By Lorraine Anyango
The reality of having the First Bone Marrow Transplant (BMT) Center in Africa is just 14 months away.
The center, named ‘Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH) Hematology Center’ will be housed within the Victoria Hospital annex in Milimani area in Kisumu City.
To make this dream a reality Fortis is sponsoring, a group of doctors from JOOTRH to undertake BMT specialized training in India for six months.
The setting up of the hematology center will make reality an infection control center run by a group of about 25 people, strictly adhering to infection control guidelines, as infections should be kept at bay for those who have gone through transplants.
The JOOTRH Hematology Center is an initiative of Kisumu County, JOOTRH with support from Fortis Memorial Research Institute, Gurgaon, India.
The facility is expected to receive clients from all over Africa, especially warriors from Nigeria who have been going all the way to India for BMT. Clients spend more than half a million for just treatment without adding the accommodation cost, The opening of the JOOTRH Hematology Center is expected to reduce this cost and cut the fleets overseas for BMT services.
Next to the center apartments for accommodation will be put up, as one needs about a year in a hospital facility before discharge to ascertain full recovery and areas free of infections.
For one to successfully go through a transplant one needs to find a donor first, who is a match fully or partially. One spends about 30,000 to pay for a kit that extracts samples for matching, and the samples are extracted through swabs from the inner lining of one’s mouth.
The transplant process cost can be paid using one’s insurance including NHIF and other covers one has as well.
To sensitize the residents of Kisumu to understand and embrace BMT, Fortis held a public lecture on the same subject. The well-attended event was graced by Sickle cell Warriors and their caregivers, the County Executive Committee Member, medical services, public health, and Sanitation, Dr. Gregory Ganda, Mr. Washingtom Akumu from NHIF, JOOTRH CEO Dr. George Rae, Director Medical Services Dr. Don Sunday Ogolla, pediatricians and nurses, pharmacists and other health care workers from various health facilities.
In his opening remarks, Dr. Vikas Dua, a hematologist specializing in BMT gave hope to warriors living with sickle cell and their families “There is cure there is hope”. Dr Vikas emphasized.
The current treatment method for sickle cell is drug treatment which allows more cells to transit in the microcirculation before sickling. There is also an allogeneic transplant using a curative strategy using bone marrow stem cells from a donor without sickle cell disease.
In the future, treatment for sickle cell will include Ex-vivo gene therapy the patient’s bone marrow cells are modified by adding a B-globin gene using a retroviral vector or with gene editing to reactive fetal hemoglobin (HbF) or correct the disease mutation.
The other option in the future could be In vivo gene therapy, direct gene editing in patients could circumvent the need for transplantation of modified patients’ cells if sufficient efficiency and safety can be achieved.
Annually 7.9 million children are born with a birth defect, there are five major disorders and hematology is the third disorder in the sequence of occurrence.
While highlighting data on sickle cell, he said daily 350 children are born in Nigeria with sickle cell, while in the world 1000 children are born daily with sickle cell, thus he concluded that sickle cell is a public health issue requiring public health solutions.
He added that 90 percent of those with the disease do not live to adulthood, which is compounded by inadequate access to hydroxyurea, penicillin, and immunization.
The first successful HCT in SCD was performed in 1984, in the case of a pediatric patient with coexisting acute myeloid leukemia (AML) from a sickle cell trait sibling.
Since then, BMT has improved over time, Event-Free Survival in Most Recent Transplant Recipients 1000 patients with SCD underwent HLA-matched sibling HSCT from 1986-2013.
5-year overall survival was 92.9%, event-free survival was 91.4%, 5-year OS was 95%, and EFS was 93% for patients younger than 16 years of age Cumulative incidence of grade II-IV acute GVHD was 14.8%, chronic VHD 14.3%.
