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Acute Myeloid Leukemia treated through BMT & Triple Vessel Coronary Artery disease with CABG

Narayana Health City becomes the first healthcare provider in the country to successfully treat a patient suffering from two life threatening disease. The patient, 48-year-old male Naresh Bala was suffering from Acute Myeloid Leukemia (AML) and Triple Vessel Coronary Artery disease (TVCAD) and has been cured of both his conditions through Bone Marrow Transplant (BMT) and a subsequent Coronary Artery Bypass Surgery (CABG). Naresh Bala was diagnosed with AML, a life-threatening disease in July 2012 and was admitted at another center for chemotherapy. He was also diagnosed with TVCAD, which also needed intervention.

After detailed examination the Dr. Sharat Damodar and team recommended following up the Chemotherapy with a Bone Marrow Transplant.  However, unlike other patients, Naresh was suffering from a heart ailment making the case a high-risk procedure. As BMT was the only option for Naresh to be cured of cancer, Dr. Sharat Damodar and team took up the challenge. They did a detailed evaluation of his cardiac condition. Once the cardiac team gave a high-risk clearance, they set out to find a matching HLA donor. Fortunately for Naresh, his brother’s HLA matched with him and the bone marrow transplant was conducted in August 2012. Naresh recovered fully and was discharged by August 2012.

Though he recovered from AML, over the next 2-3 years he gradually began developing symptoms of heart failure. As he was on immunosuppressive medications, his surgery was deferred. However, his condition continued to deteriorate over a period making it imperative to perform a by-pass surgery, a life saving procedure for his heart.

Speaking on the complexity of the case, Dr. Sharat Damodar, Clinical Director & Sr. Consultant Hematologist & Head – Bone Marrow Transplant Unit, Mazumdar Shaw Medical Centre, Narayana Health City, said, “Blood cancer and TVCAD at the same time is an extremely rare condition. While the Bone Marrow Transplant required taking utmost care and ensuring that the functioning of the heart was not adversely affected. The CABG presented high risk of infections as the patient was on immunosuppressant medicines. Handling the numerous risks required extraordinary efforts; the slightest deviation could have led to irreversible conditions, even death.”

“We are extremely pleased that we could save Naresh’s life, and with this case, we become the first hospital in India to have successfully treated a patient with two such critical life-threatening diseases,”added Dr. Damodar.

After successful surgeries without any complications, Naresh is cured not only of cancer and TVCAD, he has been leading a near normal life for the last 5 years.

Dr Ramesh Seshadri, Senior Consultant – Cardio Thoracic Surgery, Narayana Institute of Cardiac Sciences, Narayana Health City said, “Naresh Bala, post BMT patient, presented with severe coronary artery disease with severe LV Dysfunction (Low EF). He was in CCF and had chronic kidney disease with high creatinine. He was on immunosuppressant medicines. All the above said factors added to present a complicated picture of high risk CABG. He underwent CABG without any complications and has steadily shown improvement in the last one year”.

“I also believe that a lot of credit should go to Mr Naresh Bala & his wife, who remained very positive throughout the course of the treatment,”added Dr. Seshadri.

AML is a type of blood cancer that affects the blood and bone marrow of the individual. In this condition, the cancer begins in myeloid cells, which are immature forms of white blood cells. TVCAD on the other hand is a life threatening cardiac disease where in the arteries that supply blood to the heart muscle is blocked. The blockage and narrowing of the vessel is caused due to plaques which are a result of cholesterol deposits on the walls. This gradually leads to thickening of the lining of heart arteries and if ignored can cause heart attacks as well as sudden death.

Expressing his joy of being saved, Naresh Bala said, “I never imagined that I would recover. As I had multiple ailments my condition needed an extra-ordinary co-ordination between different departments.  My issues required the involvement of hematology, heart, kidney, lung and gastro teams to be a part of the treatment. Doctors at Narayana Health knew this very well and they worked together on one course of action.  I could not have dreamt of a better team and platform than NH and am extremely grateful to each member in the team to giving me back my life not once, but twice.”

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