Indo-American Stanford Professor Dies After Year- Long Unsuccessful Search For Bone Marrow Donors

STANFORD – After a yearlong,worldwide campaign byher students, friends and familyto find a bone marrow donorfor her, Nalini Ambady, a Stanfordprofessor of Indian origin,succumbed to leukaemia onMonday.As many as 13 matching donorsfor the 54-year-old professorhad been found in the globalsearch by her near and dear ones.While 6 were only half matches,rest of them ultimately refusedto donate.Ambady, an award-winningprofessor and the first Indian toteach in Standford’s psychologydepartment, had been in an outof hospital since last Novemberwhen her cancer recurred.Her disease was first detectedin 2004, after which she wastreated and the cancer went intoremission.Early on Tuesday, Ambady’shusband Raj Marphatia sent amessage to those who had campaignedfor donors for his wife,informing them of her death.“Her condition was deterioratingfast over the last month asher organs had started to collapse,”said Joseph J Chakola,Ambady’s school friend whohad been at the forefront of thecampaign in India.The campaign consistedof finding a Human Leukocyte(white cell) Antigen (HLA)match for bone marrow transplantation.The greatest possibilityof finding matches isfrom people of the same ethnicbackground as the patient. Over2000 donors were added to theregistries through the campaignfor Ambady, but every timethere was a hope for a transplant,the donor would back out.Donors back out becauseof their lack of awareness, saidDr. Sunil Parekh, member ofthe executive committee of theMarrow Donor Registry India(MDRI) which sees many refusalsby registered donors eventhough they have volunteered tobe on the list.But the current Peripheralblood stem cell (PBSC) processinvolves injecting the donor witha drug called Filgrstim to facilitatebetter circulation of bloodformingcells. The donor’s bloodis then removed from one armand passed through a machinewhich separates the bloodformingcells. The remaining bloodis then returned to the donor’sbody.In Ambady’s case, a fullmatch was found from MDRIin August but the young manrefused to donate his bonemarrow as his parents wereagainst it. “This happened severaltimes in Nalini’s case,” saidDilip D’souza, a friend, addingthat there has to be a way to getpeople who sign up to actuallydonate.MDRI, located at Parel’sTata Memorial Hospital, currentlyhas 16,327 registereddonors but is yet to facilitate atransplant.This database is consideredsmall, as the chances offinding an HLA match are onein 20,000. “We are conductingseveral awareness campaigns toexpand our database,” said DrParekh.The registered donors arefirst tested for any existing diseases.The donor and recipientmust both have the sameHLA type which entails a 10/10match of antigens. The initialtests for 6 antigens in the HLAmatching cost Rs 8000.The matching for the remaining 4 antigensis carried out only after the first 6 antigens arematched. “When there is a 10/10 matching, wehave to send the samples to the US for high resolutiontesting which is not available anywhere inIndia,” said Dr Parekh.It is very upsetting for everyone when peoplerefuse to donate their bone marrow after thisextremely lengthy process.“Due to lack of awareness here, the donordrivefor bone marrow is often individual-drivenand not community-driven. This is the main reasonfor the refusals,” said Dr Shripad Banavali,head of the medical oncology department ofTata Memorial Hospital.“The situation will improve when there arecommunity drivers,” he addded.The long-term survival chances of patientsshoot up to from 15 per cent to 60 per cent aftera bone marrow transplant.