One of the books, published when I was Founding Director and General Manager at SingHealth Academy. It chronicles stories about Blood Stem Cell Transplants at SingHealth and the excellent work of healthcare professionals, the ecosystem of support for patients and the journeys of patients.

1. Embracing Hope
Chronicles of Blood Stem Cell Transplants

2. Published by Grey Cells Series
An imprint under SingHealth Academy, Singapore Health Services Pte Ltd
31 Third Hospital Avenue, #03-03 Bowyer Block C, Singapore 168753
SingHealth Academy Publishing Team:
Publisher: Neo Chia Reei
Editorial: Patricia Ng / Sukhvinder Kaur
Marketing & Publicity: Michelle Lam / Lydia Ng
Book Concept, Co-ordination and Doctor’s Notes: Dr William Hwang
Copyright © 2010 Singapore Health Services Pte Ltd and Singapore General
Hospital Pte Ltd
All rights reserved. No part of this publication may be reproduced, stored
in a retrieval system or transmitted, in any form or by any means, electronic,
mechanical, photocopying, recording or otherwise, without the prior permission
of the copyright owner. Request for permission should be addressed to The
Publisher, c/o The Editorial Office, SingHealth Academy, 31 Third Hospital
Avenue, #03-03 Bowyer Block C, Singapore 168753. Tel: (65) 6321-4862,
fax: (65) 6221-6351. Email: publishing@singhealth.com.sg.
The publisher makes no representation or warranties with respect to the contents
of this book, and specifically disclaims any implied warranties or merchantability
or fitness for any particular purpose, and shall in no event be liable for any loss
of profit or any other commercial damage, including but not limited to special,
incidental, consequential, or other damages.
Disclaimer
This publication is intended to help encourage, exhort and edify patients,
laymen and healthcare workers around the world. Haematopoietic Stem Cell
Transplants are for the treatment of selected diseases and selected subtypes
of these diseases. They have not been employed in the treatment of many
cancers and other illnesses. This book should not be used as medical reference
material or a resource for medical information. Readers of this publication
who have medical conditions should consult their own doctors to decide on
appropriate treatments for their illness.
National Library Board Singapore Cataloguing in Publication Data
Embracing hope : chronicles of blood stem cell transplants. –
Singapore : Grey Cells Series, c2009.
p. cm.
ISBN-13 : 978-981-08-5106-4 (pbk.)
1. Hematopoietic stem cells – Transplantation – Patients – Singapore.
2. Hematopoietic stem cells – Transplantation – Patients – Care – Singapore.
3. Hematopoietic stem cells – Transplantation – Patients – Family relationships –
Singapore.
RD123.5
362.19744 -– dc22 OCN540148155

3. Contents
Contents 3
Foreword 8
Preface 11
Acknowledgements 17
About Haematopoietic Stem Cell Transplants 20
Perseverance and Faith by Grace Chan 22
Life is Full of Surprises by Madam Tan 27
Be a Fighter! by Candy Yeow 30
Don’t Give Up by Edna Tan 37
The Power of Positive Thinking by Viji Ramakrishnan 42
Being Brave by Mimi 47
Coping with Life’s Challenges by Jasmine Teo 49
Understanding the Process 54
Appreciate the Smell of Flowers by Chew King Mun 56
Sharing the Journey by Mrs Fam 62
Face Reality by Puah Chai Hock 67
Like Running a Triathlon by Leong Mei Fong 70
Taking Things as They Come by Betty 73
Have Faith by Azrul Hisyam bin Julaimi 76
Sibling Support by Fazali 79
Controlling the Monster by Lee Miow Kim 82
The Importance of Family by Low Jiunn Shong 85
Journey of Faith by Lim Soo Hoon 89

