Need for Indians to donate stem cells

A host of blood cancers such as leukaemia and lymphomas and fatal blood disorders such as thalassemia and aplastic anaemia can be completely cured by transplanting healthy blood-forming stem cells into the patient’s body.

Worryingly, however, stem cell donation remains a lesser known concept in India due to sheer lack of awareness. Currently, there are around 3.8 lakh registered stem cell donors in the country. This number is not sufficient to treat even 10% of the burden of blood cancers and fatal blood disorders.

About 2,000 stem cell transplants take place in India every year. For a populous country like ours, with a large burden of blood cancers and fatal blood disorders, in fact about 80,000 -100,000 transplants a year are needed. The reason for this acute shortfall is that most Indians are unaware that not only does a one-time stem cell donation process give a new lease of life to a dying patient, but also that it is safe for a large percentage of the population and causes minimal pain or discomfort. A significant percentage of the urgent need for transplants can be met if more Indians come forward to register themselves and donate stem cells.

Stem cells that are used for the procedure can be donated by anyone, including a family member, following a test called Human Leukocyte Antigen (HLA) typing aimed at matching blood types of the donors and patient. As there is only a 25% to 30% chance of finding a match within the family, the other option is to look for matches in unrelated registered donors. If the number of unrelated donors in the registry increases, patients have higher chances of finding a match. Therefore we need more number of registered unrelated donors. Because of the small database of donors in India the chances of finding a donor match are as low as 10-15% as compared to the west where the chances are as high as 60-70%. Clearly, this is a sad situation.

Donation methods

Stem cells are ‘special’ cells which have the ability to develop into blood cells. Patients with blood disorders such as leukaemia and thalassemia have abnormal stem cells and therefore compromised blood cell synthesis, because of which they need to undergo the life-saving procedure of stem cell transfusion.

Stem cells can be donated by registering in an authorised Stem Cell Registry. There are two widely practiced donation methods –one is bone marrow donation (indicated largely for non-malignant blood disorders) and the second is called Peripheral Blood Stem Cell (PBSC) donation (indicated for blood cancers).

Bone marrow is collected from the pelvic area under general anesthesia using a syringe. The patient may experience mild pain and bruising but the donor recovers within a week.

Peripheral Blood Stem Cell (PBSC) donation is used by 90% of the people to donate stem cells. It is an easy and quick non-surgical process (called apheresis) to collect the stem cells in the circulating blood.

When there is a requirement for stem cells with the respective matching HLA type, the volunteer gets a notification from the registry. Following a complete health check-up, the volunteer is given an injection called Granulocyte Colony Stimulating Factor (GCSF) to increase the number of stem cells present in the blood. This injection is administered for five days and on the fifth day, the stem cells are collected.

A major barrier to stem cell donation is the myths surrounding the subject.

It is important to note that Peripheral Blood Stem Cells (PBSC) donation is a non-surgical, out-patient procedure involving blood donation from the arm vein. No large needles are used as with marrow extraction from the spine. Only 5% or less of a donor’s stem cells are needed for the procedure which is replaced by the body within four to six weeks.

Sometimes, donors may have symptoms similar to a flu (headache, fatigue), but these generally disappear in a day or two after the process.

For millions around the world who have successfully donated stem cells, the simple joy of literally rebooting another life far outweighs the minor inconvenience involved in the procedure. Donor-patient meets organised by the registry a year after the donation present individuals with the opportunity to meet the person whose life they have saved. Let us come together to acknowledge that a small contribution such as this involving a few hours of your time can mean the difference between life and death for someone. It is time that more Indians join this selfless movement of stem cell donation and make a vow to help those in need.

(The writer is Head of Pediatric Hematology, Oncology, Bone Marrow Transplant Narayana Health City, Bengaluru)