How blood stem cell transplant from a healthy donor can save the life of a blood cancer patient

Blood cancer refers to defects in the blood-forming system, which cause cancer cells to enter the bloodstream and multiply uncontrollably, crowding out the healthy cells. According to experts, blood cancer which was once considered a cumbersome disease has seen a shift in treatment options leading to precise care. In many cases, a blood stem cell transplant is the only chance of a cure for patients with blood cancer, such as leukaemia, lymphoma and myeloma and blood disorders such as thalassemia and aplastic anaemia. Blood cancer accounts for 8% of all new cases of cancer diagnosed in India. Many blood cancer patients are children and young people whose only chance of recovery is a blood stem cell transplant. Only about 40% of the patients in need of a blood stem cell transplant can find a sibling match, the rest 60% depend on finding a match from an unrelated donor. This unrelated donor can be anyone.

Suresh, 19, from Bengaluru, registered himself as a potential blood stem cell donor during a drive conducted by DKMS BMST Foundation India, at his college. More than a year later, our foundation informed him that he was found to be a match for a patient. A thorough medical check-up and doctor’s clearance, which is the standard procedure before the donation process was undertaken. This gave him the confidence of going ahead and donating his blood stem cells.

How does Blood Stem Cell Transplant work?

For a successful blood stem cell transplant, blood stem cells from an unrelated donor are required. If you go on to donate your blood stem cells this will be done via the Peripheral Blood Stem Cell (PBSC) collection method. This procedure does not require anesthetic or admission to a hospital. During the collection, a sterile needle will be placed into a vein in each of your arms. Blood is drawn through one vein and passed through a machine that collects the stem cells, before the rest of the blood is returned back into the body through the other arm. It Is similar to a donation of platelets and the donation is normally completed within 4-6 hours.

From Registration to Donation: The Process Explained

  • The first step to register as a potential blood stem cell donor is by giving a simple cheek swab sample and filling a consent form with a stem cell registry. Once your swabs are received, it is sent for HLA typing.
  • The swabs are analyzed to determine the Human Leukocyte Antigens (HLA) tissue characteristics. HLA typing is used to match patients and donors for blood stem cell transplants. Once the HLA typing is done, you can be searched as a potential match for any patient in need around the world.
  • You could come up as a potential match within weeks of registering, or perhaps it might take years. There is a chance that you may never be called, but there is also the chance that, if you do get called, you are the ONLY one who can save that patient’s life.
  • When a blood cancer patient is looking for a matching donor, a search is carried out to find an unrelated donor. The national registry is searched first, but the search regularly goes global, checking all international registries to find the best possible matched donor.
  • When you come up as a match for a patient, you will go through the Confirmatory Typing (CT) processin which your tissue characteristics are analysed again using a blood sample. You will be guided through each step and a full body checkup is required to ensure your health status.
  • You will further have a medical assessment and consultation at a specialist collection center (where you will later donate your blood stem cells).

Are there any risks associated with blood stem cell donation?

A blood stem cell donation is performed via PBSC which is an out-patient procedure This procedure does not require anaesthetic or admission to the hospital.

Once you are confirmed as a match, you will undergo a thorough examination by a physician at the clinic where you will donate, to ensure that you are in good general health. This comprehensive examination ensures that the blood stem cell collection will take place with the least amount of risk for you and the patient.

Who can register?

  • A healthy adult and a citizen of India
  • 18 to 50 years of age
  • Weigh above 50 kg
  • Not already registered with a blood stem cell registry

How safe is it?

After a blood stem cell donation, the body quickly regenerates the level of blood stem cells to what they were before the donation. The process is comparable to a blood donation and does not lead to a permanent loss of blood stem cells. The donor’s immune system will not be weakened.

Patients and donors of Indian origin have unique tissue (HLA) characteristics that are severely under-represented in the global database, which makes the probability of finding a suitable donor even more difficult. Indian patients mainly require an Indian tissue match. This calls for increased awareness and need to encourage many more people in India to register as a potential blood stem cell donor and help give blood cancer patients a second chance at life.

  • The author of this article is Patrick Paul, CEO, DKMS BMST Foundation India

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