4. Dealing with Complications 96
Staying Positive by Andy Toh 98
Support, Optimism and Faith by Charmaine 106
Lonely, but Not Alone by Amanullah s/o
S Nagoor Meeran 110
A Marathon, Not a Sprint by Sebha E P 114
Understanding the Diseases 120
Appreciating Life by Paul Lim 122
To Look After Her Kids by Maria 127
Never Give Up by Benny Lim 130
Dealing with a Silent Disease by Ralph Pattinson 138
A Holiday that Never Happened by Wong Suit Lin 142
The Will to Overcome by Ravinder Singh 149
The Right Attitude by Foo Chiow Kiam 155
Fighting the Fierce Disease by Lawrence 159
Be Optimistic and Seek Early Treatment
by Cheong WF 162
More Than Just Hope by David Ong 166
From the Frontline 172
Making the Difference in People’s Lives
by Dr Yvonne Loh 174
Bone Marrow Transplants Save Lives
by A/Prof Goh Yeow Tee 178
Feeling for Our Patients by Dr Linn Yeh Ching 181

5. Individualism and Light-heartedness
by Dr Mickey Koh 184
A Rewarding Challenge by Dr Colin Diong 187
Finding The Right Match by Lee Jing Jing 189
Helping Patients Make the Connection
by Olivia Khoo 193
Patients’ Advocate by Ng Hong Yen 198
Admiration for the Fighters by Zhang Xue Hui 200
Support for the Patients by Sister Tan Chor Kien 202
Nurturing Frontliners by Jordan Hwang 205
Importance of Family Support
by Elaine Lee, Tan Wei Ting, and Yvonne Tan 208
Supporting the Weary Battle-worn Patients
by Erlinda, Hayati bte Mohamad, Jolene Guek, Kong Kam
Yong, and Elaine Lee 210
Encouraging Patient Follow-ups
by Clarice Chong, Huang Yu, Leong Hui Chien,
Lily Suriana, Ling Wei Shan, Rohani bte Salleh, and
Wahidah bte Sabtu 212
Haematology Support Group by Sister Chong Lai Ling 216
Doctors in the Department of Haematology,
Singapore General Hospital 2010 223
With Gratitude 224

7. a cardiologist with a big heart and
a patient who cared for those treating him
Dr Bobby Woo
In loving memory of

8. 8
Foreword
The process of transplanting haematopoietic stem cells from
ahealthydonorintoapatientisoneofthegreatestbreakthroughs
in medicine. Transplantation of haematopoietic stem cells
can now cure many blood cancers including leukaemia and
bone marrow failure disorders. The establishment of registries of
volunteer unrelated donors and cord blood banks around the
world has opened therapeutic avenues for patients who do
not have matched family members to serve as donors. In this
sense, the process of performing a transplant for a patient can
truly be an international endeavour.
New research continually changes the landscape of
transplantation. Patients today have choices and benefit
from the advancement of knowledge in basic and applied
immunology and improved supportive care before, during
and after transplantation. Although the specific protocols or
regimens may differ for each patient, what is universally
experienced by patients, their family members, and the
healthcare providers, is the intangible aspect of experiencing
what is no doubt one of the most physically arduous procedures
that a human being can undertake.
Embracing Hope: Chronicles of Blood Stem Cell Transplants
provides a glimpse into the innermost emotions of transplant
patients and their medical team. The family provides integral
support, helping the patient through the transplant in ways that
only family can. Although it is the patient who is receiving the
transplant, every member of his or her team is experiencing
the transplant themselves in very different ways. From the tissue
typing laboratory and co-ordinators who search for volunteer

9. 9
donors, to the couriers who deliver the unrelated stem cell
product from miles away, to the transplant nurses, physicians
and support staff, each individual has a unique reflection on the
journey of the patient through this process.
These accounts collectively share a common spirit — that
of mutual respect of the patient and healthcare providers.
These are stories that inspire. They are stories of bravery, of
compassion, of empathy, and of hope. For students of medicine
and nursing, these stories show us that compassion and being
good listeners are an integral part of being healers. For the
healthcare professionals who work “behind the scenes” to
facilitate the transplant, you are as “frontline” as those who come
face-to -face with the patient every day. For future patients
who must take this journey, rest assured that your team of
physicians, nurses, support staff, and above all, your family, have
only one goal in mind — to cure you of your cancer and return
you to leading a life that is of the highest quality.
Every patient teaches us something: sometimes we learn
something new about a disease process; other times, we gain
new understanding and appreciation of the human spirit.
These vignettes provide a unique tool for teaching — terms and
phrases that are used frequently by healthcare providers but
which may be foreign to the general reader. Use this as a tool
for learning: to patients and family members, that the science
of medicine is not always black and white; to students of
medicine and nursing, that every patient teaches us something
new. Above all, Embracing Hope serves a greater purpose in
conveying the emotional aspects of healing, concepts that are

