by Ammara Farooq Malik, Founder, SEPLAA Foundation.
It was very fortunate for me to be able to meet the man who helped save my daughter’s life in a face to face informal sitting, in Pavia (Italy). Doctors truly do wonders. But what these special doctors do is give a new life to the most destitute of patients: patients with acute leukemia and genetic blood disorders through bone marrow transplants. A facility not yet easily available in Lahore.
Introduction to Dr. Marco Zecca:
As the Director of the Pediatric Hematology and Oncology, Dr. Zecca leads the team at the Pediatric Hematology/Oncology Laboratories which have been active for more than ten years in the field of adoptive T-cell therapy for the treatment of viral infections and related diseases arising in immune suppressed hosts.
AFM: Dr. Zecca please tell us a little about yourself including your areas of research.
M.Z: I have been a close collaborator of the former Director, Prof. Locatelli, since 1989, and have been appointed this present position in February 2010. I am active in the field of clinical research and am quite involved in the new conditioning regimens for HSCT (stem cell transplants) in patients with acute leukemias and myelodysplastic syndromes.
AFM: What have been your areas of interest?
MZ: One of my fields of interest has been the study of the characterization and treatment of Graft-versus-Host-Disease, a frequent and serious post transplantation complication.
In the field of non-malignant hematological diseases, I have focused on the study of congenital and acquired anemias and thrombocytopenias, In particular I have also pioneered the use of anti-CD20 monoclonal antibodies for the treatment of autoimmune cytopenias.
AFM: What does your hospital specialize in?
M.Z.: Our department specializes in the treatment of children affected by hematological pathologies, both malignant and non malignant. This Unit has performed the largest number of allografts for pediatric patients in Italy and represents one of the most active and experienced Institutions in the field of HSCT world-wide.
A.F.M.: How many transplants has your hospital performed?
M.Z.: Over the last 20 years, more than 1000 transplants have been performed, averaging 80 per year over the last ten years.
A.F.M.: What is the average cost of a transplant in Italy?
M.Z.: The cost of a transplant is roughly 70-80,000 euros if there is an HLA compatible donor such as a sibling.
If the donor has to be found then the cost can be approximately 110,000 euros.
A.F.M.: What is the chance of someone being able to get a perfect 100% HLA compatible donor to be able to have the highest chances of a successful transplant?
M.Z.: Only 1 in 4. In other words there is a 25% chance that two siblings will be HLA compatible (in simple words this means that their genetic codes have to match in order to become donor and recipient.).
A.F.M.: Does the Italian government extend its support to deserving patients from developing countries such as Pakistan?
M.Z.: Yes, though the competition is very tough, we can expect a deserving patient to co finance a transplant by paying 30-50% of the total cost and the rest can be paid by the government of Lombardia.
A.F.M.: Can Pakistani doctors come to Italy to get training at your Bone Marrow Transplant Facility?
M.Z.: Yes, we are under contract to extend such collaborations to medical professionals in the developing countries.
A.F.M.: In the recent meeting of the European Bone Marrow Transplant Group at Vienna in Austria in March 2010, you presented your recent and very encouraging findings. Can you please tell us a little about it?
M.Z.: Yes, in the meeting I discussed my recent research findings that age is no longer a the determining factor to establish whether a bone marrow transplant will be successful. This means that the old myth that only young persons can have successful transplants does not hold truth anymore.
A.F.M.: What factors determine a successful transplant then?
M.Z.: General good health, iron and ferritin levels and the condition of other organs particularly the liver and heart.
A.F.M.: What would be your advice to patients of leukemia?
M.Z.: My message is positive: 80% of people with leukemia can be cured today with the help of advancing technology in the field of transplantation.
A.F.M.: What would be your advice to patients of thalassemia or other blood disorders?
M.Z.: I would suggest to everyone that they must preserve their chord blood for the future as it can be used for transplants to save others too. There is a very high probability that if patients with thalassemia receive a bone marrow transplant then they can be cured permanently.
There is hope, even for people in Pakistan who suffer from leukemia or blood disorders. But much can and still needs to be done in this area.
SEPLAA Foundation’s Suggestions for Health Institutions in Pakistan:
To help facilitate the treatment of patients with blood disorders, the following are needed in Pakistan:
- The awareness about the importance of preservation and the facilities to preserve chord blood in Chord Blood Banks.
- A National Bone Marrow Registry so that people can get themselves registered once and may act as donors for patients who do not have HLA compatible siblings as donors.
- Bone Marrow Transplant Centres in all the major cities in Pakistan. There is no such centre in Lahore!
– Extract from a health awareness publication by Ammara Farooq Malik, April 2010.