Swarali and Swaranjali, like other twin sisters, do everything together. They dress alike, go to the same school, and even have the same preferences in food and music. But woefully, they both also suffered from the same disease- thalassemia major.

Over the last 12 years, both sisters were to go for blood transfusions every fortnight to maintain haemoglobin levels. Although the parents were informed about bone marrow transplant as the only curative option exists for the thalassemia major, they did neither have the right information regarding the centres that offer the services for children nor have the means to get the HLA typing done – the first prerequisite for bone marrow transplant. SRCC Children’s Hospital, managed by Narayana Health, helped them to get the HLA typing done for the whole family. And what a turn of events! The younger sibling was found to be a full match for both. The Bone Marrow Transplant Team decided to transplant the twin either simultaneously or one after another, as there was a single donor. “Bone marrow transplants are the only curative option for children with hemoglobinopathies. The children who have matched sibling donors should be transplanted early as this gives them a better life post-transplant. Success rates for matched sibling donor transplants are between 85-90% when done between the ages of 2- 8. Those cases that do not have a matched sibling donor can still be offered transplants using matched unrelated donors or even half-matched family donors with success.” Dr Ruchira Misra, Senior Consultant, Pediatric haematology-oncology and BMT unit at SRCC Children’s Hospital, managed by Narayana Health, opined.

Knowing that the hospitalisation would be for a month and the parents it would be difficult to arrange accommodation for that long period, the hospital arranged everything to ensure a smooth procedure. All three got admitted, and the acclimatisation and conditioning started. Since their names were very similar, they were housed on different floors to try and decrease inadvertent medication errors. The brother was administered a Granulocyte Colony Stimulating Factor (G-CSF) injection to ensure a higher stem cell generation. After transplantation, Swaranjali developed mild complications of mucositis and infection, but Swarali did extremely well, and soon the sisters showed signs of engraftment. On day 21, the girls were discharged with full donor chimerism! Though the road ahead is long, and the journey is not yet over, the 1st hurdle has been crossed.

Doctor	Designation	Specialization	Fields of Expertise
Dr. Ruchira Misra	Sr. Consultant	Paediatric Hemato-Oncology & Bone Marrow Transplant (BMT)	- BMT for Relapsed Malignancies - BMT for Thalassemia - BMT for Inborn Errors of Metabolism
Dr. Chintan Vyas	Consultant	Paediatric Hemato-Oncology & Bone Marrow Transplant (BMT)	- Paediatric Blood / Marrow / Cord Blood Transplant - Advanced Cellular Therapy (CART / Activated NK cell therapy) - Paediatric Immunodeficiency Diseases and EBV-related disorders - Metabolic disorder and Congenital Syndromes - Late effect & Survivorship