My son died of cancer: Why I'm celebrating his birthday with stem cell awareness
Grief is a personal matter. Each of us has our own mechanisms to cope — there is no format set in stone, there are no boundaries. For me, the week leading up to my son Arjan Vir's birthday has always been the most difficult to deal with.
I am overwhelmed by a well of emotions: On the one hand, there are all those happy memories, so much excitement building up to planning those wonderful birthday parties — themes to be decided, lists to be made, cards to be distributed, menus, games and oh, the return gifts one mustn't forget — and then this sudden feeling of hollowness, the sinking depths of which words cannot describe.
Beyond words
I lost my 26-year-old son Arjan Vir to Leukaemia in 2012. Arjan was one of those hugely social people with an enviable optimism about him — he loved to have people around him and had the enormous ability to attract people, make friends and share his life with them. His friendships were deeply honest and truly meaningful, there was nothing hollow about them. Those around Arjan loved his happy-go-lucky nature and his laidback attitude towards life.
My son never lost his ability to make friends despite the battle he was fighting with cancer. Arjan had a battalion of friends in the hospital: ward boys, nurses, lab technicians and resident doctors could be seen about his room whenever they had spare time; some asking for advice on which phone to buy, to have the odd computer issue sorted, if nothing else, just to watch him play computer games.
Losing Arjan did not just leave us — his family and friends — with an irrevocable sense of vacuum, it was felt by the many lives he had touched in some way or the other.
An intensely sensitive child, Arjan worried more about others than himself — he was an avid reader, wrote beautiful poetry and had an imagination that went beyond words.
His passion for computer games had pre-determined his career options, he had decided to study computer graphics and 3D computer animation. Even at the hospital, as he underwent treacherous rounds of chemotherapy, cycle after cycle, his imagination worked overtime planning some game or the other based on his treatment.
Knowing BMT
A Leukaemia patient, Arjan needed a bone marrow transplant (BMT). In a layperson's terms, BMT means that the unhealthy bone marrow is killed under highly sanitised conditions — by giving the patient very high doses of chemotherapy and radiation — and replaced by a healthy bone marrow. That sounds perfectly simple, but bone marrow transplant remains a complicated and dangerous procedure.
What consequences does that come with?
For the uninitiated, bone marrow is the soft tissue where all our vital blood components — RBCs, WBCs, platelets, plasma and stem cells are formed. Killing one's bone marrow essentially means there is no immunity left to take care of our body.
Where does the healthy bone marrow come from if we are to attempt to rid the body of cancer?
There are two broad types of BMT: Autologous — where the unhealthy bone marrow from our body is removed, worked upon or mutated and replaced, and the allogenic transplant in which another person's healthy bone marrow replaces our own.
With the second type of transplant come incredible complications and the daunting task of finding the donor bone marrow that must replace ours: one needs to find another person whose DNA is identical to ours. The first and most obvious choice, of course, would be a sibling.
However, the chances of finding the identical DNA — HLA typing — that matches your siblings' is only 1:4, and if such a match isn't possible, where do we go?
In Arjan's case, our younger son's HLA typing did not match, and the chances of finding an unrelated donor match were one in a million.
This was the worst possible news we could get, worse than the news of Arjan being diagnosed with Leukaemia.
How does one find an identical HLA typing match in this whole world — where do you start, whom do you turn to?
Discovering stem cell registry
In 2012, there were no substantial HLA typing registries in India unlike in developed countries, which maintain nationwide registries that are linked to the worldwide bone marrow registry.
The doctors guided us to approach All India Institute of Medical Sciences (AIIMS) — while AIIMS did not have a significant registry of its own, it had a membership with the World Marrow Donors Association (WMDA), and hence could do a worldwide search to find an HLA match for Arjan.
However, institutes like AIIMS have become desensitised to the urgency that such cases demand and we got no response from them.
At the time, Datri in Chennai was the sole functioning stem cell registry — it had about 12,000 donors in its data bank, but we did not get a quick response from them either.
Our son's doctors here told us that we were sitting on a "time bomb" — we needed to act swiftly, we could lose no time — and that's when we decided to take Arjan to the US for his further treatment and then, hopefully, a BMT.
Arjan was distressed to discover the situation in India; when he heard about the lack of registries, his first thought was that once he had recovered, he would set up a meaningful registry at home. His biggest concern was: What do the poor do, where do they go?
And so, five years on, the Arjan Vir Foundation was set up in the memory of our very dear son. Our aim is to run a widespread registry that addresses all blood disorders.
We hope to provide assistance at all stages of treatment, recovery, after care, and the rehabilitation and resettlement of patients.
Registering as a donor is easy: any individual over age 18 can become a donor and be a part of the registry till the age of 60, provided they are healthy.
All that one needs is a simple mouth swab test and the consent to donate stem cells when the need arises. The swabs are sent to a highly-specialised laboratory in the US for HLA typing and the results shared with the worldwide registry maintained by WMDA.
Upon finding a match for a patient, the registry contacts the concerned donor.
The process is not complicated, it is exactly like platelet donation, only a few hours longer: a volunteer must undergo a complete medical check-up prior to donating stem cells and is put on stem cell boosting therapy for about four days before the procedure. No incision is involved and the donor does not require hospitalisation.
It just takes one day of your life and busy schedule to save a life.
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Today, as I sat down to write this article, I also planned another kind of a celebration for Arjan's birthday on September 6: this year, we are holding a camp to bring about awareness about stem cells and register donors at a university in Noida.
Once again there is excitement, albeit of a different kind — one held together with a sense of pathos.
Also read: Memories of my mother that Alzheimer's can't wipe clean