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Family of 50 unites to find stem cell match for ailing relative

A joint family of nearly 50 members, which resides under a single roof in Kandivli (W), is racing against the clock, and in different time zones, to save the life of one of their own under threat from a rare disease. The Bachanis who settled in the city after Partition, traditionally ran a textile business. The Bachani brood, now numbering 48, embarked on different ventures over time, but all work - and leisure - in the family came to a halt a couple of months ago.

Nimesh Joshi

The eldest family member’s grandnephew, Nimesh Joshi, has been diagnosed with a rare blood cancer, and needs a stem cell donor in a month. His granduncle Lachhubhai Bachani was distraught. Ever since, the family has made it a life mission to find a stem cell donor for him. Nimesh, meanwhile, is under treatment at the City of Hope medical centre in Los Angeles. His wife, mother and younger brother are with him there.

Mumbai camp
After having held camps in Dubai, US, UK and other countries in the past month, the Bachanis organised two more in Kandivli and Ghatkopar yesterday, to find a donor for Nimesh Joshi

Thirty-eight-year-old Nimesh, a civil engineer who lives with his wife and child in Dubai, often complained of nerve-wracking stomach aches. A test of the spleen, carried out in a hospital in Mumbai in November last year, revealed that he was in the third stage of Hepatosplenic T-Cell Lymphoma. Given the aggressive nature of the disease, Nimesh has been undergoing chemotherapy, which has to be followed by a stem cell (bone marrow) transplant. For this, Nimesh needs a donor match within a month. The chances of finding a perfect match, doctors say, are one in a million.

All for one
But his vast family back in India is resolute on fighting the epic odds together to find that perfect match, even if that means putting life on hold. Various members of the family have been holding donor camps for Nimesh in different corners of the world. After having held camps in Dubai, US, UK and other countries in the past month, the Bachanis organised two more in Kandivli and Ghatkopar on Sunday.

Mumbai camp
The family members of Nimesh Joshi organised donor camps in Kandivli and Ghatkopar yesterday

One of Nimesh’s cousins Hitshu Bachani - one of the 48 inhabitants of Laxmi Prabhu, the two-storey Bachani mansion sprawled across 25,000 sq ft in Kandivli (W) - said, “In the last couple of months, the elders and the family’s third generation - which has diversified from the family textile business - have put their lives on hold to organise camps in Dubai, UK and US, and Udaipur and Bangalore in the country.”

So far, the family has collected roughly 3,000 cheek swab samples from various donors the world over, which are ready to be sent to Chennai for analysis. Some 500 more are expected from Mumbai, a family member said. The expenses in organising these donation events, which will soon run into eight-digit figures, are not a concern for the Bachanis when the life of a family member is hanging in the balance.

“We are bearing the entire cost, which is Rs 2,400 per test,” said Hitshu, adding, “The samples which don’t match will become part of a database which can be accessed for free by doctors the world over, looking for a stem cell match for their patients.” The real treatment hasn’t even begun yet. The stem cell transplant is likely to cost the Bachanis around Rs 5 crore.

Tracing up the tree
An uncle even charted the family’s genealogy to find out where their flesh and blood is likely to be found. “Our family, which comes from a line of Pushkarn Brahmins, moved here from Karachi after the Partition. So one of our uncles tracked a genetically-linked ethnic group in Bhuj, Gujarat and travelled there to hold a camp, close to the Indo-Pak borde,” said Hitshu, who has played for the Ranji Trophy.

Another of Nimesh’s cousins, Meghraj Bachani, said his immediate family was devastated, as his only sibling, his parents and their next of kin are not a match. “The closest we have is a person in the UK, who is a 75 per cent match, he said. He added, “We were overwhelmed when over 2,000 strangers from different races showed up for our camp in Dubai. We expect around 500 samples from Mumbai.” Nimesh’s wife Aditi recently inaugurated a restaurant in Dubai but the enterprise has been shelved so she can focus on getting him back in good health. Their seven-year-old son is still in Dubai, in the care of other family members.

The disease and its cure
Hepatosplenic T-cell lymphoma is a rare form of non-Hodgkin lymphoma that causes enlargement of spleen and liver and, rarely, swelling near neck, armpits and groins. One of the ways to treat it, in addition to conventional chemotherapy, is bone marrow stem cell transplant.

Bone marrow transplantation (BMT) is a procedure that restores stem cells that are destroyed by high doses of chemotherapy and/or radiation therapy. Since bone marrow contains hematopoietic (blood-forming) stem cells, patients can be given stem cells from siblings or parents (allogenic procedure). An unrelated donor may be used.

After being treated with high-dose anticancer drugs and/or radiation, the patient receives the stem cells through an intravenous (IV) line. After entering the bloodstream, the stem cells travel to the bone marrow, where they begin to produce new white blood cells, red blood cells, and platelets in a process known as engraftment. Engraftment usually occurs within 2-4 weeks after transplantation, which is usually monitored by daily blood counts.

Expertspeak
The major risk of the treatment (bone marrow transplant) is an increased susceptibility to infection and bleeding as a result of the high-dose cancer treatment. The patient needs antibiotics to prevent infection, red blood cell and platelets transfusions to prevent bleeding and low haemoglobin till recovery, and also intravenous nutrition sometimes. Short-term side effects include nausea, fatigue, loss of appetite, mouth sores, hair loss, and skin reactions,” said Dr Ganapathi Bhat M, honorary consultant, medical oncologist and stem cell transplant physician, of Jaslok Hospital.

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