10. 10
all too difficult to express. I hope you enjoy reading this book as
much as I have, and leave inspired and full of hope, and learn
something about yourself in the process.
Dr Effie Petersdorf is currently President of World Marrow
DonorAssociationandProfessorofMedicineattheUniversity
of Washington. She is also serving as an Associate Program
Head at the Fred Hutchinson/University of Washington
Cancer Consortium. Dr Petersdorf’s research is focused
on human genetics in transplantation and cancer biology,
in particular, genes within the major histocompatibility
complex and immune response genes. She is Project Leader
of the International Histocompatibility Working Group in
HaematopoieticCellTransplantation,acollaborativeresearch
consortium of transplant clinicians and immunogeneticists.
Dr Effie Petersdorf

11. 11
Preface
I rushed into the room.
The patient’s family was gathered around him.
I politely asked if they could step out for a moment.
The patient lay still and motionless. His ECG showed a flat line. His
heart had stopped. I examined him and tested his brain reflexes.
He was dead.
The year was 1996. Mr Tan (not his real name) had a bone
marrow transplant a few months before for acute leukaemia. His
leukaemia came back and he received chemotherapy to bring
his disease back under control. However, his illness proved to be
untreatable and, as he lay in a semi-comatose state, the family
was told to prepare for the fact that he would die soon. True
enough, after barely a few hours, the patient’s heart stopped
beating and I was called to certify death.
As I held my stethoscope against his chest and examined
him, I recalled the many months of struggle Mr Tan had
against his leukaemia. Through it all, I got to know him and
his family. I rejoiced with them when they had good news
and agonised with them when there were disappointments.
I thought about all that we had done to try and save the
patient. Was it all worth it now that he did not make it? Was
it worth all that effort? I said a prayer for him under my breath
and, as I turned to give the final declaration of death to the
patient’s mother, I was somewhat surprised when she gave me
a hug. She was distraught and heartbroken. But she seemed to

12. 12
convey in that gesture that she was satisfied that all that could
be done had been done to save her son. I gave her a hug back
in return and shed a few tears with her.
That same afternoon, a man stepped into the outpatient clinic.
His eyes were bright and he walked with more energy and zest
for life than me or the nurses who went up to greet him.
“He’s an ex-patient,” said one of the nurses to me.
When I talked to him a while later, he told me that he would not
still be alive if he not received had a bone marrow transplant
from his sibling some years ago. I remarked at how energetic
and full of life he looked.
“When you have been through what I have,” he replied. “You
treasure life a lot more.”
At that moment, something in me clicked.
An image of firefighters trying to save people from a burning
house came to my mind. Sometimes, they can save some
people from the fire. Sometimes, they cannot. The sights they
see can haunt their memories and the fire can also leave the
firefighters themselves burnt and badly scarred. However,
for the sake of those who can be saved, someone has to
do the job. I thought of Mr Tan who passed away earlier
that day and I knew we gave the patient and his family the
satisfaction of knowing that we did all that we could to treat
his relentless disease.
I knew that the field of bone marrow transplant would be one
filled with happiness and heartache, joy and despair. I knew that I
would see many patients die even if there were many others who
could be saved. I knew that I could become cold, embittered,
hardened or depressed. But I also knew that someone had to do

