The country's first and, as yet, only recipient of a groundbreaking bone marrow and stem cell transplant is in good health more than two months after the operation.

A seven-year-old boy underwent the procedure on May 21 at Ramathibodi Hospital. Doctors there hailed the life-saving treatment a success.

Blood from newborn babies' umbilical cords can be used to treat blood diseases and cancers. The new technique employed by Ramathibodi used the cells from the umbilical-cord blood of two donors and matched bone-marrow tissue from the patient's mother, explained hospital paediatrician Dr Suradej Hongeng. The umbilical-cord blood was provided by the Thai Red Cross Society blood bank. It was an 80-per-cent genetic match with the recipient.

Previously, blood from a single donor only was used. This proved insufficient, according to Suradej, a leading expert on blood diseases and stem-cell transplants.

"The technique is not that new in Western hospitals but here in Thailand this was the first and it was a success," he said.

But one of the procedure's limitations was collecting sufficient blood. Each umbilical cord provided approximately 100 cubic centimetres, sometimes less.

And finding blood matches was rare, he explained.

When a matching donor and recipient was found, transplants were often impossible because there was insufficient blood.

The volume of cord blood required for a transplant varies depending on the recipient's body weight, Suradej said.

To date, Ramathibodi had successfully treated 10 patients with either blood diseases or cancers using stem cells from just one donor.

The hospital was preparing the results of the two-donor technique for review and publication by international medical journals. The two-donor-marrow transplant patient was identified as a 7-year-old boy suffering from thalassaemia type beta E. Thalassaemia was also known as "Cooley's anaemia".

About five weeks after the transplant, the new bone marrow inside his body started to function, said Suradej, adding that "the patient is now in very good health and doctors are most satisfied with their work".

Thalassaemia is an inherited disease of the red blood cells. The genetic defect results in synthesis of an abnormal haemoglobin molecule. The blood cells are vulnerable to mechanical injury and die easily.

It is among three groups of blood diseases and cancers which can be cured only by bone-marrow transplant, said Prof Saengsuree Jootar, head of Ramathibodi's programme providing free transplants for the underprivileged.

"If the patient does not receive life-saving treatment for the inherited disease, he or she will usually die before reaching adulthood," she said.

Since 1989, Ramathibodi has conducted about 430 bone-marrow transplants, Saengsuree said.

However, the cost is high, ranging between Bt300,000 and Bt700,000. It is also hard to find matching donors, said Prof Ratchata Ratchatanawin, the dean of Ramathibodi's Medicine Faculty.

Each year, approximately 500 new cases of thalassaemia are diagnosed in Thailand, all of which require life-saving transplants. As many as 300 patients die for lack of a donor or because they could not afford the procedure, Suradej said.

The hospital began offering free transplants for the less fortunate in 1989 to commemorate Her Majesty the Queen's 72nd birthday.

To date 34 people have had the life-saving operation.

Ramathibodi encourages people to make cash contributions to the hospital or register with the Thai Red Cross Society as a bone-marrow or cord-blood donor.

Arthit Khwankhom

The Nation