The only alternative available for people suffering from some blood disorders is Stem Cell Transplant. In simple terms, this involves preparing the patient’s body to make new blood cells from the Stem Cells of a donor who matches the patient. Clearly, this will first require the destruction of all the bad blood cells in the patient’s body - which is achieved using Chemotherapy. Chemotherapy has a good chance of killing the cancer cells but also kills the stem cells in the bone marrow.
In the past, stem cells were harvested from the bone marrow of a matching donor. Nowadays donors are given a booster shot which increases the number of stem cells in their veins and the stem cells are extracted from the peripheral blood. The process is similar to blood donation with the difference being that all the other components of the blood are returned to the donor’s body and the stem cells are harvested.
It is a harmless procedure, with little, if any, discomfort to the donor but life-saving for the patient benefiting from the donation. But, as always, in rare situations the discomfort lasts for a few days. Given the odds of this, compared to the massive import of saving a patient's life, to me, the choice, if called upon to become a donor, should be obvious. So, I find it unfortunate that on many occasions, when we have done bone marrow donor registration drives, we have encountered young people shying away because of the above issue.
Nevertheless, it is somewhat better to declare upfront that you do not want to register, rather than registering in response to someone's harrangue, and later, when the patient is anxiously awaiting this donor's stem cells, backing out.
To avoid such occurrences, an information session is conducted by doctors to bring awareness about stem cell donations. Following this, potential donors register themselves, providing information like ethnicity, address, phone number, medical history along with a 5cc blood sample (or a swab). The sample is tested for blood diseases and HLA typing is done.
On the other side, if a patient comes along, anxiously looking for a matching donor, the registry is searched. If there is a match the matching stem cell donor is called for further tests.
The probability for a match from a donor not related to the recipient is disappointingly small. The matching also depends on the ethnicity, for example Keralites would have a higher probability to match with Keralites. A larger database would clearly improve the chances of a match. Even if there is a perfect match, a receiver’s immune system might reject the donation from a particular donor -- a larger database of registered donors increases the number of potential donors and the reduces the odds of rejection.
In the US and other western countries, there is awareness about the need for donations of all kinds, and there are 10-15 matches for an average blood cancer patient, with a database with ten's of millions of donors. Even if we add the entries in all the stem cell donor registration organizations in India, we will not find more than 200,000 entries.
Young donors are important because once they register they would be in the database, and be potential donors, for more years.
With leukaemia set to soon become as prevalent as diabetes and blood pressure, the Registries and the volunteers who passionately work for them, have their work cut out.
May their efforts succeed!
The entire procedure is nicely described!
ReplyDeletePlease add a few references -- 1) age limit, if any, to register as a donor. 2) link to donation site(s). 3) Wonder if one could do this even remote, like an ice packed sample, or register in the USA and have the details cross registered in India too.
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