsibility of arranging the finances was taken up by the team of social workers of our hospital.

He was started on intense chemotherapy protocol to bring his disease under control and he received 4 such cycles needing hospitalization for over 3 months. After chemotherapy, to prevent recurrence, he needed Bone Marrow Transplant (BMT)to get complete cure. In that direction, his HLA testing was done to see if he was having a match among his siblings. Luckily his sister was full 10/10 match with him. The sister had delivered a baby 2 months back. With all the apprehension of her family members to take her as a stem cell donor for this patient, we assured them about the donor’s safety during the procedure.

Challenges did not end here. The protocol of chemotherapy (Conditioning) that we had decided for this patient to give him the best possible outcome, was with incorporation of Total Body Irradiation (TBI), which needed high dose radiation to whole body. This was never performed before in our region beyond Pune. We discussed this with the team of our Radiation Oncologists. They agreed to accept the challenge taking it as an opportunity to prove that we can provide the best service to our patients without any compromise.

His Bone Marrow Transplant was performed successfully with his sister being the donor. This was not the end. We were a little apprehensive as it has been seen that there are more problems in BMT patients whose donors are femaleswho have had children. Our night mare came live when he started pouring loose motions from 15^th day post BMT. Our gastroenterologist was called and a biopsy from his large intestine was taken. It showed a disease called Graft Vs Host Disease(GVHD) (Donor cell reaction in recipient). He was started on steroids which got failed. But with supportive nursing care and second line medications, his GVHD came in control and he was discharged from the hospital in stable condition. His success of transplant was documented by a test called Chimerism.

Managing this case required support from all the departments of the hospital, amongst which the nursing staff requires a special mention. They were just so particular in their function, that the day of discharge that he is seeing, I believe is because of their meticulous care.