Consultant, Paediatrics, Paediatric Oncology & Stem Cell Transplantation
MBBS, DCH, FRCPCH, FRCP(Edin), CCT Paediatrics(UK)
At Kokilaben Dhirubhai Ambani Hospital he has treated all cases of paediatric cancers including leukemia, lymphoma, brain and other tumours. He is the In Charge of the Paediatric Stem Cell Transplantation program which has to its credit transplanting the smallest baby in the world (transplanted for Neuroblastoma at the age of 4 months) and the youngest thallassemia transplant in India at 9 months. With tie ups with world renowned institutions such as Royal Marsden Hospital in London, Royal Victoria Infirmary in Newcastle and Karolinksa Institute in Sweden he ensures that the latest technology and therapy is available for all his patients.
I find no words in my vocabulary to thank Dr. Shantanu Sen. No word of gratitude could explain what we feel for him. He is not just a doctor, he is personified God, I do say I have seen God as I have seen him. I wish the best of the best for Dr. Shantanu Sen. May he has a blessed future and continue the good work he is doing.
I also thank the doctors in this hospitals, especially Dr Santanu Sen and Dr Tanu Singhal. Also the sisters Marina and Ankita.
Thanks for teaching us the difference between Fact and Faith: Fact is when any ordinary doctor diagnoses illness in a report. Faith is when good doctors like you give their patients the strength to recover.
Despite being busy he use to take time out and explain each and every possibility that could arise....I could freely ask him as many questions as I wanted, and he used to answer most of them to clear my anxiety. Doctors like him replaces the fear of illness with trust in recovery. Though I am not the right person to comment but he has good subject knowledge and during the treatment of my child he had at times taken tough and favorable decisions which were life saving for my child. His concern for illness, personal attention and professional approach was just remarkable. He has saved my child from a critical illness.
And we cannot imagine a paediatric ward without Dr.Santanu Sen....He surely is a good samaritan, an angel to all his infant patients...The best quality in him is his patience and he has never shown us at any point of time tantrums or attitude...or never has he given us an impression of obliging us by attending to our needs whenever we required his urgent help.
As a patient i am highly satisfied with the treatment and care offered by Dr Sen in my tough and tide. He is a clam listener who always helps us to express our problems and silly queries. He have asked him the most lamest questions and disturbed him in the most peaceful hours of his life but never ever he have showed any disrespect or harshness. Even during times when he is busy he makes an effort to let us know that he will revert back soon...and he surely does!!
Words fail me to describe our regard, love and faith we have for Dr. Shantanu. The way our daughters are handled by him is beyond a 'Doctor's duty'. We do not trust ANY other doctor except him to take care of our little babies, not even for simple things such as vaccinations.
We gained confidence in your capability and the entire team’s helpfulness in our first serious emergency. We still remember the day when our 5 year old child got an attack of HSP. We were a bit late in realising that it was more than ordinary rashes and reached the hospital very confused. Your timely diagnosis was a key reason why our child Mann could manage to recover soon.
Dr Shantanu calm, positive and outgoing demeanor has always had a calming and positive influence on our entire family. Radhika looks forward to her visit to Dr Shantanu.
The diagnosis and treatment each time has been completely satisfying..Thank-you ever so much Dr. Sen!You rock!!
He gives time, available on a call...very patient, less medicines!!
I'll be perfectly fine my heart is rest assue for that. As a patient your doc approach would very important & as per my experience the way Dr.sen is treating patient friendly. He never let me down even though in hard to hard situations like operations/Chemo/Radiation/Therapy etc.
Your approach towards patients is so good that we could feel free to approach you over phone / sms at any time for which you have always responded, which has helped us to give proper medication without any loss of time and has led to his speedy recovery. In fact, We have no words to express our gratitude for bringing out and saving our son from such a serious and complicated surgery which can be achieved only by such a competent, well-dedicated, patient-friendly, experienced and sincere Doctor like you.
We are extremely convinced and we know exactly whom to go to regarding any health issues of our daughter. We would like to thank Dr.sen and the staff at the paediatric clinic and ward of the hospital who have cared for and helped us and beautifully fulfilled their duties towards patients. We are glad and thank Dr.Santanu Sen for building and maintaining the trust that we have put in him regarding our only daughters health. We wish him all the very best for all the future endeavours.
Dr. Sen is one of the most humble human beings I have come across in my life. As a doctor, he is something anyone can totally trust on with closed eyes...... No matter what time of day it is, he is always there whenever needed... A person very committed to his profession....