13. 13
the work. I looked at what my seniors had done and was inspired.
But I was also sure that we could do a lot more — more patients
could be saved and the transplant process could also be a lot
safer and more effective. I think it was at that moment that I
decided I would make the practice, study and enhancement
of this field my goal.
Today, the field of Bone Marrow Transplantation has progressed
significantly. Besides using bone marrow as a source of
haematopoietic (blood forming) stem cells, we now regularly
use stem cells collected from the peripheral blood of individuals
(so called peripheral blood stem cell transplants) as well as
from the umbilical cord of babies after birth (umbilical cord
blood transplants). In addition, we can also, to some extent,
manipulate and grow these cells outside the human body to
make them more effective. In the last decade, many new drugs
have been developed to be given to patients in preparation for
and after the transplant. Thanks to the work of many researchers
around the world, results for these all haematopoietic stem cell
transplants have improved tremendously. While it is true that
these transplants are not needed for many illnesses, it is also
true that the role of these transplants is clear in the treatment
of many fatal blood diseases and aggressive blood cancers.
Currently more than 200,000 of these transplants have been
performed and many thousands of lives have been saved. At
the Singapore General Hospital alone, about a thousand such
transplants have been carried out. With the use of stem cells
from the umbilical cord as well as other family members, we will
soon reach the day when almost everyone who needs blood
stem cells for transplant can have access to a donor.
While the journey that each and every individual patient goes
through is unique, there are many challenges that they can all
identify with. In fact, there are many themes common to many
patients going through difficult treatments for difficult diseases.
To this end, we decided to compile our patients’ personal

14. 14
accounts of their struggles, written as personal testimonies of
their journey through sickness. We asked them to write as if they
were writing to another patient in the future. We asked them to
especially write those things which they wished someone could
have shared with them when they were sick. Having seen how
our own staff are dedicated to the patients, we have also asked
them to share their personal testimonies of how they saw their
own struggles and their own role in the patient’s journey.
I became most convinced about the need for a book like this
when I started speaking to some patients.
“You know,” I would ask. “We are putting together this book for
patients who have gone through a bone marrow transplant and
we would like you to write something for it.”
I would usually get a wary look from the patient at this point. A
friendly look, yet wary of what I was asking.
“You see,” I would continue. “Although we can try to encourage
patients who are going through the transplant process, we can
only do as much. Patients would like to hear from someone or
some people who have been through it.”
At this point, eyebrows would lift and I would see a spark
of interest.
“As you probably know,” I continued. “Although we have
seen all these patients and know all these medical facts, there
is no way we can actually truly KNOW all that you guys are
going through.”
At this point, eyes would brighten and the response would
inevitably be, “You are so right, doctor! You have no idea!”

15. 15
Some of them would then go into a long explanation about
how we, as healthcare providers, could not possibly know all
the physical turmoil and emotional anguish that they as patients
go through. How true! A humbling moment for me as I realise
that, while I can understand with my head and maybe even
perceive with my heart some of the things they go through,
there is so little that I truly share in the struggles a patient has to
go through from the initial diagnosis of disease to treatment and
also, in dealing with complications and other hurdles along the
way. This is something that only those who have travelled this
road can fully appreciate.
Actually, this book has another important readership: our
hospital nurses, social workers, physiotherapists, dieticians,
pharmacists, students and doctors. Our dedicated staff spent
countless hours looking after our patients and they often
grow attached to them. Unfortunately, the patients whom
our staff grow close to are also those who come into hospital
repeatedly for relapsed disease or various complications.
The patients whom we grow most familiar with have
a high chance of not doing very well eventually and our staff
become disheartened when these patients die. That is how I
felt too when I was a medical officer in the department; but
when I covered the post-transplant clinic, I was amazed to
see that there were many patients who were doing well years
after their transplant. These patients looked healthy, well
and apparently cured of their disease. Yes, really and truly
cured! That was an epiphany for me and certainly a big factor
that motivated me to join this field of medicine.
Patients are our best teachers and the process of reading and
editing this book has enriched me greatly. So whether you are a
patient, a relative, a healthcare worker, or simply an interested
concerned individual, we hope that this book will give to you an

