Ramathibodi Hospital on Tuesday announced the world's first successful case of a stem cell transplant involving a young patient with coronavirus disease, who donated his bone marrow to save his sister.
Prof Dr Suradet Hongeng, an expert in stem cell transplants at the department of paediatrics of the faculty of medicine Ramathibodi Hospital, announced the success to reporters on Tuesday.
He said the procedure was performed in April. A five-year-old boy, Sila "Jio" Boonklomjit, donated bone marrow stem cells to save his seven-year-old sister Jintanakan, also known as "Jean", who was born with thalassemia.
"This case was very challenging and complicated. Right on the day when we had to collect stem cells from Jio, we found he was infected with Covid-19. That made Jio another patient. Besides, both patients are young, five and seven years old. So, each and every step had to be done with special care.
"The collection of stem cells from bone marrow was surrounded with risks, including the risk of having stem cells infected with Covid-19. Procedures also increased because Jio had to be quarantined... In addition, there was the matter of safety for the medical personnel who were at risk during the operation," Dr Suradet said.
"This case is the first in the world when it comes to an urgent operation to collect stem cells from a Covid-19 patient for transplant," he said.
Apart from the Covid-19 risks, doctors also had to race against time because Jean had been completely physically prepared with chemotherapy, and consequently her body had low immunity. Without the urgent stem cell transplant, her life would have been in grave danger, Dr Suradet said.
The transplant was performed by Assoc Prof Dr Usanarat Anurathapan, of the division of haematology and oncology of the department of pediatrics at the faculty of medicine Ramathibodi Hospital, Mahidol University.
"It was not easy to find another stem cell donor for Jean because it is rare to find compatible stem cells from a donor who is not genetically related. The chance is 1 in 20,000-50,000. That would have taken time," Dr Usanarat said
"Genetic modification is impossible. Therefore, the only hope was stem cells from Jio. Doctors carefully considered the case until they were confident that the chances of success were greater than the risks," he said.
"The moment when we found that the stem cells were free of Covid-19 and the transplant to Jean was successful not only brought the joy of saving the siblings' life, but also marked another milestone in the treatment of patients that is a pride of Thai medicine," he said.
Sasiwimol Boonklomjit, the children's 39-year-old mother, had received prenatal care twice at Ramathibodi Hospital. She caught Covid-19 first, from a relative, and her son was infected in the lead-up to the transplant.
"A doctor diagnosed Jean with thalassemia when she was in her mother's womb. Jean received treatment from doctors at Ramathibodi Hospital until late 2018, when the family received the good news that the Jean's tissue type was compatible with that of Jio, their father Suchai Boonklomjit said.
"Doctors said that our family was very lucky because there is only a 25% chance that siblings will have the same tissue type," he said
"I admit that I almost collapsed. I felt that disasters would never end. As the stem cell transplant for Jean that we were hoping for approached, we were struck with the bad news that our son was infected with Covid-19. My wife also had it.
"Everyone had to be separated in our worst time. If I had been in another situation, I would have been completely in the dark. Despite the concern, I rested assured that our family was in the care of doctors at Ramathibodi Hospital," he said.
He expressed his gratitude to the Ramathibodi Foundation for subsidising the transplant costs. All coronavirus infected family members have recovered.
Jio, right, the stem cell donor, and his family (Photo: Ramathibodi Hospital)