We all have immense trust, respect and love for you as our daughter's doctor and have your loving care and professional advise to thank for her proper growth and development.
Dr. Sen's approach towards children is very friendly which comforts them a lot! His room is so inviting for children with all the colourful miniatures displayed... We love it too!
| No. | Journal Code | Department | Type | Download | |
|---|---|---|---|---|---|
| 1 | 427 | Center for Cancer | International | - | |
Publication/Talk Title : Panayiotopoulos syndrome presenting with status epilepticus and cardiorespiratory arrest: a case report Journal Published : Pediatric Emergency Care |
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| 2 | 426 | Center for Cancer | International | - | |
Publication/Talk Title : Rejection of paternal vs maternal fully matched bone marrow grafts in children with thalassemia Journal Published : Bone Marrow Transplant |
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| 3 | 425 | Center for Cancer | International | - | |
Publication/Talk Title : Haploidentical bone marrow transplants in a pediatric and young adult population: A tertiary centre experience Journal Published : Pediatric Hematology Oncology Journal |
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| 4 | 424 | Center for Cancer | International | - | |
Publication/Talk Title : Voriconazole induced periostitis: A rare entity Journal Published : Pediatric Hematology Oncology Journal |
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| 5 | 423 | Center for Cancer | International | - | |
Publication/Talk Title : Role of G-CSF Priming of Donor Marrow Prior to Transplant In Low Risk HLA Matched Sibling Transplant in Children With Severe Thalassemia Journal Published : Pediatric Hematology Oncology Journal |
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| 6 | 422 | Center for Cancer | International | - | |
Publication/Talk Title : Impact of Splenomegaly on Outcomes of Full Matched Sibling Bone Marrow Transplant Among Children with low Risk Thalassemia Journal Published : Blood Journal |
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| 7 | 421 | Center for Cancer | International | - | |
Publication/Talk Title : Low-cost Matched Sibling Bone Marrow Transplant for Standard-Risk Thalassemia In A Limited-Resource Setting Journal Published : Pediatric Hematology Oncology Journal |
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| Disease | International Survival Rates | KDAH Survival rates |
|---|---|---|
| Acute Lymphocytic Leukemia | 85% | 92% |
| Acute Myeloid Leukemia | 64% | 54% |
| Brain Tumours | 72% | 70% |
| Wilms Tumours | 90% | 85% |
| Hodgkins Lymphoma | 95% | 95% |
| Non-Hodgkins Lymphoma | 85% | 90% |
| Neuroblastoma | 79% | 70% |
| Osteosarcoma | 71% | 85% |
| Ewings Sarcoma | 75% | 80% |
Naveen(name changed for privacy of patient) was only 1 week old when his doctors told his devastated parents that he has a large tumour in his tummy.
A lot of detailed tests including ultrasonography and CT scan of his abdomen confirmed the suspicion that he has a neuroblastoma, a tumour that originates from the supra-renal gland on top of the kidneys.
Further tests and a biopsy of the tumour showed that though the tumour was limited only to the original site with no distal spread (metastasis), it was positive for ‘Myc-N’, a genetic marker which signifies that it was a very aggressive tumour that needs intensive treatment.
Chemotherapy was started from 1 month of age and he underwent 8 cycles of intensive chemotherapy over the next 3 months and at the age of 5 months had surgery to remove the tumour.
But even this was not enough as this aggressive tumour needs further high dose therapy followed by stem cell transplantation for its treatment.
The problem was that at this young age of 6 months and weighing only 6 kg, a transplant was a difficult proposition and very few institutions has the expertise for such a procedure.
The BMT team at KDAH, which has the significant experience of doing paediatric, transplant was uniquely suited for this difficult task. Dr Santanu Sen, who had extensive experience of paediatric transplants in UK said that the fact that they have a complete multidisciplinary team with full time consultants makes it a safe place for such difficult procedures.
The first major challenge was collecting the stem cells from the patient for the transplant. A special machine called a cell separator is used to centrifuge and filter out the stem cells from the blood but using it on such a small baby was challenging. This was because almost the entire child blood volume had to be cycled very rapidly and constantly through the machine. In fact the machine had to be primed (filled) with a separate blood unit from a donor prior to use as otherwise the childs own blood volume would have been inadequate to even start the machine. In fact the child blood was cycled through the machine once every 10-15 minutes for 6 hours to get enough stem cells for the transplant.