16. 16
Dr William Hwang is Senior Consultant and Director of the
Haematopoietic Stem Cell Transplant Programme of the
Department of Haematology, Singapore General Hospital.
He also serves as Medical Director of the Singapore Cord
Blood Bank and Assistant Professor of the Cancer Stem Cell
Biology Program at the Duke-NUS Graduate Medical School.
He is currently also Chairman of the Medical Advisory of
the Bone Marrow Donor Programme in Singapore as well
as Vice President (Asia and Pacific Islands) of the World
Marrow Donor Association. He hopes, with his colleagues in
Singapore and around the world, to make Haematopoietic
Stem Cell Transplants safer and more effective for patients
with each passing year.
Dr William Hwang
epiphany of sorts. Maybe you will read it and say, “Hey, I didn’t
know that…” or “Wow, that really inspires me to…” Whatever
your conclusion, we hope that you will come away encouraged
and blessed with a different perspective on life.

17. 17
Acknowledgements
We would like to dedicate this book to our patients. They are this
book’s reason for existence. Some of them are its authors. They are
our friends and our teachers. We have learned so much from each
and every one of them. Thank you.
We would especially like to dedicate this book to Dr Bobby Woo,
a gentle and courageous person who was always concerned
about the welfare of those around him. He was a cardiologist who
was big of heart and a doctor who understood that true healing
comes from deep within the soul. He fought a good fight against
his leukaemia and, even though he could not control it with
chemotherapy, he managed to get remission of his disease after
a transplant. He had more than a year free of leukaemia, touching
and encouraging many people, before he finally relapsed from
his disease. When he was able to go back to work for a period of
time, he was so happy to see his patients again. It brought him such
joy to heal others. Through his life and death, he was an inspiration
to us all. It is through a generous donation from his family through
the Haematopoeitic Stem Cell Transplant and Research Fund
(administered and managed by the SingHealth Foundation) that
we are able to publish this book and be able to devote all proceeds
from sales of this book to the welfare, education and research of
patients undergoing haematopoietic stem cell transplants.
We would like to thank our fellow transplanters and mentors through
the years. Some of them have retired and others are working in
other hospitals locally and abroad. To our current Head, Dr Lee Lai
Heng, thank you for your amazing support. Our former Heads of
Department, Dr Kwa Soon Bee, Dr Ong Yong Wan and Dr Patrick
Tan have also laid the foundation for us through the years. Many of

18. 18
us have been for a period of training in transplant centres overseas
like the Fred Hutchinson Cancer Research Centre in Seattle, Duke
University Medical Centre in North Carolina, Stanford University in
California, Northwestern University in Chicago and others. To our
teachers and mentors at these centres, thank you for sharing your
knowledge and imparting your skills to us so generously.
We would like to thank the staff of SingHealth Academy, who have
helped us in the publication of this book. Our special thanks go to
Patricia Ng and Sukhvinder Kaur who spent many hours interviewing
patients and revising the testimonials written by patients. They are
the wordsmiths who helped this book take shape.
We would like to thank our friends and collaborators in other
institutions. Our friends at the National Cancer Centre, Singapore
(NCCS), National University Health System and many other hospitals
in the region have been our close collaborators through the years.
Our friends at the Duke-NUS Graduate Medical School, the Health
Sciences Authority, the various A*Star Institutes and other research
institutes have been our fellow researchers for many projects that
have made a difference to transplant research. Special mention
must be made of our friends at the Health Sciences Authority who,
besides providing us with various blood products through the years,
are now also helping to provide us with various engineered cellular
therapy products through the Cell Therapy Laboratory.
We are indebted to the support of charitable institutions like the
Leukemia and Lymphoma Foundation for their generous support,
as well as the Singapore Cancer Society, and the Make-a-Wish
Foundation among others, for their support of our patients. They
step in to significantly augment the generous support given by the
Ministry of Health for our Singaporean patients. The support of the
Singapore Bone Marrow Donor Programme and the Singapore Cord
Blood Bank have also helped us to find matches for our patients
when there are no siblings who can match the patient. On behalf
of our patients, thank you for the work you do.

