04 Jun 2026

You get told about GvHD but you don’t realise it can be this severe.

Tarun and his wife Yoshi

“Everything happened so fast. We were both just so shocked I don’t think we knew what to say to each other for the first time in our lives.”

Tarun Ramjeeawon survived his rare leukaemia but lost his fight against severe Graft Vs Host Disease (GvHD). GvHD is a common side effect after a donor stem cell transplant, where the graft cells attack the recipient’s body.

Tarun and his wife Yoshi were on honeymoon in Croatia in June 2024 when he began to show early blood cancer symptoms. Just 24 at the time, the recruitment consultant said his calves ached, which stopped him walking too far.

“We’d had a beautiful wedding at the start of June,” said Yoshi, 26 who works as a speech and language therapist and lives in Wallington in Surrey. “He’d had a few bad nose bleeds that year and then on holiday had the aching legs. The nose bleeds became more frequent in the autumn, and then on 26th October a lump suddenly appeared on his neck. He had lower back pain which we just put down to working long hours. But the lump was soon bigger and harder.

“The GP said the nose bleeds and the back pain were weak vessels in his nose and a hernia. Due to this lump, I pushed Tarun to call the GP again. They said to wait a few weeks as it may be a response to infection. I’m in the health service and to me this didn’t seem right so we called again and the GP said “it’s probably nothing to worry about but we will refer you for an ultrasound”. They didn’t offer him a blood test. But then he started sweating at night and developed sleep apnea and a purple cloud of lumps in the back of his throat.”

Yoshi’s brother and sister became concerned and they all pushed him to see his GP again before the ultrasound results.

“He didn’t want to as he’d been turned away before. So we took him to A&E with a lot of force. They did a blood test and sent us home. His GP told me they couldn’t access the results so by mid-November I had had enough and I registered him at a new medical centre. He had a new patient health check. I asked them to access the blood records and the ultrasound results. She told Tarun immediately that this lump is not normal and he would need to be referred onto a two-week pathway for people with suspected cancer.”

On 3rd December Tarun has his first appointment at Epsom General Hospital for blood tests and biopsies. By then he’d also developed lumps under his armpits, his groin and elsewhere on his neck. He had a PET scan on 11th December and was then referred for blood tests at the Royal Marsden Hospital in Sutton which showed a very low platelet count and elevated white cells.

Just six months after celebrating his wedding, on 20th December 2024, Tarun was diagnosed with leukaemia.

“The initial diagnosis was ALL but once the bone marrow results came back from the biopsy, myeloid cells were detected and we were informed this was T/myeloid mixed phenotype acute leukaemia (T/M-MPAL).”

(T/M-PAL) (also referred to as T-lymphoid/myeloid mixed phenotype acute leukemia). This extremely rare and aggressive combination of acute forms of myeloid and T-lymphoid leukaemia accounts for less than 1% of all leukaemia cases globally*

“I still remember Tarun saying “Are you sure you haven’t got this wrong?”. My heart sunk. I kind of knew this was going to be serious but I thought it was maybe lymphoma and remember looking at cure rates before I even got to this appointment.

“He really wanted to go home and open presents because it was his first Christmas after we got married. We went home assuming they would call us back the next day. However, the haematologist called the same night asking him to return, saying that they are really concerned about how unwell he was.

“Everything happened so fast. We were both just so shocked I don’t think we knew what to say to each other for the first time in our lives.”

Tarun’s treatment began on Christmas Day 2024.

“We had been to the andrology department so he could give a sperm sample. That was a whole other thing to take on board. And then his treatment started. He was given steroids at first and then chemotherapy. He had a really tough time on Mercaptopurine (6MP) which was adjusted from 120mg to 60mg. He took three types of anti-sickness to manage it and even then we had to plan when he ate to avoid nausea.”

After two months in hospital, Tarun allowed home for a few days before returning for a second round of chemotherapy. Tarun went into remission in April 2025. But he was told chemotherapy alone would not cure him and he would need a stem cell transplant.

“He was concerned because it was already so tough and we knew transplant chemo was even tougher but at this point it felt like “what is the alternative?”. I still remember sitting with the consultant and she genuinely said this is your decision. I really felt like he was going to say no. But he took a really long hard look at me and said okay and that moment I knew he was just going to fight this for me.”

On Friday 9th of May Tarun was admitted to the Royal Marsden in Sutton to begin his five-day regimen of intense chemotherapy and full body radiation ahead of the transplant. On 15th and 16th May 2025 he was given a transplant of stem cells from two unrelated cord blood donors via Anthony Nolan and NHS Blood and Transplant.

“Afterwards he had all the side effects; nausea, vomiting, his naso-gastric tube wouldn’t stay in, and he lost more than 10kg. He had neuropathy and mucositis in the mouth and needed a nebuliser to help with his breathing. Everything felt difficult.”

Tarun went through multiple infections and fevers which proved resistant to antibiotics. He also contracted norovirus. He was taken to intensive care at the Royal Marsen in Chelsea where he spent three months and was diagnosed with Graft versus Host Disease (GvHD).

“Eventually by some miracle his white cells started engrafting and that was the first positive sign, and he was given two treatments for GvHD which turned things around.”

In August Tarun was transferred back to the Royal Marsden in Sutton and at the end of the month was allowed home with a walking frame, community nursing support and regular hospital trips for tests and treatment.

Yoshi describes September 2024 as their “beautiful month together”.

“We went to my sister’s wedding, even though he was in a wheelchair. We went to the gender reveal party of the first baby in our friend circle. There were dinners and parties and he asked to do all these things.

“Then all of the sudden in October he was back in hospital with gall stones, an infected gall bladder, klebsiella (a dangerous gut bacteria) and pneumonia. They didn’t want to operate on the gall bladder because his platelets were extremely low but he was given fluid and medications.”

After three weeks Tarun was allowed home for a fortnight but was again admitted in November. The gallstones were removed but he contracted covid on the ward which left him on a ventilator. He was taken back to the Royal Marsden in Chelsea. Tarun died with Yoshi by his side on 30th December 2025.

“What a whirlwind of treatment we truly went through and an unsurmountable level of pain to get him cancer free but the level of immunocompromisation from the GvHD and the gallstone infection plus covid meant there was a point of no return anymore.

“The importance of the need for kinder treatments is so clear to me now in this journey, and also greater research into mixed phenotype acute leukemia. You get told about GvHD but you don’t realise it can be this severe. I have support and counselling, and I post online rather than keep it all to myself. But my heart is broken. He was incredibly beautiful and my perfect person.”

*Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, et al. WHO classification of tumours of haematopoietic and lymphoid tissues, revised. 4th ed. Lyon, France: World Health Organization; 2017.