Rare Old

Four –year-old Thalassemic Girl gets a new lease of life at Apollo Hospitals

Isha Gohel, a 4 year old girl from Saurastra was diagnosed as a Thalassemia major when she was one year old. Thalassemia is a medical condition which requires lifelong blood transfusion and most children die by the age of 15- 20 years of age due to complications of iron overload. But this won’t be the case with Isha.

Isha’s parents brought her to Apollo Hospitals, Ahemdabad seeking a new lease of life for their daughter who had started receiving blood transfusions at the age of 18 months. Dr Chirag A Shah, Apollo Hospitals Ahemdabad was consulted for the case and he advised Isha to undergo a Stem Cell Transplant which is the only curative option for Thalassemia Major.

“On investigations, we found that Isha was a Class 3 Thalassemia Major which was a major challenge for us. Such patients are not usually advised to undergo this treatment,” says Dr Chirag A Shah. He further explains, “Since Isha did not get good quality blood transfusion and iron chelation due to socioeconomic restraints her condition was very poor. She had developed marked enlargement of the spleen at 17.9 cm, leading to further poor response to blood transfusions. Such patients frequently have poor results with transplant and have high risk of complications.”

The first step to Isha’s treatment was to reduce her iron overload which required extensive iron chelation medicines and regular follow up. However, her spleen size did not reduce enough with use of medicines. Hence, in January 2011, a small operation was performed to remove her spleen. A small biopsy was also taken from her liver, which showed that her liver still had very high levels of iron deposition (4+ i.e. highest level), and had signs of liver damage secondary to iron.

In February 2011, she was started on a special protocol of medicines to reduce her risk of being Class 3. This step took over one month. Thereafter, she underwent Stem Cell Transplant procedure in April, with stem cells from her younger brother, who is about two and a half years of age. Stem cells were collected from bone marrow under anesthesia.

“Isha was given special medicines to clear off her old blood making stem cells. Transplant was then performed i.e. brother’s healthy stem cells were given to child. There was no operation involved. Stem cells are transplanted without any operation in this method, given in blood stream as a blood transfusion,” says Dr Chirag A Shah.

Isha’s treatment also faced financial challenges as her father did not have the huge amount of money the operation requires. However, he was very motivated to treat his daughter and rid her of this devastating illness. Fortunately, however, his employer was enrolled in ESIS, employee state insurance scheme. Apollo Hospital is recognized by this scheme to treat patients. Hence, this one major concern was cleared.

Isha is now on the road to recovery and would be transfusion free forever in a couple of months. According to Dr Chirag A Shah, “She needs to stay in town for three months for close follow up, and will be transfusion free forever as her underlying Thalassemia major is now cured after stem cell transplantation. She needs to continue some medicines for few months to complete the course and to prevent any complications from transplanted stem cells. Thereafter she will not need any type of medicine.”

Her parents believe that Isha got a new life at Apollo hospitals and are thankful to Dr Shah for making their daughter Blood transfusion free for life time which is very rare for a Thalassemia major.

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