Frequently asked questions about (bone marrow) blood stem cell transplants
Every year hundreds of South Africans of all ages and races are diagnosed with diseases such as leukaemia, aplastic anaemia or some rare genetic disorders. At times their only hope of survival is a blood stem cell transplant from a donor who shares the same tissue type. Without this transplant it would mean certain death. It all depends on ordinary people like you … YOU could be the MATCH for someone with leukaemia or other life threatening blood disorders.
The chances of finding a match are about 1 in 100 000 and it could be you! You may well be the only one in the world who could save a life.
Every healthy person between 18 and 45 can be a donor. “Tissue-types” are inherited characteristics, and this is what is used to match donors and patients. As ethnic origin plays a significant role in the search for a donor, South Africa’s rainbow nation requires a large pool of prospective stem cell donors.
A bone marrow transplant is a medical procedure performed to replace bone marrow that has been damaged or destroyed by disease, infection, or chemotherapy. This procedure involves transplanting blood stem cells, which travel to the bone marrow where they produce new blood cells and promote growth of new marrow.Every year, thousands of individuals worldwide with blood diseases such as leukaemia, marrow failure or aplasia, and inherited metabolic and immune deficiency syndromes reach a stage where only a stem cell transplant can drive the disease into remission.
Family members, particularly brothers and sisters are generally most suitable. However, due to the average family size, only a small percentage of patients have a compatible sibling match. About 75 % will have to search for an unrelated matched donor.
The patient’s diseased marrow is destroyed by combinations of cytotoxic drugs and radiation. The stem cells from the healthy donor is given intravenously. Thereafter the blood-forming stem cells travel to cavities in the large bones and, following engraftment, begin producing normal blood.
This is the tissue that could be regarded as the factory for the production of red cells to carry oxygen, white cells to fight infection and platelets to prevent bleeding.
Stem cells are immature cells that can develop into any cell present in the bloodstream: red blood cells, white blood cells, platelets and other blood components. Blood stem cells are not embryonic stem cells. They come from bone marrow, circulating (peripheral) blood or umbilical cord blood. People whose diseases inhibit their ability to produce these kinds of cells need a transplant of healthy stem cells from a donor. Donors may be asked to donate either peripheral blood stem cells or bone marrow depending on the physician’s choice of therapy for the patient. After donating, most donors are back to their usual routine in a few days.
Peripheral stem cells are collected from circulating (peripheral) blood. Because only a small number of stem cells is released into the blood stream, a cell growth stimulating drug is administered to donors prior to the donation to dramatically increase the volume of stem cells in the blood for collection and transplant.
Bone marrow is the soft, jelly-like tissue found in the hollow centre of bones. It is like a factory that produces stem cells, which are the building blocks of blood. Bone marrow donors undergo a surgical procedure where the marrow containing the stem cells is collected from the pelvic bones.
In the same way as red cell blood groups exist, so white cells may be categorised into groups known as “tissue-types”. Very many possible tissue types exist, so that finding the correct match depends upon having a very large register of volunteers.
Volunteers, if deemed to be suitable, need to have a small blood sample taken, which is sent to specialised laboratories for tissue-typing. The results are placed on the national registry.
Possible matching donors will be asked to provide further blood samples to help select the donor who matches best for a particular patient.
A donor can withdraw from the registry at any time. However, if a match is found and the donor commits to the procedure, a point is reached when withdrawing will have serious, possibly fatal consequences for the patient.
We would prefer to have committed donors, as you may be the only one in the world who can provide that match. Most donors are delighted to hear that they have been chosen to donate – after all, that’s why they joined the registry.
The stem cells that are needed for a transplant may be obtained by a relatively simple procedure called peripheral blood stem cell collection or ‘harvests’. This is similar to the blood donation process but just takes a bit longer (4 to 6 hours).
Sibling transplants have been taking place for more than 30 years; a short-term side effect is flu-like symptoms during G-CSF stimulation and a small percentage of donors have also reported mild bone pain after making the donation.
The medical procedure for obtaining stem cells is called a harvest. If you are asked to donate, you would be required to attend a specialist harvest centre in South Africa at no cost to the donor.
Unfortunately, the field of stem cell transplantation is complex and a number of patients still die of complications, despite the best medical care.
Increasing numbers of successful transplants are being carried out using matched unrelated donors. However, donors can only be assured that they offer the hope of a future to patients whose disease would almost certainly otherwise prove fatal.
The Sunflower Fund recruits donors nationally. You can register telephonically via our call centre: 0800-12-10-82. We also hold donor drives or sponsored corporate drives. Interested parties can request their HR departments at their companies to arrange a drive.
It is vitally important that you keep us updated with your current contact details – so that you can be found when you are needed, because your details are kept on the registry until you are 60 years old!
Remember that all information that you supply is kept strictly confidential.