Baban Pandurang Shinde (57) from Kalyan who had been on bed rest for over a year owing to back ache can now drive his four wheeler peacefully with transfusion-free, autologous stem cell transplant (ASCT). Shinde, who is the General Secretary of union for Mathadi workers, was suffering from multiple myeloma and had not been able to work for his union since a year. After showing multiple doctors, he reached Kokilaben Dhirubhai Ambani Hospital in Navi Mumbai wherein he was advised ASCT. After the successful completion of the treatment, the hospital has claimed it to be a landmark procedure representing a significant advance in patient-centred care, offering new hope to individuals who cannot undergo traditional blood transfusions due to medical conditions, religious beliefs, or personal preferences.
Shinde, had quadriparesis or weakness in all four limbs. He was diagnosed with multiple myeloma, a blood cancer that occurs when plasma cells in the bone marrow become cancerous and multiply rapidly. In addition to multiple myeloma, he also had multiple health challenges, including hypertension, diabetes, hypertriglyceridemia, functional iron deficiency, borderline vitamin B12 levels, compromised lung function, and kidney disease. Given the complexity of his medical condition, traditional blood transfusions posed significant risks.
Understanding these challenges, Dr. Kunal Goyal, Consultant Haemato-Oncologist specializing in Bone Marrow Transplant (BMT) and Cellular Therapies (CAR-T) at Kokilaben Dhirubhai Ambani Hospital Navi Mumbai decided to adopt a cutting-edge approach and performed a bloodless or transfusion-free autologous stem cell transplant. Dr. Goyal explained, “Bloodless ASCT (Autologous transplant) is an innovative medical approach aimed at minimizing or completely eliminating the need for blood product transfusions during the surgical procedure. This method is beneficial for patients who cannot receive transfusions due to religious beliefs, personal preferences, or medical conditions that increase transfusion risks as in Shinde’s case.”
In Shinde’s case, several key steps ensured the success of the transfusion-free procedure. The patient’s bone marrow was utilised as the source of stem cells, which reduced reliance on blood transfusions compared to peripheral blood stem cell collection. Iron levels were optimized to enhance the body’s natural ability to produce red blood cells, and erythropoiesis-stimulating agents (ESAs) were used to stimulate the bone marrow, to treat the anaemia without transfusions. Medication was given to preserve platelet function and count, reducing bleeding risks. Meticulous surgical techniques and blood conservation methods were employed to minimize blood loss due to the procedure. Through proactive management with symptoms monitored for infections and potential complications led to a successful stem cell transplant with positive outcome for the patient, said the doctor.
For the patient, the transfusion-free approach also offered other benefits. It removed the risk of potential complications associated with blood transfusions, such as allergic reactions, infections, and immune system responses. It allowed for fewer postoperative complications and quicker recoveries with improved outcomes. This approach also respects a patient’s beliefs and preferences, building satisfaction and trust, said the doctor.
Dr Goyal added, “A bloodless or transfusion free autologous transplant (ASCT) and particularly a complex procedure such as a stem cell transplant requires a multidisciplinary team with specialised expertise in bloodless medicine and transplantation techniques. Careful planning, detailed preoperative assessments, and rigorous post-transplant care are crucial to ensure patient safety and optimal clinical outcomes.” The patient was discharged after a successful recovery without the need for blood transfusions. “He is doing well and has returned to a normal life with his family and work,” doctor added.
