Page 175 - GSTL_21st May 2020_Vol 36_Part 3

2020 ] IN RE : DKMS BMST FOUNDATION INDIA 421
(a) Low dose chemotherapy : using cell-killing drugs with
the aim of killing cancerous cells and stopping them
from multiplying;
(b) Some biological therapies/immunotherapies/mono-
clonal antibodies : drugs that encourage the patient’s
immune system to fight cancerous cells.
(i) Many patients suffering from blood cancer and other blood disor-
ders need a blood stem cell transplant to survive. For a stem cell
transplant, the primary step is finding a matching donor. Only
about 30% of the patients in need of a stem cell transplant as life-
saving treatment, are able to find a sibling match. The rest 70% de-
pend on finding a matching unrelated donor. Currently, 7 out of 10
blood cancer patients in India are unable to find a compatible donor
within the family and are likely to find an unrelated matching blood
stem cell donor. The odds are even lower for those with diverse an-
cestry. This can change by registering more potential blood stem
cell donor.
(j) In some cancers, such as certain leukemias, multiple myeloma, and
some lymphomas, a stem cell transplant can be an important part of
treatment and often their only chance of survival. A high dose of
chemo works better than standard dose to kill cancer cells but high
doses can also kill all the stem cells and cause bone marrow to com-
pletely stop making blood cells, which are required to be alive. Giv-
en the same, a stem cell transplant is a better way in many cases as
the transplanted stem cells replace the body’s stem cells after the
bone marrow and its stem cells have been destroyed by treatment.
Transplant lets doctors use much higher doses of chemo to try to
kill all of the cancer cells. A stem cell transplant from another per-
son can also help treat certain types of cancer in a way other than
just replacing stem cells. Donated cells can often find and kill cancer
cells better than the immune cells of the person who had the cancer
ever could.
(k) The need for stem cell transplant depends case wise and the health
status of the patient, but mostly doctor recommends stem cell
transplant seeing the long-term effects and better quality of life in
such patients. Most of the patients living with blood cancer would
require a stem-cell transplant in life for a longer survival.
(l) A successful blood stem cell transplant needs a perfect HLA tissue
match i.e. a 10/10 match which increases the chance that the pa-
tient’s body will accept donated cells as its own and not fight them.
Patients and donors of Indian origin have unique HLA characteris-
tics that are severely underrepresented in the global database,
which makes the probability of finding a suitable donor very diffi-
cult.
(m) The applicant works on finding a HLA-matched donor for every pa-
tient in need of a transplant. As Indian patients mainly require an
Indian tissue match, the applicant focuses on increasing the aware-
ness and on encouraging many more people in India to register as a
potential blood stem cell donor. It maintains a register or database
GST LAW TIMES  21st May 2020  175