There are many people who are living with life-threatening sicknesses and that may often make life seem hopeless but there are many out there who are fighting this feeling daily. One such case is that of a Bengaluru man who has been living with a rare leukaemia, and while life seemed difficult, a new development with the help of his sister gives him hope.
Persistent fatigue and fever were the first signs that something was wrong for a 32-year-old man from Bengaluru. Blood tests showed low platelet and haemoglobin levels, prompting doctors to investigate further. The diagnosis was mixed phenotype acute leukaemia, or MPAL, a rare and difficult-to-treat form of blood cancer.
Diagnosis and treatment journey of rare leukaemia
MPAL is uncommon because the leukaemia cells carry features of more than one blood-cell lineage. In this patient’s case, specialised testing identified both myeloid and T-lymphoid characteristics. Bone-marrow studies, particularly flow cytometry, were crucial in confirming the diagnosis and determining the treatment approach.
Induction chemotherapy brought the leukaemia into complete remission, with no measurable residual disease detected. Although this was an encouraging response, the possibility of the disease returning remained. Given that risk, the medical team recommended a stem-cell transplant to help sustain the remission.
The family’s next challenge was finding a suitable donor.
Relatives underwent matching tests, while doctors also searched a registry for an unrelated donor. No, fully compatible donor was identified. The medical team then considered a haploidentical transplant, which can use stem cells from a partially matched family member. After careful assessment, the patient’s sister was found suitable to donate.
“A family member does not always need to be a full match to be considered as a stem-cell donor. A haploidentical transplant can expand donor options for some patients, but suitability requires careful assessment,” said Dr Neema Bhat, Haemato Oncologist at Apollo Hospitals, Bannerghatta.
The sister’s role in her brother’s treatment began with growth-factor injections to increase the number of stem cells circulating in her blood. The cells were then collected through apheresis, a procedure similar to platelet donation. Once the medical team confirmed that enough cells had been collected, she returned home the following day. She experienced no side effects and resumed her daily routine within a day of discharge.
For her brother, the transplant began another period of waiting and close observation. Around the third week, improving blood counts indicated that the donated cells were taking hold. Post-engraftment testing recorded 98 per cent donor chimerism, meaning that 98 per cent of the blood cells tested originated from his sister. With blood-cell production established and his early recovery uncomplicated, he was discharged in good clinical condition.
Two months after the transplant, his blood counts were reported as normal. Recovery was not entirely without difficulty. A respiratory infection required a brief hospital admission, but he recovered. He continued to attend follow-up visits every two weeks, with tests monitoring his blood counts, liver and kidney function, medication levels and low-level viral infections. If his progress continued, the frequency of these visits could gradually reduce to once a month.
While his sister was able to return to her routine soon after the donation, her brother’s recovery continued through regular hospital visits and careful monitoring. The stem cells she donated were rebuilding his blood and immune system.
For the siblings, the transplant connected two very different experiences. It saw a sister returning home shortly after donating and a brother beginning a longer, closely monitored recovery. His discharge did not mark the end of treatment, and his long-term outcome will depend on continued follow-up. Yet after a rare diagnosis and a search that found no fully matched donor, the cells donated by his sister provided a way forward. The documented engraftment and normal blood counts represent an important early milestone in that continuing journey.
B'luru: Sister's stem cell donation gives hope to brother with rare leukaemia
