Pune: In what doctors described as a rare case, three-and-a-half year old twin sisters, who were diagnosed with high-risk Acute Lymphoblastic Leukaemia (ALL), underwent simultaneous stem cell transplants at Sahyadri Hospital in Pune.The procedure was made possible after stem cells from a single unrelated donor, identified through DATRI Stem Cell Registry, were used. Doctors said while ALL is one of the more common childhood cancers, it is uncommon case because both twins were affected at the same time. The challenge, they added, was compounded by the need to find a donor whose stem cells could match both siblings and in sufficient quantity to perform transplantation simultaneously.“The case became complex because the donor had to be a perfect match for both children, the stem cells had to be collected in adequate volume and the girls had to be in remission at the same time for the procedure to proceed safely,” said Dr Kannan Subramanian, consultant haematologist at Sahyadri Hospital.The transplants were declared successful after a specific observation period. Even though the operation happened in Jan 2022, it was declared successful after the observation period.The collection of stem cells was carried out in Hyderabad and transported to Pune, where both transplants were carried out on Jan 9, 2022. Doctors said published literature shows only a few such cases have been reported worldwide where one donor’s stem cells were used for twin transplants.The transplant involved a conditioning regimen — treatment designed to destroy cancer cells and prepare the bone marrow to accept new stem cells — followed by close post-transplant monitoring. “Managing two critically ill children simultaneously added another layer of challenge,” said Dr Subramanian.A multidisciplinary team including transplant physicians, haematologists, critical care specialists and nurses coordinated over several weeks to pursue the transplant with accuracy. Hospital authorities said both children were currently recovering and were under regular follow-up.“The treatment was emotionally and physically demanding for their family, but today, the twins were doing well. They were back to their normal lives, and the family has found hope again,” said Dr. Shashikant Apte, director of haematology, Sahyadri Hospitals.Doctors added that the case underlines the need for more voluntary stem cell donors in India, where registries still face shortages in finding matches for patients with blood cancers.