19. 19
This book was written from first-hand accounts of patients,
caregivers and healthcare providers from the frontline in
haematopoietic stem cell transplants.
Our contributors have graciously shared personal and
intimate accounts of their journey and battle against
illness. It is our hope that it will bring encouragement,
enlightenment and exhortation to patients, public and
medical staff everywhere.
Last, but most importantly, we would like to thank our fellow
colleagues in the Singapore General Hospital. Haematopoietic
stem cell transplantation is a team effort and our Haematology
Nurses, Haematology Pharmacists, Medical Social Workers,
Haematology Laboratory staff, Physiotherapists, Dieticians and
many others have been an invaluable and treasured part of
our team. Our other wonderful colleagues in the Department of
Haematology (Doctors Tien, Lim, Wong, Ng, Chuah, Tan, Yiu, Ang,
Kam, Diong, Lee and others) have been instrumental in referring
and looking after our patients. Our sincerest gratitude goes to all the
other Departments (Gastroenterology, Infectious Disease, Medical
Oncology, Orthopaedics, Radiology, Radiation Oncology, Renal
Medicine, Respiratory and Critical Care, Surgery and many others)
that have helped us treat and manage our patients when they are
sick. We also thank our administrators, human resource personnel,
finance executives and IT staff who have helped sustain the normal
functioning of the entire hospital machinery — without your help we
would not be able to do what we could.
For every one of you, and the many others we have neglected to
mentioned, thank you for being part of our team. We hope you will
all be richly rewarded by the difference you have made in the lives
of these and many other patients.

20. 27
Having been through
a scare, Madam
Tan* now takes each
day as it comes.
She keeps positive
by spending time
with her family and
pursuing the simple
things in life.
*not her real name
Life is Full of Surprises
Madam Tan*
It was just six months after my last check up
when I started feeling an uncomfortable
pain in my chest and noticed some
unexplainable bruises on my hands. I went
to see a doctor at the Singapore General
Hospital who admitted me for observation.
After doing several blood tests, the doctors
told me that I had leukaemia. I was stunned,
especially since I lead a healthy lifestyle
and go for my annual check-ups promptly.
Other than chest pains and bruises, the
only other symptom I had was a sense of
tiredness that I attributed to age creeping
up on me.
Facts in a Capsule
Diagnosed with: Acute Myeloid Leukaemia
Date of Diagnosis: 2006
Type of Transplant: Nonmyeloablative Allogeneic
Peripheral Blood Stem Cell
Transplant (Matched Unrelated
Donor)
Date of Transplant: November 2006

21. 28 Embracing Hope
The doctors advised me to call my family and inform them of
my diagnosis. After the initial shock wore off, I accepted my
condition and started on treatment. I had to go through four
chemotherapy sessions and the last was a radiotherapy session.
During this time, I felt nauseous and started losing my hair. My
Bone Marrow Transplant was done in November 2006 and I spent
one month in hospital. Unfortunately, none of my family members
was a match so I received my stem cells from an unrelated
donor, thanks to the efforts of the hospital staff and the bone
marrow registry who conducted the search for a donor.
After being discharged, I took great care to eat healthy organic
food. I was mostly a vegetarian and only ate fish to replenish my
energy needs. I am thankful that my treatment went smoothly
and I did not develop any graft-versus-host complications.
I spent several months resting at home and went back to work
only in March 2008. My life is almost back to normal, although I
Finding a Bone Marrow or Blood Stem Cell Donor
for Transplant
Only one out of four patients is able to find a sibling who is a
HLA (Human Leukocyte Antigen) match for transplant. When
a sibling match cannot be found, we will look for an unrelated
donor by searching bone marrow registries throughout the
world. The process is not easy because HLA typing is a type
of tissue typing that is extremely stringent and an almost
“perfect” match is needed for a bone marrow or blood stem
cell transplant. HLA typing takes precedent over many other
factors like donor’s ABO blood group and, in fact, the blood
group can be different because the patient’s blood group
will change to that of the donor’s after the transplant!
Doctor ’s NotesDoctor ’s Notes

22. 29About Haematopoietic Stem Cell Transplants
do feel tired and cannot do very long hours of work. Otherwise
I am doing fine.
When my chemotherapy sessions were completed, I was hit by
infections three times. I also developed ulcers in my mouth. What
kept me going was my religious faith and my faith in the doctors.
Only when you co-operate with the doctors can they help you
get over the illness. I feel that when I accepted the illness and
proceeded with the treatment, things worked well. I have friends
who have gone through treatment for breast cancer and colon
cancer and they have had a difficult time.
These days I take things in my stride and I do not let anybody’s
comments bother me. I pray for peace of mind. My advice
to those who have an illness is that they must seek treatment
and be positive in their outlook. With a positive mindset, they
will be able to cope with their illness better and be on the road
to recovery.

