Rakesh Singh is a medical rarity for two reasons: Rakesh (named changed) took immunosuppressant pills to prevent rejection of a donated kidney. He was able to live a normal life until about 18 months ago, when he became one of the only kidney transplant patients to develop multiple myeloma. For Rakesh, the disease caused large boils to erupt throughout his body, affecting his ability to speak.
Secondly, and more importantly, he is the only transplant patient in India who has undergone a stem cell transplant. And according to nephrologist Dr. Madan Bahadur, hematologist Dr. Sameer Shah and oncologist Dr. Ganpati Bhat, "Singh is the first kidney transplant patient in the world to undergo a stem cell transplant to beat multiple myeloma after ablative chemotherapy." Rakesh just recently had a PET scan. The results? It's been just over a month since the 49-year-old underwent the procedure, and his scan shows "categorically" that there are no remaining cancer cells in his body. He is also breathing much easier.
Rakesh's story could have turned out quite differently. His doctors at Mumbai's Jaslok Hospital faced a real dilemma about how to treat him. Should they reduce the immuno-suppressants to let his body fight the cancer cells? If they chose that route, it could have led to a possible rejection of the donated kidney. That's when they decided to give him a second transplant -- bone marrow this time -- with his own stem cells. The head of nephrology at KEM Hospital, 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." And he adds that renal failure is a known complication of multiple myeloma. "So, in the western world, multiple myeloma patients would undergo a stem cell transplant first and a renal transplant later. In the Mumbai case, the opposite has happened."
In the United States, there are 5 to 7 new cases per 100,000 persons each year who have this type of cancer of the plasma cells -- cells that are a critical part of the immune system and produce immunoglobulins to help fight infection and disease. Multiple myeloma represents approximately one percent of all cancers in white U.S. residents and about two percent of cancers in African Americans.
News Release: Patient's own stem cells used to cure cancer
www.timesofindia.indiatimes.com July 2009.