The stem cell collection was done in the Paediatric Intensive Care Unit with both the Paediatric and Neonatal Intensive Care Consultants in constant attendance to monitor the baby. In fact, the Paediatric Cardiac Intensivist was at the bedside constantly monitoring the babys heart throughout the procedure to ensure the child safety.
Successful collection of stem was done with no untoward events and a second collection was again done the next day.
This was the first time that such a procedure has been done on such a small child in India and internationally, less than five such cases has been reported in the literature.
The stem cell transplantation was successfully carried out and the child showed signs of recovery within 10 days which also is very early (usual is 14-21 days). In fact the child was discharged in a stable condition on the 18th day after the transplant which also is a record as usually it takes upto 4 weeks before a child is discharged.
It is a genetic disease that causes severe disability and even death in many patients. The disease causing geneis passed from generation to generation in a pattern of inheritance called autosomal recessive inheritance. This means that both the mother and the father must pass on the defective form of the gene for a child to be affected.
Affected children suffer from anaemia, severe episodes of pain in chest, abdomen or joints, painful swelling of hands and feet, frequent infections, shortening of height, blindness, stroke or even death if not treated properly.
It happened because in sickle cell disease, the red blood cells become rigid and shaped like sickles. These irregularly shaped cells can get stuck in small blood vessels, which slows and blocks blood flow and oxygen to parts of the body.
If only one parent passes defective gene to the child, that child will have the sickle cell trait. Their blood might contain some sickle cells, but they generally don't have symptoms. But they are carriers of the disease, which means they can pass the gene to their children.
It is a disease that causes severe debility and misery. Children suffer severe infections with frequent episodes of severe incapacitating joint pains and even paralysis due to strokes. In fact, in India, one of the ICMR surveys found that 20% of children with sickle cell disease die by the age of 2 years! In some affected areas, 30% of all affected patients die before reaching adulthood!
In India, there is a huge sickle population in parts of Maharashtra, Gujrat, Madhya Pradesh, Chattisgarh, Bihar and some parts of West Bengal, Kerala and Tamil Nadu. Valsad and Nagpur have large population of patients suffering from the disease. It is estimated that upto 40% of the population in the affected regions carry the defective gene. Exact numbers for the disease in India is not know, but is is estimated that worldwide 300,000 children are born every year with sickle cell disease.
Treatment includes medicines to reduce pain, blood transfusions to treat the anaemia and antibiotics to treat infections. A Bone Marrow Transplantation offers the only known cure for the disease.
A BMT done early from an unaffected brother or sister who doesn’t have the genetic defect offers an excellent outcome with long term cure. Finding a suitable donor can be a problem as siblings may also be affected and in India finding an unrelated matched donor is very difficult.
Recent advances in BMT has made it possible for patients to have a transplant from brothers and sisters who are not fully matched with the patient. This new type of BMT called Haploidentical BMT offers the chance of a cure for a vast majority of patients.
Manish Bhoi, a 16-year-old patient, suffered from repeated painful swelling of hands and feel and had multiple admissions for infections, joint swellings and severe headaches. He was diagnosed to have Sickle Cell Disease and even with optimum medical therapy continued to suffer with recurrent painful episodes and repeated hospital admissions. He was also admitted with suspected stroke! In fact, he became so distressed at the prospect of a lifelong battle with the disease that he got severe depression and needed extensive psychiatric therapy.
Understanding that a BMT offered him the only possibility of a cure, we started the process of identifying a suitable donor. HLA typing to identify a suitable match was done for the family, and though his sister was disease free, she unfortunately was only a half-match, as were his parents. A search was initiated to identify any possible fully matched unrelated donors, but unfortunately none were found.
As any further delay would only increase disease related problems and would make a transplant even more complicated, we decided to proceed with a half-matched (Haploidentical) transplant with his sister.
Unfortunately, we found that his sister had very high levels of antibodies directed against her brother’s cells (Donor Specific Antibody – DSA). This makes BMT extremely difficult as there is a high possibility of graft failure. Hence we initiated a novel innovative protocol to reduce the antibody levels before initiating the transplant protocol.
The BMT was done using his sister stem cells and he engrafted early by Day +11. He was kept under close supervision and discharged after a successful transplant.
First successful transplant for Sickle Cell Disease in Western India and that too using a Haploidentical donor.
Previous cases were mostly from Chennai, Delhi and Bangalore and were almost all using a fully matched sibling.
Our BMT program can bring about a paradigm change in the lives of all patients with Sickle Cell Disease.