23. 178
A/Prof Goh’s
involvement with
leukaemia spans
many years. He
joined the Singapore
General Hospital
(SGH) Haematology
Centre in 1987 and
has the honour of
being the longest
serving doctor in the
area of Bone Marrow
Transplants. He has
been active in wide
ranging areas of
research involving
many drugs that have
made a difference
in the treatment
of blood disorders.
He is currently a
senior consultant in
the Haematology
Department and
Director of the
Clinical Trials and
Research Centre,
Department of
Clinical Research, SGH.
Bone Marrow Transplants
Save Lives
A/Prof Goh Yeow Tee
There have been vast improvements in the
areaofBoneMarrowTransplants(BMTs)since
it started in 1985. I have been privileged to
be a part of the evolution, seeing first-hand
how this area of transplantation has gained
importance over the last two decades. This
is evidenced particularly by the increased
number of supportive drugs available to
patients as well as the staff dedicated to
this area of treatment. Compared to when
we first started, there are now many more
nurses, ancillary personnel, and pharmacists
who specialise in the care of BMT patients.
In addition to these, there are also specialist
physicians that we can turn to if our patients
have co-morbidities or infections.
New developments in the field have also
led to more effective ways of treating the
patients. In the past matching donors were
needed before a transplant could take
place. Today, other means are available
and transplants are possible with unrelated
donors, cord blood and purged blood
(autologous). We have managed to reduce

24. 179From the Frontline
the intensity of the regimens so it is less toxic and we are able to
extend the treatment to a wider range of people. Previously the
cut-off age for a person to undergo BMT was 40. These days the
bar has been raised — 60 years of age for allogeneic transplants
and 70 for autologous.
BMTs have become safer, more effective, and more widely
available. This has been made possible because of the research
and development done in this field. Yes, some people still
think that there is no cure for cancer. It is like in those popular
Chinese serials where the word “leukaemia” means a death
knell has sounded. You can almost hear the ominous music
in the background. But this is far from the truth in reality. There
are so many more clinical trials being conducted and tonnes
of research being done in the area of blood cancers and its
treatment as well as stem cell transplantations. Look at how
Some members of the transplant team. Seated, from left to right: Dr Yvonne Loh, Dr Ang Ai Leen, Dr William
Hwang, A/Prof Goh Yeow Tee, Dr Grace Kam and Dr Linn Yeh Ching. Standing, from left to right: Dr Lee Yuh
Shan, Ng Hong Yen, Lee Jing Jing, Jordon Hwang, Zhang Xuehui and Kathleen Cheung.

25. 180 Embracing Hope
much we have accomplished over the last 20 years. Think how
much more we can achieve!
Transplants have been saving lives for a long time. About ten
years ago, we had a gathering of transplant survivors at the
Raffles Hotel. It was like a family reunion and marked a milestone
in the history of BMT. I was extremely gratified to see how many
lives had been saved and how they were now living a normal
and fruitful existence. Some have even gone on to have families
of their own. The smiles on their faces spoke a million words. The
smiles on their families’ faces spoke a million more.
Of course not all leukaemia patients who we treat are saved.
Sadly there are casualties. In the past, we use to lose a lot of
patients. That was about 20 to 30 years ago. I consider that the
Dark Ages. Now things have changed and when a patient is
lost, I try not to dwell on this too much. I do feel upset but I have
to harden my heart as I cannot let that loss stop my work. I tell
myself to focus on the future and think about how I can save the
next life. That is what keeps me going. That is what keeps a lot
of us going.