News

South Africa needs more bone marrow donors of all races to give hope to children with blood disorders

KZN pioneer paediatric haemato-oncologist in private practice urges greater public support

Friday, December 7 2018

One of South Africa’s foremost medical academics and a specialist in the field of paediatric haematology and oncology is appealing to the public to register with the South African Bone Marrow Registry (SABMR) as donors, to help ensure that children who have blood disorders have a better chance of finding matching bone marrow stem cells, which could save their young lives.

“The reality is that at present, donors on the South African Bone Marrow Registry do not reflect the demographics of our country, which means that we urgently need more people of all race groups to sign up as donors so that when a patient with a blood disorder requires bone marrow stem cells for treatment, there is a greater likelihood that they can be helped in time,” says paediatric haemato-oncologist, Dr Monica Vaithilingum, who practises at Netcare Parklands Hospital in Durban.

Dr Vaithilingum introduced the first dedicated paediatric haematology/oncology services to private patients in KwaZulu-Natal some 17 years ago. She is also a director on the board of the South African Bone Marrow Registry.

Pic: Netcare Parklands Hospital general manager, Fuad Salie (back), is pictured with paediatric nursing staff members and Dr Vaithilingum. From left to right, are registered nurse, Cindy Shange; enrolled nurse Nomandla Zincume, and enrolled nursing auxiliary, Zintle Sibiya, with paediatric haemato-oncologist, Dr Monica Vaithilingum; paediatric ward administrator, Charmaine Mchunu, and paediatric unit manager, Sr Arlene Lorenzo.

According to Dr Vaithilingum, leukemia is one of the more common forms of childhood cancer. “It is never easy for a family to come to terms with the fact that their child has been diagnosed with such a serious illness, however there is always hope. Some 85% of the child patients we see with acute leukemia have a positive prognosis. The majority of patients can be cured with chemotherapy but for those who require a stem cell transplant, the need is usually dire because they are either relapsed or have poorer prognostic markers. Hence the need for members of the public to make a commitment to sign up as bone marrow stem cell donors.”

As a paediatric haemato-oncologist, which is the field of medicine dedicated to treating children diagnosed with cancer and both benign and malignant blood disorders, Dr Vaithilingum says the shortage of donors is a matter of great concern.

Registering with the South African Bone Marrow Registry is simple and free of charge to the donor. “The SABMR has an online application process; donors are screened and successful applicants are invited to complete an application form. If they meet the required criteria, a buccal swab sample, which is a swab of cells taken from the inner cheek of the applicant, is obtained from the donor for the all-important HLA tissue typing. These records are then added to our registry’s database, as well as the global database,” she explains.

“When a patient, particularly a child, requires a bone marrow stem cell transplant, we look for the closest possible match on the registry.”

According to the SABMR, ‘tissue-types’ are inherited characteristics, used in matching donors and patients. The likelihood of finding a suitable donor will, therefore, be considerably greater within the same ethnic background1.

Dr Vaithilingum co-ordinates a multi-disciplinary team of healthcare professionals, including a paediatric surgeon, dietician, psychologist and a specially trained team of nurses, in order to customise each child’s treatment in accordance with international protocols. In certain cases, Dr Vaithilingum draws on an international network of paediatric specialists for their input. She, in turn, lends her expertise when called on to assist with patients in both public and private sectors’ hospitals in South Africa, as well as being consulted by her counterparts abroad.

“Not only is this collaboration helping to enhance our knowledge and experience, it is also reassuring to patients and their families to know that they are receiving world-class treatment. Clinicians referring patients to our centre at Netcare Parklands Hospital appreciate that we draw on the collective wisdom of a range of experts in paediatric oncology, to arrive at the most appropriate treatment method for each child’s condition.”

Dr Vaithilingum’s practice at Netcare Parklands Hospital is equipped with an established, accredited outpatient chemotherapy facility for paediatric patients. Chemotherapy may be used alone or in combination with surgery and/or radiation therapy, which is also available at the Netcare Parklands Hospital, ensuring the prompt and effective treatment of patients.

“While we do not perform bone marrow stem cell transplants at this hospital, my role is to help work up the child’s physical condition and perform the necessary tests in preparation to receive the transplant once a suitable donor has been identified.Children requiring bone marrow transplantation are then referred to a private facility performing such transplants. Once they have had the transplant, the family returns to me for their child’s follow-up care.”

Dr Vaithilingum invests time in training the nurses caring for her patients on various techniques that are specific to paediatric care. “It is important to understand that children are not merely smaller versions of adults, but rather require a very specific approach.”

She notes that when a child has a serious illness, the whole family requires support. “A psychologist is part of our multi-disciplinary team, and we have recently also had the benefit of the services of a social worker from the Childhood Cancer Foundation [CHOC], and this has been most helpful for families.”

Dr Vaithilingum also serves on the boards of the South African Oncology Consortium and the South African Children’s Cancer Study Group, which promotes clinical excellence in paediatric oncology through multi-disciplinary research and collaboration.

The general manager of Netcare Parklands Hospital, Fuad Salie, says Dr Vaithilingum has shown a tireless commitment to her patients since she commenced private practice at the hospital in 2002.

“Parents bring their children from all over KwaZulu-Natal, the Eastern Cape and, in fact, from all over the African continent to benefit from Dr Vaithilingum and her team’s vast expertise and experience, and we consider it a great privilege that our patients have access to medical professionals of her calibre,” concludes Salie.

Warning signs of childhood cancer
Dr Vaithilingum is involved with a number of non-profit organisations and outreach projects, including the Childhood Cancer Foundation (CHOC), which she has worked with for some 20 years, and is passionate about raising awareness of childhood cancer among healthcare practitioners and the public.

She advises parents and healthcare practitioners to be aware that the following signs should not be ignored, as they may be signs of cancer in children. The acronym ‘SILUAN’, named after Saint Siluan2 –  a Russian monk who prayed tirelessly for all humanity – is a helpful way of remembering the following:

  • S – Seek medical attention early for persistent symptoms.
  • I – the phonetic reminder for ‘Eye-related symptoms including a white spot in the eye, the development of a squint or visual impairment, or bulging of the eyeball.
  • L – Lump noticeable in the abdomen, pelvis, head, neck, limbs, testes or glands.
  • U – Unexplained symptoms of prolonged fever for more than two weeks, weight loss, pallor, fatigue, easy bruising or bleeding.
  • A – Aching bones, joints, back or bones unusually susceptible to breaking.
  • N – Neurological signs, such as change or deterioration in walk, balance or speech, regression of developmental milestones, headache lasting more than a week and sometimes with vomiting, or enlargement of the head.

Ends

References and further reading:

Issued by:           Martina Nicholson Associates (MNA) on behalf of Netcare Parklands Hospital
Contact:               Martina Nicholson, Graeme Swinney, Meggan Saville, and Estene Lotriet-Vorster
Telephone:        (011) 469 3016
Email:                   martina@mnapr.co.za, graeme@mnapr.co.za, meggan@mnapr.co.za or estene@mnapr.co.za